CDM Item Number,Revenue Code,Service ID,Service Mod1,Service Mod2,Service Mod3,Service Mod4,DRG Qualifier,DRG Code,Service Description,Gross Charge,Discounted Cash Price,Minimum Negotiated Charge,Maximum Negotiated Charge,Payer Negotiated Charge: Aetna (Plan: Default),Payer Negotiated Charge: AmeriGroup (Plan: Medicaid Replacement),Payer Negotiated Charge: Blue Cross Blue Shield of TX (Plan: HMO),Payer Negotiated Charge: Blue Cross Blue Shield of TX (Plan: PPO),Payer Negotiated Charge: Cigna (Plan: Default),Payer Negotiated Charge: Coventry Health Care (Plan: Default),Payer Negotiated Charge: FirstCare Scott White (Plan: Default),Payer Negotiated Charge: Humana Advantage Care Plans Med Advantage (Plan: Medicare Advantage),Payer Negotiated Charge: Medicaid Texas (Plan: Federal),Payer Negotiated Charge: Scott & White Health Plan/SCHC Total Care Inc (Plan: Medicaid Replacement),Payer Negotiated Charge: Superior Health Plan of TX MCD Rep (Plan: Medicaid Replacement),Payer Negotiated Charge: Texas True Choice (Plan: Medicaid Replacement),Payer Negotiated Charge: Tricare East Region (Plan: Federal),Payer Negotiated Charge: Tricare For Life (Plan: Federal),Payer Negotiated Charge: United Healthcare (Plan: Default)
24343,360,24343,,,,,,,RPR LCL ELBOW,7274.85,2909.94,867.38,7274.85,6183.62,SKIPPED,7274.85,7274.85,6183.62,6183.62,6183.62,3065.63,867.38,867.38,SKIPPED,SKIPPED,3128.19,3128.19,6183.62
27592,360,27592,,,,,,,AMP. LEG AT THIGH,5955.98,2382.39,0,5062.58,5062.58,SKIPPED,3349.75,3349.75,5062.58,5062.58,5062.58,2509.85,0,0,0,1786.79,2561.07,2561.07,5062.58
3010001,987,99221,,,,,,,ADMISSION LEVEL 1,375.36,150.14,0,375.36,319.06,SKIPPED,375.36,375.36,319.06,319.06,319.06,108.72,183.93,183.93,0,112.61,110.94,110.94,0
3010002,987,99222,,,,,,,ADMISSION LEVEL 2,513.39,205.36,0,513.39,436.38,SKIPPED,513.39,513.39,436.38,436.38,436.38,147.03,251.56,251.56,0,154.02,150.03,150.03,0
3010003,987,99223,,,,,,,ADMISSION LEVEL 3,632.95,253.18,0,632.95,538.01,SKIPPED,632.95,632.95,538.01,538.01,538.01,216,310.15,310.15,0,189.88,220.41,220.41,0
3010004,987,99231,,,,,,,SUBS VISIT LEVEL 1,93.65,37.46,0,93.65,79.6,SKIPPED,93.65,93.65,79.6,79.6,79.6,42.04,45.89,45.89,0,28.1,42.9,42.9,0
3010005,987,99232,,,,,,,SUBS VISIT LEVEL 2,271.37,108.55,0,271.37,230.66,SKIPPED,271.37,271.37,230.66,230.66,230.66,77.71,132.97,132.97,0,81.41,79.3,79.3,0
3010006,987,99233,,,,,,,SUBS VISIT LEVEL 3,392.39,156.96,0,392.39,333.53,SKIPPED,392.39,392.39,333.53,333.53,333.53,111.73,192.27,192.27,0,117.72,114.01,114.01,0
3010007,987,99251,,,,,,,IP CONSULT 20 MIN,331.94,132.78,0,282.15,282.15,SKIPPED,235.27,235.27,282.15,282.15,282.15,0,162.65,162.65,0,99.58,0,0,0
3010008,987,99252,,,,,,,IP CONSULT 40 MIN,425.08,170.03,0,361.32,361.32,SKIPPED,359.72,359.72,361.32,361.32,361.32,0,208.29,208.29,0,127.52,0,0,0
3010009,987,99253,,,,,,,IP CONSULT 1 HOUR,521.18,208.47,0,521.18,443,SKIPPED,521.18,521.18,443,443,443,0,255.38,255.38,0,156.35,0,0,0
3010010,987,99254,,,,,,,IP CONSULT 80 MIN,649.95,259.98,0,649.95,552.46,SKIPPED,649.95,649.95,552.46,552.46,552.46,0,318.48,318.48,0,194.98,0,0,0
3010011,987,99255,,,,,,,IP CONSULT 110 MIN,814.37,325.75,0,814.37,692.21,SKIPPED,814.37,814.37,692.21,692.21,692.21,0,399.04,399.04,0,244.31,0,0,0
3010012,987,99291,,,,,,,ICU 1 HOUR,532,212.8,0,532,452.2,SKIPPED,532,532,452.2,452.2,452.2,237.73,260.68,260.68,0,159.6,242.58,242.58,0
3010013,987,99292,,,,,,,ICU EA 30 MIN AFTER 1 HR,266.7,106.68,0,266.7,226.7,SKIPPED,266.7,266.7,226.7,226.7,226.7,119.35,130.68,130.68,0,80.01,121.79,121.79,0
3010014,987,99238,,,,,,,HOSPITAL DISCHG <30 MIN,293.21,117.28,0,293.21,249.23,SKIPPED,293.21,293.21,249.23,249.23,249.23,78.42,143.67,143.67,0,87.96,80.02,80.02,0
3010015,987,99239,,,,,,,HOSPITAL DISCHG>30 MIN,355.26,142.1,0,355.26,301.97,SKIPPED,355.26,355.26,301.97,301.97,301.97,114.83,174.08,174.08,0,106.58,117.17,117.17,0
3010016,987,99234,,,,,,,ADMIT/DISCHG OBS MINOR,317.98,127.19,0,317.98,270.28,SKIPPED,317.98,317.98,270.28,270.28,270.28,141.73,155.81,155.81,0,95.39,144.62,144.62,0
3010017,987,99235,,,,,,,ADMIT/DISCHG OBS MODERATE,404.22,161.69,0,404.22,343.59,SKIPPED,404.22,404.22,343.59,343.59,343.59,180.25,198.07,198.07,0,121.27,183.93,183.93,0
3010019,974,93016,,,,,,,PHYS SUPV ONLY W/O INTERP STRESS TEST,55.13,22.05,0,55.13,46.86,SKIPPED,55.13,55.13,46.86,46.86,46.86,23.96,27.01,27.01,0,16.54,24.45,24.45,0
3010020,987,99334,,,,,,,SUBS VISIT LEVEL 1,212.54,85.02,0,180.66,180.66,SKIPPED,161.53,161.53,180.66,180.66,180.66,66.04,104.14,104.14,0,63.76,67.39,67.39,0
3010021,987,99335,,,,,,,SUBS VISIT LEVEL 2,287.06,114.82,0,244,244,SKIPPED,218.17,218.17,244,244,244,104,140.66,140.66,0,86.12,106.12,106.12,0
3010022,987,99336,,,,,,,SUBS VISIT LEVEL 3,414.24,165.7,0,352.1,352.1,SKIPPED,314.82,314.82,352.1,352.1,352.1,147.18,202.98,202.98,0,124.27,150.18,150.18,0
3010023,982,99217,,,,,,,OBSERV DISCHARGE,231.18,92.47,0,231.18,196.5,SKIPPED,231.18,231.18,196.5,196.5,196.5,78.05,113.28,113.28,0,69.35,79.64,79.64,0
3010024,982,99218,,,,,,,OBSERV DETAILED CARE,238.56,95.42,0,238.56,202.78,SKIPPED,238.56,238.56,202.78,202.78,202.78,106.17,116.89,116.89,0,71.57,108.34,108.34,0
3010025,982,99219,,,,,,,OBSERV COMPREHENSIVE CARE,359.95,143.98,0,359.95,305.96,SKIPPED,359.95,359.95,305.96,305.96,305.96,144.32,176.38,176.38,0,107.98,147.27,147.27,0
3010026,987,99304,,,,,,,ADM/25 MIN DETAILED,217.35,86.94,0,184.75,184.75,SKIPPED,165.19,165.19,184.75,184.75,184.75,97.01,106.5,106.5,0,65.2,98.99,98.99,0
3010027,987,99305,,,,,,,ADM/35 MIN COMPREHENSIVE,310.95,124.38,0,264.31,264.31,SKIPPED,236.32,236.32,264.31,264.31,264.31,140.28,152.37,152.37,0,93.28,143.14,143.14,0
3010028,987,99306,,,,,,,ADM/45 MIN COMPLEX,398.07,159.23,0,338.36,338.36,SKIPPED,302.53,302.53,338.36,338.36,338.36,179.77,195.05,195.05,0,119.42,183.44,183.44,0
3010029,987,99307,,,,,,,SUBS/10 MIN BRIEF,119.42,47.77,0,101.51,101.51,SKIPPED,90.76,90.76,101.51,101.51,101.51,47.54,58.52,58.52,0,35.83,48.51,48.51,0
3010030,987,99308,,,,,,,SUBS/15 MIN EXPANDED,173.82,69.53,0,147.75,147.75,SKIPPED,132.1,132.1,147.75,147.75,147.75,74.85,85.17,85.17,0,52.15,76.38,76.38,0
3010031,987,99309,,,,,,,SUBS/25 MIN MODERATE,257.58,103.03,0,218.94,218.94,SKIPPED,195.76,195.76,218.94,218.94,218.94,98.86,126.21,126.21,0,77.27,100.88,100.88,0
3010032,987,99310,,,,,,,SUBS/35 MIN COMPREHENSIVE,323.85,129.54,0,275.27,275.27,SKIPPED,246.13,246.13,275.27,275.27,275.27,145.86,158.69,158.69,0,97.16,148.84,148.84,0
3010033,987,99315,,,,,,,< OR = 30 MINS,207.86,83.14,0,176.68,176.68,SKIPPED,157.97,157.97,176.68,176.68,176.68,78.79,101.85,101.85,0,62.36,80.4,80.4,0
3010034,987,99316,,,,,,,> 30 MINS,271.37,108.55,0,230.66,230.66,SKIPPED,206.24,206.24,230.66,230.66,230.66,113.1,132.97,132.97,0,81.41,115.41,115.41,0
3010035,975,50200,,,,,,,RENAL BIOPSY,448.27,179.31,0,448.27,381.03,SKIPPED,448.27,448.27,381.03,381.03,381.03,138.8,219.65,219.65,SKIPPED,SKIPPED,141.63,141.63,0
3010036,982,99324,,,,,,,NURS HOME NEW PT MINOR,119.24,47.7,0,101.35,101.35,SKIPPED,90.62,90.62,101.35,101.35,101.35,59.15,58.43,58.43,0,35.77,60.36,60.36,0
3010037,982,99325,,,,,,,NURS HOME NEW PT MODERATE,173.76,69.5,0,147.7,147.7,SKIPPED,132.06,132.06,147.7,147.7,147.7,86.28,85.14,85.14,0,52.13,88.04,88.04,0
3010039,987,36569,,,,,,,PICC LINE PLACEMENT,207.43,82.97,0,207.43,176.32,SKIPPED,207.43,207.43,176.32,176.32,176.32,101.91,101.64,101.64,SKIPPED,SKIPPED,103.99,103.99,0
3010040,987,99220,,,,,,,INTIAL OBS CARE,490.68,196.27,0,490.68,417.08,SKIPPED,490.68,490.68,417.08,417.08,417.08,195.2,240.43,240.43,0,147.2,199.18,199.18,0
3010041,982,99224,,,,,,,SBSQ OBSERVATION CARE/DAY 15 MINUTES,100.45,40.18,0,100.45,85.38,SKIPPED,100.45,100.45,85.38,85.38,85.38,42.4,49.22,49.22,0,30.14,43.27,43.27,0
3010042,982,99225,,,,,,,SBSQ OBSERVATION CARE/DAY 25 MINUTES,174.75,69.9,0,174.75,148.54,SKIPPED,174.75,174.75,148.54,148.54,148.54,77.34,85.63,85.63,0,52.42,78.92,78.92,0
3010043,982,99226,,,,,,,SBSQ OBSERVATION CARE/DAY 35 MINUTES,264.35,105.74,0,264.35,224.7,SKIPPED,264.35,264.35,224.7,224.7,224.7,110.53,129.53,129.53,0,79.3,112.79,112.79,0
3010044,760,30999,,,,,,,NG Replacement/Bridle Placement,2766.58,1106.63,0,2351.59,2351.59,SKIPPED,847.88,847.88,2351.59,2351.59,2351.59,1165.84,1355.62,1355.62,0,829.97,1189.63,1189.63,2351.59
3020001,120,,,,,,,,ROOM CHARGE,1304.05,521.62,0,4322,1108.44,SKIPPED,808.51,808.51,1108.44,0,1108.44,4235.56,0,0,0,0,4322,4322,0
3020002,120,,,,,,,,SEMI-PRIVATE ROOM,1197.66,479.06,0,4322,1018.01,SKIPPED,742.55,742.55,1018.01,0,1018.01,4235.56,0,0,0,0,4322,4322,0
3020010,120,,,,,,,,ROOM CHARGE<24 HOURS (ACUTE CARE),684.92,273.97,0,4322,582.18,SKIPPED,424.65,424.65,582.18,0,582.18,4235.56,0,0,0,0,4322,4322,0
3020011,710,,,,,,,,EXTENDED RECOVERY,70.19,28.08,0,59.66,59.66,SKIPPED,53.34,53.34,59.66,59.66,59.66,29.58,34.39,34.39,0,21.06,30.18,30.18,59.66
3162713,975,49568,,,,,,,SURGICAL ASSIST-RPR HERNIA ENT/IMP MES,129.81,51.92,0,291.19,110.34,SKIPPED,0,0,110.34,110.34,110.34,285.37,63.61,63.61,0,38.94,291.19,291.19,0
3290001,200,,,,,,,,ICU,3541.61,1416.64,0,4322,3010.37,SKIPPED,2195.8,2195.8,3010.37,0,3010.37,4235.56,0,0,0,0,4322,4322,0
3584119,450,27750,,,,,,,CLOSED TIBIAL SHAFT FX W/O MANIPULATION,630.63,252.25,265.75,630.63,536.04,SKIPPED,630.63,630.63,536.04,536.04,536.04,265.75,309.01,309.01,SKIPPED,SKIPPED,271.17,271.17,536.04
3600001,120,,,,,,,,PRIVATE ROOM-SWING BED,615.25,246.1,0,4322,522.96,SKIPPED,381.46,381.46,522.96,0,522.96,4235.56,0,0,0,0,4322,4322,0
3600002,120,,,,,,,,ROOM - SWING BED,825.24,330.1,0,4322,701.45,SKIPPED,511.65,511.65,701.45,0,701.45,4235.56,0,0,0,0,4322,4322,0
3610002,360,12042,,,,,,,CLSR LYR NK/HD/FT 2.6-7.5,1144.85,457.94,129.16,973.12,973.12,SKIPPED,769.02,769.02,973.12,973.12,973.12,482.44,129.16,129.16,SKIPPED,SKIPPED,492.29,492.29,973.12
3610005,360,12001,,,,,,,RPR SMPLE SCLP/NCK AX EXT,740,296,0,740,629,SKIPPED,740,740,629,629,629,311.84,0,0,0,222,318.2,318.2,629
3610007,360,45379,,,,,,,#COLONOSCOPY FLX W/RMVE F,4435.34,1774.14,361.12,4435.34,3770.04,SKIPPED,4435.34,4435.34,3770.04,3770.04,3770.04,1869.06,361.12,361.12,SKIPPED,SKIPPED,1907.2,1907.2,3770.04
3610008,360,56405,,,,,,,I&D VULVA/PERINEAL ABS,1318.65,527.46,56.01,1120.85,1120.85,SKIPPED,242.82,242.82,1120.85,1120.85,1120.85,555.68,56.01,56.01,SKIPPED,SKIPPED,567.02,567.02,1120.85
3610010,360,15852,,,,,,,DRESSING CHANGE W/ANES,2252.43,900.97,0,2252.43,1914.57,SKIPPED,2252.43,2252.43,1914.57,1914.57,1914.57,949.17,0,0,0,675.73,968.54,968.54,1914.57
3610011,360,36590,,,,,,,REMOVE TUNNELED CVP LINE,1317.06,526.82,254.87,1317.06,1119.5,SKIPPED,1317.06,1317.06,1119.5,1119.5,1119.5,555.01,254.87,254.87,SKIPPED,SKIPPED,566.34,566.34,1119.5
3610012,360,46922,,,,,,,DESTRUCT LES ANUS SMPLE,7446.37,2978.55,748.53,7446.37,6329.41,SKIPPED,7446.37,7446.37,6329.41,6329.41,6329.41,3137.9,748.53,748.53,SKIPPED,SKIPPED,3201.94,3201.94,6329.41
3610014,360,11450,,,,,,,EX SKIN AX F/HIDRADENITIS,8929.45,3571.78,582.36,8929.45,7590.03,SKIPPED,8929.45,8929.45,7590.03,7590.03,7590.03,3762.87,582.36,582.36,SKIPPED,SKIPPED,3839.66,3839.66,7590.03
3610017,360,43248,,,,,,,#UPPER GI ENDOSCOPY,3589.86,1435.94,269.69,3531.58,3051.38,SKIPPED,3531.58,3531.58,3051.38,3051.38,3051.38,1512.77,269.69,269.69,SKIPPED,SKIPPED,1543.64,1543.64,3051.38
3610021,360,46604,,,,,,,ANOSCOPY WITH DILATION,4964.26,1985.7,361.12,4219.62,4219.62,SKIPPED,2316.96,2316.96,4219.62,4219.62,4219.62,2091.94,361.12,361.12,SKIPPED,SKIPPED,2134.63,2134.63,4219.62
3610023,360,65420,,,,,,,EX/TRAN PTERYG W/O GRAFT,5677.81,2271.12,582.36,5677.81,4826.14,SKIPPED,5677.81,5677.81,4826.14,4826.14,4826.14,2392.63,582.36,582.36,SKIPPED,SKIPPED,2441.46,2441.46,4826.14
3610027,360,36561,,,,,,,INSERT CTRL VENOUS 5YR>,7288.12,2915.25,867.38,7288.12,6194.9,SKIPPED,7288.12,7288.12,6194.9,6194.9,6194.9,3071.21,867.38,867.38,SKIPPED,SKIPPED,3133.89,3133.89,6194.9
3610030,360,28119,,,,,,,REMOVAL HEEL SPUR,10443.52,4177.41,867.38,10443.52,8876.99,SKIPPED,10443.52,10443.52,8876.99,8876.99,8876.99,4400.9,867.38,867.38,SKIPPED,SKIPPED,4490.71,4490.71,8876.99
3610031,360,64704,,,,,,,REVISE HAND/FOOT NERVE,4317.16,1726.86,510.13,4317.16,3669.59,SKIPPED,4317.16,4317.16,3669.59,3669.59,3669.59,1819.25,510.13,510.13,SKIPPED,SKIPPED,1856.38,1856.38,3669.59
3610033,360,28485,,,,,,,TRT FX METATARSAL OPN EA,12143.82,4857.53,1051.35,12143.82,10322.25,SKIPPED,12143.82,12143.82,10322.25,10322.25,10322.25,5117.4,1051.35,1051.35,SKIPPED,SKIPPED,5221.84,5221.84,10322.25
3610034,360,27650,,,,,,,RPR RUPTURE ACHILLES TEND,7796.01,3118.4,1051.35,7796.01,6626.61,SKIPPED,7796.01,7796.01,6626.61,6626.61,6626.61,3285.23,1051.35,1051.35,SKIPPED,SKIPPED,3352.28,3352.28,6626.61
3610035,360,28296,,,,,,,BUNION CORR W/MTRSL BONE,11068.66,4427.46,867.38,11068.66,9408.36,SKIPPED,11068.66,11068.66,9408.36,9408.36,9408.36,4664.33,867.38,867.38,SKIPPED,SKIPPED,4759.52,4759.52,9408.36
3610036,360,28055,,,,,,,NEURECTOMY FOOT,7465.01,2986,510.13,7465.01,6345.26,SKIPPED,7465.01,7465.01,6345.26,6345.26,6345.26,3145.75,510.13,510.13,SKIPPED,SKIPPED,3209.95,3209.95,6345.26
3610037,360,11000,,,,,,,DEBRIDE INFECT SKIN,1914.36,765.74,0,1627.21,1627.21,SKIPPED,155.61,155.61,1627.21,1627.21,1627.21,806.71,27.43,27.43,0,574.31,823.17,823.17,1627.21
3610038,360,32554,,,,,,,THORACENTESIS,1511.52,604.61,0,1511.52,1284.79,SKIPPED,1511.52,1511.52,1284.79,1284.79,1284.79,636.95,254.87,254.87,0,453.46,649.95,649.95,1284.79
3610041,360,11750,,,,,,,REMOVAL OF NAIL BED,1329.37,531.75,79.4,1129.96,1129.96,SKIPPED,456.57,456.57,1129.96,1129.96,1129.96,560.2,79.4,79.4,SKIPPED,SKIPPED,571.63,571.63,1129.96
3610042,360,20680,,,,,,,REMOVAL SUPPORT IMPLANT,5823.67,2329.47,582.36,5823.67,4950.12,SKIPPED,5823.67,5823.67,4950.12,4950.12,4950.12,2454.1,582.36,582.36,SKIPPED,SKIPPED,2504.18,2504.18,4950.12
3610043,360,28285,,,,,,,REPAIR OF HAMMERTOE,4858.79,1943.52,867.38,4858.79,4129.97,SKIPPED,4858.79,4858.79,4129.97,4129.97,4129.97,2047.49,867.38,867.38,SKIPPED,SKIPPED,2089.28,2089.28,4129.97
3610044,360,28288,,,,,,,PART REMOVE FOOT BONE,5055.79,2022.32,867.38,5055.79,4297.42,SKIPPED,5055.79,5055.79,4297.42,4297.42,4297.42,2130.51,867.38,867.38,SKIPPED,SKIPPED,2173.99,2173.99,4297.42
3610045,360,97597,,,,,,,DEBRIDE SKIN FULL THICK,406.46,162.58,0,345.49,345.49,SKIPPED,115.9,115.9,345.49,345.49,345.49,171.28,0,0,0,121.94,174.78,174.78,345.49
3610046,360,10081,,,,,,,INC&DRAIN PILONIDAL CYST,3772.91,1509.16,166.88,3206.97,3206.97,SKIPPED,827.64,827.64,3206.97,3206.97,3206.97,1589.9,166.88,166.88,SKIPPED,SKIPPED,1622.35,1622.35,3206.97
3610048,360,29898,,,,,,,ARTHROSCOPY/SURGERY,9677.24,3870.9,867.38,9677.24,8225.65,SKIPPED,9677.24,9677.24,8225.65,8225.65,8225.65,4077.99,867.38,867.38,SKIPPED,SKIPPED,4161.21,4161.21,8225.65
3610049,360,28238,,,,,,,RECST PST TIBIAL TENDN W/,13279.41,5311.76,1051.35,13279.41,11287.5,SKIPPED,13279.41,13279.41,11287.5,11287.5,11287.5,5595.95,1051.35,1051.35,SKIPPED,SKIPPED,5710.15,5710.15,11287.5
3610050,360,28122,,,,,,,PARTIAL EXC FOOT BONE,7525.44,3010.18,867.38,7525.44,6396.62,SKIPPED,7525.44,7525.44,6396.62,6396.62,6396.62,3171.22,867.38,867.38,SKIPPED,SKIPPED,3235.94,3235.94,6396.62
3610052,360,28292,,,,,,,MAYO TYPE PROCEDURE,10080.46,4032.18,867.38,10080.46,8568.39,SKIPPED,10080.46,10080.46,8568.39,8568.39,8568.39,4247.91,867.38,867.38,SKIPPED,SKIPPED,4334.6,4334.6,8568.39
3610053,360,28286,,,,,,,REPAIR OF HAMMERTOE,7299.11,2919.64,867.38,6412.22,6204.24,SKIPPED,6412.22,6412.22,6204.24,6204.24,6204.24,3075.85,867.38,867.38,SKIPPED,SKIPPED,3138.62,3138.62,6204.24
3610054,360,27685,,,,,,,LENGTH/SHORT TENDON LEG,7733.43,3093.37,867.38,7733.43,6573.42,SKIPPED,7733.43,7733.43,6573.42,6573.42,6573.42,3258.86,867.38,867.38,SKIPPED,SKIPPED,3325.37,3325.37,6573.42
3610055,360,28080,,,,,,,"EXC,INTERDIG(MORTON)NEURO",7195.11,2878.04,510.13,6412.22,6115.84,SKIPPED,6412.22,6412.22,6115.84,6115.84,6115.84,3032.02,510.13,510.13,SKIPPED,SKIPPED,3093.9,3093.9,6115.84
3610057,360,28060,,,,,,,"PARTIAL RMV, FOOT FASCIA",7446.37,2978.55,867.38,7446.37,6329.41,SKIPPED,7446.37,7446.37,6329.41,6329.41,6329.41,3137.9,867.38,867.38,SKIPPED,SKIPPED,3201.94,3201.94,6329.41
3610060,361,12053,,,,,,,INTMD RPR WND 5.1CM-7.5CM,1323.21,529.28,129.16,1124.73,1124.73,SKIPPED,769.02,769.02,1124.73,1124.73,1124.73,557.6,129.16,129.16,SKIPPED,SKIPPED,568.98,568.98,1124.73
3610061,975,17110,,,,,,,DESTRUCT B9 LESION 1-14,492.52,197.01,0,492.52,418.64,SKIPPED,492.52,492.52,418.64,418.64,418.64,72.71,241.33,241.33,0,147.76,74.19,74.19,0
3610062,360,27327,,,,,,,REMOVAL OF THIGH LESION,7012.06,2804.82,414.14,6403.14,5960.25,SKIPPED,6403.14,6403.14,5960.25,5960.25,5960.25,2954.89,414.14,414.14,SKIPPED,SKIPPED,3015.19,3015.19,5960.25
3610066,360,29891,,,,,,,ANKLE ARTHROSCOPY/SURGY,11115.3,4446.12,867.38,11115.3,9448,SKIPPED,11115.3,11115.3,9448,9448,9448,4683.99,867.38,867.38,SKIPPED,SKIPPED,4779.58,4779.58,9448
3610067,360,38740,,,,,,,RMVE ARMPIT LYMPH NODES,12651.03,5060.41,1051.35,12651.03,10753.38,SKIPPED,12651.03,12651.03,10753.38,10753.38,10753.38,5331.14,1051.35,1051.35,SKIPPED,SKIPPED,5439.94,5439.94,10753.38
3610068,360,28820,,,,,,,AMPUTATION OF TOE,7281.95,2912.78,867.38,6412.22,6189.66,SKIPPED,6412.22,6412.22,6189.66,6189.66,6189.66,3068.62,867.38,867.38,SKIPPED,SKIPPED,3131.24,3131.24,6189.66
3610069,360,38525,,,,,,,BIO/RMVE LYMPH NODES,6825.89,2730.36,807.26,6825.89,5802.01,SKIPPED,6825.89,6825.89,5802.01,5802.01,5802.01,2876.43,807.26,807.26,SKIPPED,SKIPPED,2935.13,2935.13,5802.01
3610070,360,28505,,,,,,,BIG TOE FRACTURE,8405.07,3362.03,867.38,8405.07,7144.31,SKIPPED,8405.07,8405.07,7144.31,7144.31,7144.31,3541.9,867.38,867.38,SKIPPED,SKIPPED,3614.18,3614.18,7144.31
3610072,360,28124,,,,,,,PARTIAL REMOVAL OF TOE,5907.41,2362.96,241.37,5021.3,5021.3,SKIPPED,1439.82,1439.82,5021.3,5021.3,5021.3,2489.39,241.37,241.37,SKIPPED,SKIPPED,2540.19,2540.19,5021.3
3610078,360,36571,,,,,,,INSERT PICVAD CATH,8558.88,3423.55,867.38,8558.88,7275.05,SKIPPED,8558.88,8558.88,7275.05,7275.05,7275.05,3606.71,867.38,867.38,SKIPPED,SKIPPED,3680.32,3680.32,7275.05
3610079,360,46610,,,,,,,"ANOSCOPY, REMOVE LESION",7019.69,2807.88,748.53,7019.69,5966.74,SKIPPED,7019.69,7019.69,5966.74,5966.74,5966.74,2958.1,748.53,748.53,SKIPPED,SKIPPED,3018.47,3018.47,5966.74
3610081,360,11772,,,,,,,REMOVAL OF PILONIDAL CYST,9655.53,3862.21,582.36,9655.53,8207.2,SKIPPED,9655.53,9655.53,8207.2,8207.2,8207.2,4068.84,582.36,582.36,SKIPPED,SKIPPED,4151.88,4151.88,8207.2
3610083,360,19300,,,,,,,REMOVAL OF BREAST TISSUE,10199.87,4079.95,807.26,10199.87,8669.89,SKIPPED,10199.87,10199.87,8669.89,8669.89,8669.89,4298.22,807.26,807.26,SKIPPED,SKIPPED,4385.94,4385.94,8669.89
3610084,360,49654,,,,,,,LAP INC HERNIA REPAIR,16346.36,6538.54,1051.35,16346.36,13894.41,SKIPPED,16346.36,16346.36,13894.41,13894.41,13894.41,6888.35,1051.35,1051.35,SKIPPED,SKIPPED,7028.93,7028.93,13894.41
3610085,360,28035,,,,,,,DECOMPRESS OF TIBIA NERVE,7455.62,2982.25,510.13,7455.62,6337.28,SKIPPED,7455.62,7455.62,6337.28,6337.28,6337.28,3141.8,510.13,510.13,SKIPPED,SKIPPED,3205.92,3205.92,6337.28
3610086,360,22903,,,,,,,EXC ABD LES SC > 3CM,7679.15,3071.66,582.36,7679.15,6527.28,SKIPPED,7679.15,7679.15,6527.28,6527.28,6527.28,3235.99,582.36,582.36,SKIPPED,SKIPPED,3302.03,3302.03,6527.28
3610088,360,21931,,,,,,,EXC BACK LES SC=3 CM,8298.14,3319.26,414.14,7053.42,7053.42,SKIPPED,6403.14,6403.14,7053.42,7053.42,7053.42,3496.84,414.14,414.14,SKIPPED,SKIPPED,3568.2,3568.2,7053.42
3610089,360,28299,,,,,,,CORR BUNION W/WO SESAMOID,10770.88,4308.35,1051.35,10770.88,9155.25,SKIPPED,10770.88,10770.88,9155.25,9155.25,9155.25,4538.85,1051.35,1051.35,SKIPPED,SKIPPED,4631.48,4631.48,9155.25
3610090,360,28297,,,,,,,CORR BUNION LAPIDUS-TYPE,12578.28,5031.31,1051.35,12578.28,10691.54,SKIPPED,12578.28,12578.28,10691.54,10691.54,10691.54,5300.49,1051.35,1051.35,SKIPPED,SKIPPED,5408.66,5408.66,10691.54
3610093,360,28289,,,,,,,RPR HALLUX RIGIDUS,10167.71,4067.08,867.38,10167.71,8642.55,SKIPPED,10167.71,10167.71,8642.55,8642.55,8642.55,4284.68,867.38,867.38,SKIPPED,SKIPPED,4372.12,4372.12,8642.55
3610094,360,28298,,,,,,,CORRECTION OF BUNION,8734.08,3493.63,1051.35,8734.08,7423.97,SKIPPED,8734.08,8734.08,7423.97,7423.97,7423.97,3680.54,1051.35,1051.35,SKIPPED,SKIPPED,3755.65,3755.65,7423.97
3610096,360,49652,,,,,,,LAP VENT/ABD HERNIA RPR,17765.8,7106.32,1051.35,17765.8,15100.93,SKIPPED,17765.8,17765.8,15100.93,15100.93,15100.93,7486.5,1051.35,1051.35,SKIPPED,SKIPPED,7639.29,7639.29,15100.93
3610097,360,20240,,,,,,,"BONE BIOPSY, EXCISIONAL",7643.37,3057.35,582.36,7643.37,6496.86,SKIPPED,7643.37,7643.37,6496.86,6496.86,6496.86,3220.92,582.36,582.36,SKIPPED,SKIPPED,3286.65,3286.65,6496.86
3610100,360,28300,,,,,,,INCISION OF HEEL BONE,12798.46,5119.38,1051.35,12798.46,10878.69,SKIPPED,12798.46,12798.46,10878.69,10878.69,10878.69,5393.27,1051.35,1051.35,SKIPPED,SKIPPED,5503.34,5503.34,10878.69
3610102,271,,,,,,,,EBICE W/BACK PAD,436.59,174.64,0,371.1,371.1,SKIPPED,331.81,331.81,371.1,371.1,371.1,183.98,213.93,213.93,0,130.98,187.73,187.73,371.1
3610114,360,20670,,,,,,,REMVE OF SUPPORT IMPLANT (SUPERFICIAL),5041.86,2016.74,414.14,5041.86,4285.58,SKIPPED,5041.86,5041.86,4285.58,4285.58,4285.58,2124.64,414.14,414.14,SKIPPED,SKIPPED,2168,2168,4285.58
3610115,360,21552,,,,,,,EXC NECK LES SC=3 CM,5972.54,2389.02,582.36,5972.54,5076.66,SKIPPED,5972.54,5972.54,5076.66,5076.66,5076.66,2516.83,582.36,582.36,SKIPPED,SKIPPED,2568.19,2568.19,5076.66
3610116,360,20694,,,,,,,RMVE BONE FIXATION DEVICE,5204.66,2081.86,510.13,5204.66,4423.96,SKIPPED,5204.66,5204.66,4423.96,4423.96,4423.96,2193.24,510.13,510.13,SKIPPED,SKIPPED,2238,2238,4423.96
3610118,360,26535,,,,,,,REVISE FINGER JOINT,10646.8,4258.72,867.38,10646.8,9049.78,SKIPPED,10646.8,10646.8,9049.78,9049.78,9049.78,4486.56,867.38,867.38,SKIPPED,SKIPPED,4578.12,4578.12,9049.78
3610119,360,29897,,,,,,,ANKLE/ARTHROSCOPY/SURG,8979.18,3591.67,867.38,8979.18,7632.3,SKIPPED,8979.18,8979.18,7632.3,7632.3,7632.3,3783.83,867.38,867.38,SKIPPED,SKIPPED,3861.05,3861.05,7632.3
3610120,360,10080,,,,,,,DRAIN OF PILONIDA LCYST,847.1,338.84,0,720.04,720.04,SKIPPED,636.12,636.12,720.04,720.04,720.04,356.96,132.23,132.23,0,254.13,364.25,364.25,720.04
3610121,360,28234,,,,,,,INCISION OF FOOT TENDON,5701.17,2280.47,510.13,5701.17,4845.99,SKIPPED,5701.17,5701.17,4845.99,4845.99,4845.99,2402.47,510.13,510.13,SKIPPED,SKIPPED,2451.5,2451.5,4845.99
3610122,360,28008,,,,,,,INCISION OF FOOT FASCIA,7378.17,2951.27,867.38,7378.17,6271.44,SKIPPED,7378.17,7378.17,6271.44,6271.44,6271.44,3109.16,867.38,867.38,SKIPPED,SKIPPED,3172.61,3172.61,6271.44
3610123,360,47600,,,,,,,CHOLECYCSTECTOMY,19995.02,7998.01,0,16995.77,16995.77,SKIPPED,5265.85,5265.85,16995.77,16995.77,16995.77,8425.9,0,0,0,5998.51,8597.86,8597.86,16995.77
3610126,360,27691,,,,,,,REVISE LOWER LEG TENDON,9792.09,3916.84,1051.35,9792.09,8323.28,SKIPPED,9792.09,9792.09,8323.28,8323.28,8323.28,4126.39,1051.35,1051.35,SKIPPED,SKIPPED,4210.6,4210.6,8323.28
3610130,360,28039,,,,,,,EXC FOOT/TOE TUM SC> 1.5C,7660.4,3064.16,582.36,7660.4,6511.34,SKIPPED,7660.4,7660.4,6511.34,6511.34,6511.34,3228.09,582.36,582.36,SKIPPED,SKIPPED,3293.97,3293.97,6511.34
3610132,360,27695,,,,,,,RPR ANKLE LIGAMENT(COLLATERAL),8178.61,3271.44,1051.35,8178.61,6951.82,SKIPPED,8178.61,8178.61,6951.82,6951.82,6951.82,3446.46,1051.35,1051.35,SKIPPED,SKIPPED,3516.8,3516.8,6951.82
3610133,360,28309,,,,,,,INCISION OF METARSALS,10181.38,4072.55,1051.35,10181.38,8654.17,SKIPPED,10181.38,10181.38,8654.17,8654.17,8654.17,4290.43,1051.35,1051.35,SKIPPED,SKIPPED,4377.99,4377.99,8654.17
3610135,360,27337,,,,,,,EX THIGH/KNEE LES SC 3+CM,8648.59,3459.44,582.36,8648.59,7351.3,SKIPPED,8648.59,8648.59,7351.3,7351.3,7351.3,3644.51,582.36,582.36,SKIPPED,SKIPPED,3718.89,3718.89,7351.3
3610136,360,28465,,,,,,,TREAT MEDFOOT FX EA,8375.54,3350.22,1051.35,8375.54,7119.21,SKIPPED,8375.54,8375.54,7119.21,7119.21,7119.21,3529.45,1051.35,1051.35,SKIPPED,SKIPPED,3601.48,3601.48,7119.21
3610137,360,28041,,,,,,,EXC FOOT/TOE TUM DP1.5CM+,8994.59,3597.84,582.36,8994.59,7645.4,SKIPPED,8994.59,8994.59,7645.4,7645.4,7645.4,3790.32,582.36,582.36,SKIPPED,SKIPPED,3867.67,3867.67,7645.4
3610139,360,57105,,,,,,,BIOPSY OF VAGINA,6622.62,2649.05,867.38,6622.62,5629.23,SKIPPED,6622.62,6622.62,5629.23,5629.23,5629.23,2790.78,867.38,867.38,SKIPPED,SKIPPED,2847.73,2847.73,5629.23
3610140,360,28290,,,,,,,CORRECTION OF BUNION,9050.46,3620.18,0,7692.89,7692.89,SKIPPED,6878.35,6878.35,7692.89,7692.89,7692.89,3813.87,0,0,0,2715.14,3891.7,3891.7,7692.89
3610141,360,28322,,,,,,,REPAIR OF METATARSALS,16281.08,6512.43,1051.35,16281.08,13838.92,SKIPPED,16281.08,16281.08,13838.92,13838.92,13838.92,6860.84,1051.35,1051.35,SKIPPED,SKIPPED,7000.86,7000.86,13838.92
3610142,360,28805,,,,,,,AMP FOOT; TRANSMETATARSAL,12156.28,4862.51,0,12156.28,10332.84,SKIPPED,12156.28,12156.28,10332.84,10332.84,10332.84,5122.66,0,0,0,3646.88,5227.2,5227.2,10332.84
3610143,360,28825,,,,,,,AMP TOE; INTERPHAL JNT,7444.76,2977.9,867.38,6412.22,6328.05,SKIPPED,6412.22,6412.22,6328.05,6328.05,6328.05,3137.22,867.38,867.38,SKIPPED,SKIPPED,3201.25,3201.25,6328.05
3610144,360,28108,,,,,,,REMOVAL OF TOE LESIONS,6565.26,2626.1,510.13,6412.22,5580.47,SKIPPED,6412.22,6412.22,5580.47,5580.47,5580.47,2766.6,510.13,510.13,SKIPPED,SKIPPED,2823.06,2823.06,5580.47
3610145,360,11042,,,,,,,DEB SUBQ TISSUE 20 SQCM/<,3194.12,1277.65,129.16,2715,2715,SKIPPED,1476.3,1476.3,2715,2715,2715,1346,129.16,129.16,SKIPPED,SKIPPED,1373.47,1373.47,2715
3610146,360,28104,,,,,,,REMOVAL OF FOOT LESION,7471.17,2988.47,867.38,7471.17,6350.49,SKIPPED,7471.17,7471.17,6350.49,6350.49,6350.49,3148.35,867.38,867.38,SKIPPED,SKIPPED,3212.6,3212.6,6350.49
3610147,360,28090,,,,,,,REMOVAL OF FOOT LESION,8420.62,3368.25,510.13,7157.53,7157.53,SKIPPED,6412.22,6412.22,7157.53,7157.53,7157.53,3548.45,510.13,510.13,SKIPPED,SKIPPED,3620.87,3620.87,7157.53
3610151,360,11770,,,,,,,EX OF PILONIDAL CYST SIMP,5432.83,2173.13,582.36,5432.83,4617.91,SKIPPED,5432.83,5432.83,4617.91,4617.91,4617.91,2289.4,582.36,582.36,SKIPPED,SKIPPED,2336.12,2336.12,4617.91
3610152,360,46020,,,,,,,PLACEMENT OF SETON,7257.33,2902.93,748.53,7257.33,6168.73,SKIPPED,7257.33,7257.33,6168.73,6168.73,6168.73,3058.24,748.53,748.53,SKIPPED,SKIPPED,3120.65,3120.65,6168.73
3610153,360,28202,,,,,,,REPAIR/GRAFT OF FOOT,12032.19,4812.88,1051.35,12032.19,10227.36,SKIPPED,12032.19,12032.19,10227.36,10227.36,10227.36,5070.36,1051.35,1051.35,SKIPPED,SKIPPED,5173.84,5173.84,10227.36
3610154,360,28120,,,,,,,PART REMOVAL OF ANKLE,8036.02,3214.41,867.38,8036.02,6830.62,SKIPPED,8036.02,8036.02,6830.62,6830.62,6830.62,3386.38,867.38,867.38,SKIPPED,SKIPPED,3455.49,3455.49,6830.62
3610157,360,11043,,,,,,,DEB MUSC/FASCIA 20 SQ CM<,3865.9,1546.36,200.91,3286.02,3286.02,SKIPPED,2318.95,2318.95,3286.02,3286.02,3286.02,1629.09,200.91,200.91,SKIPPED,SKIPPED,1662.34,1662.34,3286.02
3610158,360,46275,,,,,,,REMOVE ANAL FIST INTER,8037.49,3215,748.53,8037.49,6831.87,SKIPPED,8037.49,8037.49,6831.87,6831.87,6831.87,3387,748.53,748.53,SKIPPED,SKIPPED,3456.12,3456.12,6831.87
3610159,360,46320,,,,,,,RMVE HEMMORIOD CLOT,7213.61,2885.44,107.69,6131.57,6131.57,SKIPPED,577.98,577.98,6131.57,6131.57,6131.57,3039.81,107.69,107.69,SKIPPED,SKIPPED,3101.85,3101.85,6131.57
3610160,360,19301,,,,,,,"MASTECTOMY, PARTIAL",9269.17,3707.67,807.26,9269.17,7878.79,SKIPPED,9269.17,9269.17,7878.79,7878.79,7878.79,3906.03,807.26,807.26,SKIPPED,SKIPPED,3985.74,3985.74,7878.79
3610161,360,19302,,,,,,,"MASTECTOMY, PARTIAL",15437.37,6174.95,1051.35,15437.37,13121.76,SKIPPED,15437.37,15437.37,13121.76,13121.76,13121.76,6505.31,1051.35,1051.35,SKIPPED,SKIPPED,6638.07,6638.07,13121.76
3610163,360,19307,,,,,,,"MASTECTOMY, MOD RADICAL",16391.37,6556.55,0,16391.37,13932.66,SKIPPED,16391.37,16391.37,13932.66,13932.66,13932.66,6907.32,0,0,0,4917.41,7048.29,7048.29,13932.66
3610171,360,27676,,,,,,,REPAIR LOWER LEG TENDONS,10454.35,4181.74,1051.35,10454.35,8886.2,SKIPPED,10454.35,10454.35,8886.2,8886.2,8886.2,4405.46,1051.35,1051.35,SKIPPED,SKIPPED,4495.37,4495.37,8886.2
3610173,360,28675,,,,,,,REPAIR OF TOE DISLOCATION,9999.8,3999.92,867.38,9999.8,8499.83,SKIPPED,9999.8,9999.8,8499.83,8499.83,8499.83,4213.91,867.38,867.38,SKIPPED,SKIPPED,4299.91,4299.91,8499.83
3610174,360,28730,,,,,,,FUSION OF FOOT BONES,14509.62,5803.85,1051.35,14509.62,12333.18,SKIPPED,14509.62,14509.62,12333.18,12333.18,12333.18,6114.36,1051.35,1051.35,SKIPPED,SKIPPED,6239.14,6239.14,12333.18
3610175,360,22612,,,,,,,LUMBAR SPINE FUSION,18924.86,7569.94,1051.35,18924.86,16086.13,SKIPPED,18924.86,18924.86,16086.13,16086.13,16086.13,7974.94,1051.35,1051.35,SKIPPED,SKIPPED,8137.69,8137.69,16086.13
3610176,399,86891,,,,,,,AUTO BLOOD OP SALVAGE,2085.07,834.03,0,2055.65,1772.31,SKIPPED,2055.65,2055.65,1772.31,1772.31,1772.31,878.65,1021.68,1021.68,0,625.52,896.58,896.58,1772.31
3610177,391,36430,,,,,,,BLOOD TRANSFUSION SVC,1822.8,729.12,0,1549.38,1549.38,SKIPPED,167.58,167.58,1549.38,1549.38,1549.38,768.12,893.17,893.17,0,546.84,783.8,783.8,1549.38
3610178,272,,,,,,,,BMN NEEDLE,577.5,231,0,490.88,490.88,SKIPPED,438.9,438.9,490.88,490.88,490.88,243.36,282.98,282.98,0,173.25,248.33,248.33,490.88
3610179,360,38510,,,,,,,BIOPSY/REM LYMPH NODES,9694.25,3877.7,807.26,9694.25,8240.11,SKIPPED,9694.25,9694.25,8240.11,8240.11,8240.11,4085.16,807.26,807.26,SKIPPED,SKIPPED,4168.53,4168.53,8240.11
3610180,278,,,,,,,,CANCELLOUS SHEET,3071,1228.4,0,2610.35,2610.35,SKIPPED,2333.96,2333.96,2610.35,2610.35,2610.35,1294.12,1504.79,1504.79,0,921.3,1320.53,1320.53,2610.35
3610181,278,,,,,,,,INDUX,4688,1875.2,0,3984.8,3984.8,SKIPPED,3562.88,3562.88,3984.8,3984.8,3984.8,1975.52,2297.12,2297.12,0,1406.4,2015.84,2015.84,3984.8
3610182,278,,,,,,,,CAN CUBES 15CC 4-10MM,661,264.4,0,561.85,561.85,SKIPPED,502.36,502.36,561.85,561.85,561.85,278.55,323.89,323.89,0,198.3,284.23,284.23,561.85
3610183,278,,,,,,,,SpF PLUS MINI MESH CATH60,19429,7771.6,0,16514.65,16514.65,SKIPPED,14766.04,14766.04,16514.65,16514.65,16514.65,8187.38,9520.21,9520.21,0,5828.7,8354.47,8354.47,16514.65
3610184,278,,,,,,,,STR SPACE 7H-18H 25L CVX,15628,6251.2,0,13283.8,13283.8,SKIPPED,11877.28,11877.28,13283.8,13283.8,13283.8,6585.64,7657.72,7657.72,0,4688.4,6720.04,6720.04,13283.8
3610185,278,,,,,,,,STR SPACE 7H-18H 20L CVX,10750,4300,0,9137.5,9137.5,SKIPPED,8170,8170,9137.5,9137.5,9137.5,4530.05,5267.5,5267.5,0,3225,4622.5,4622.5,9137.5
3610187,278,,,,,,,,6.5MM 20-55MM SCREW REDUC,4823,1929.2,0,4099.55,4099.55,SKIPPED,3665.48,3665.48,4099.55,4099.55,4099.55,2032.41,2363.27,2363.27,0,1446.9,2073.89,2073.89,4099.55
3610188,278,,,,,,,,PLUGS,1028,411.2,0,873.8,873.8,SKIPPED,781.28,781.28,873.8,873.8,873.8,433.2,503.72,503.72,0,308.4,442.04,442.04,873.8
3610189,278,,,,,,,,30MM-90MM PRE-CURV ROD,1505,602,0,1279.25,1279.25,SKIPPED,1143.8,1143.8,1279.25,1279.25,1279.25,634.21,737.45,737.45,0,451.5,647.15,647.15,1279.25
3610190,278,,,,,,,,CROSS CONNECT XXSM-LARGE,4243,1697.2,0,3606.55,3606.55,SKIPPED,3224.68,3224.68,3606.55,3606.55,3606.55,1788,2079.07,2079.07,0,1272.9,1824.49,1824.49,3606.55
3610191,278,,,,,,,,6.5MM MULTI-AX SCREW,4445,1778,0,3778.25,3778.25,SKIPPED,3378.2,3378.2,3778.25,3778.25,3778.25,1873.12,2178.05,2178.05,0,1333.5,1911.35,1911.35,3778.25
3610192,272,,,,,,,,TISSEEL FIBRIN SEAL FROZE,654.15,261.66,0,556.03,556.03,SKIPPED,497.15,497.15,556.03,556.03,556.03,275.65,320.53,320.53,0,196.24,281.28,281.28,556.03
3610193,360,27705,,,,,,,INCISION OF TIBIA,9449.15,3779.66,1051.35,9449.15,8031.78,SKIPPED,9449.15,9449.15,8031.78,8031.78,8031.78,3981.87,1051.35,1051.35,SKIPPED,SKIPPED,4063.13,4063.13,8031.78
3610194,360,27745,,,,,,,REINFORCE TIBIA,20057.08,8022.83,1051.35,20057.08,17048.52,SKIPPED,20057.08,20057.08,17048.52,17048.52,17048.52,8452.05,1051.35,1051.35,SKIPPED,SKIPPED,8624.54,8624.54,17048.52
3610479,278,,,,,,,,INTERGRO 10CC (PUTTY),3972,1588.8,0,3376.2,3376.2,SKIPPED,3018.72,3018.72,3376.2,3376.2,3376.2,1673.8,1946.28,1946.28,0,1191.6,1707.96,1707.96,3376.2
3610480,360,49655,,,,,,,LAP INC HERN REP COMP,17011.84,6804.74,1051.35,17011.84,14460.06,SKIPPED,17011.84,17011.84,14460.06,14460.06,14460.06,7168.79,1051.35,1051.35,SKIPPED,SKIPPED,7315.09,7315.09,14460.06
3611001,360,,,,,,,,OPER RM 30 MIN,1566.83,626.73,0,1331.81,1331.81,SKIPPED,1190.79,1190.79,1331.81,1331.81,1331.81,660.27,0,0,0,470.05,673.74,673.74,1331.81
3611007,361,46600,,,,,,,#ANOSCOPY DIAG W/WO,3425.28,1370.11,0,2911.49,2911.49,SKIPPED,498.94,498.94,2911.49,2911.49,2911.49,1443.41,0,0,0,1027.58,1472.87,1472.87,2911.49
3611010,360,21555,,,,,,,EX TUMOR SOFT NCK/TH,5212.42,2084.97,414.14,5212.42,4430.56,SKIPPED,5212.42,5212.42,4430.56,4430.56,4430.56,2196.51,414.14,414.14,SKIPPED,SKIPPED,2241.34,2241.34,4430.56
3611012,360,,,,,,,,OPER RM 60 MIN,1894.24,757.7,0,1610.1,1610.1,SKIPPED,1439.62,1439.62,1610.1,1610.1,1610.1,798.23,0,0,0,568.27,814.52,814.52,1610.1
3611014,360,11771,,,,,,,EX CYST PILONIDAL/SI,9059.73,3623.89,582.36,9059.73,7700.77,SKIPPED,9059.73,9059.73,7700.77,7700.77,7700.77,3817.77,582.36,582.36,SKIPPED,SKIPPED,3895.68,3895.68,7700.77
3611017,360,44394,,,,,,,#COLONSCOPY W/RMVE T,4345.26,1738.1,361.12,4345.26,3693.47,SKIPPED,4345.26,4345.26,3693.47,3693.47,3693.47,1831.09,361.12,361.12,SKIPPED,SKIPPED,1868.46,1868.46,3693.47
3611021,360,10121,,,,,,,I&RMVE FB SUBQ COMPL,5684.14,2273.66,414.14,5684.14,4831.52,SKIPPED,5684.14,5684.14,4831.52,4831.52,4831.52,2395.3,414.14,414.14,SKIPPED,SKIPPED,2444.18,2444.18,4831.52
3611023,360,,,,,,,,OPER RM 90 MIN,2271.2,908.48,0,1930.52,1930.52,SKIPPED,1726.11,1726.11,1930.52,1930.52,1930.52,957.09,0,0,0,681.36,976.62,976.62,1930.52
3611024,360,12031,,,,,,,"LAYER CLS SCLP,AXI,T",1396.26,558.5,129.16,1186.82,1186.82,SKIPPED,766.08,766.08,1186.82,1186.82,1186.82,588.38,129.16,129.16,SKIPPED,SKIPPED,600.39,600.39,1186.82
3611025,360,12002,,,,,,,RPR SM SP NK AX TK 2,702.07,280.83,0,702.07,596.76,SKIPPED,702.07,702.07,596.76,596.76,596.76,295.85,0,0,0,210.62,301.89,301.89,596.76
3611027,360,15100,,,,,,,GRFT SPT TK SP ARM L,8537.08,3414.83,582.36,7450.04,7256.52,SKIPPED,7450.04,7450.04,7256.52,7256.52,7256.52,3597.52,582.36,582.36,SKIPPED,SKIPPED,3670.94,3670.94,7256.52
3611028,360,12052,,,,,,,RPR FC EAR EL NS 2.6,1134,453.6,129.16,963.9,963.9,SKIPPED,769.02,769.02,963.9,963.9,963.9,477.87,129.16,129.16,SKIPPED,SKIPPED,487.62,487.62,963.9
3611030,360,24075,,,,,,,EX TUMOR UP ARM/ELBW,5209.52,2083.81,414.14,5209.52,4428.09,SKIPPED,5209.52,5209.52,4428.09,4428.09,4428.09,2195.29,414.14,414.14,SKIPPED,SKIPPED,2240.09,2240.09,4428.09
3611032,360,36556,,,,,,,INSERT CV 5YR OR OLDER,3726.26,1490.5,414.14,3726.26,3167.32,SKIPPED,3726.26,3726.26,3167.32,3167.32,3167.32,1570.24,414.14,414.14,SKIPPED,SKIPPED,1602.29,1602.29,3167.32
3611034,360,,,,,,,,OPER RM 120 MIN,2654.35,1061.74,0,2256.2,2256.2,SKIPPED,2017.31,2017.31,2256.2,2256.2,2256.2,1118.54,0,0,0,796.3,1141.37,1141.37,2256.2
3611035,360,,,,,,,,CANCELED CASE FEE,543.01,217.2,0,461.56,461.56,SKIPPED,412.69,412.69,461.56,461.56,461.56,228.82,0,0,0,162.9,233.49,233.49,461.56
3611036,361,13121,,,,,,,RPR CMPLX SCLP ARM LEG,1787.14,714.86,200.91,1787.14,1519.07,SKIPPED,1787.14,1787.14,1519.07,1519.07,1519.07,753.1,200.91,200.91,SKIPPED,SKIPPED,768.47,768.47,1519.07
3611038,975,28039,,,,,,,EXC FOOT/TOE SC >1.5C PROF,1067.25,426.9,0,1067.25,907.16,SKIPPED,1067.25,1067.25,907.16,907.16,907.16,379.63,522.95,522.95,SKIPPED,SKIPPED,387.38,387.38,0
3611041,360,23073,,,,,,,EXC SHOULDER TUM DEEP 5CM/>,9058.23,3623.29,582.36,9058.23,7699.5,SKIPPED,9058.23,9058.23,7699.5,7699.5,7699.5,3817.14,582.36,582.36,SKIPPED,SKIPPED,3895.04,3895.04,7699.5
3611042,975,23073,,,,,,,EXC SHOULDER TUM DEEP 5CM/> PROF,2075.68,830.27,0,2075.68,1764.33,SKIPPED,2075.68,2075.68,1764.33,1764.33,1764.33,757.93,1017.08,1017.08,SKIPPED,SKIPPED,773.4,773.4,0
3611045,360,,,,,,,,OR EA ADDL 30 MIN,412.76,165.1,0,350.85,350.85,SKIPPED,313.7,313.7,350.85,350.85,350.85,173.94,0,0,0,123.83,177.49,177.49,350.85
3611065,360,,,,,,,,MINOR OR PROCEDURE,775.78,310.31,0,659.41,659.41,SKIPPED,589.59,589.59,659.41,659.41,659.41,326.92,0,0,0,232.73,333.59,333.59,659.41
3611090,360,,,,,,,,OR BASE LEVEL III,2913.37,1165.35,0,2476.36,2476.36,SKIPPED,2214.16,2214.16,2476.36,2476.36,2476.36,1227.7,0,0,0,874.01,1252.75,1252.75,2476.36
3611200,276,,,,,,,,IOL,179.55,71.82,0,152.62,152.62,SKIPPED,136.46,136.46,152.62,152.62,152.62,75.67,87.98,87.98,0,53.86,77.21,77.21,152.62
3611201,360,66830,,,,,,,REMOVAL LENS LESION,4588.9,1835.56,748.53,4588.9,3900.56,SKIPPED,4588.9,4588.9,3900.56,3900.56,3900.56,1933.77,748.53,748.53,SKIPPED,SKIPPED,1973.23,1973.23,3900.56
3611202,360,28307,,,,,,,INCISION MEATARSAL,4985.96,1994.38,1051.35,4985.96,4238.07,SKIPPED,4985.96,4985.96,4238.07,4238.07,4238.07,2101.08,1051.35,1051.35,SKIPPED,SKIPPED,2143.96,2143.96,4238.07
3611203,360,28225,,,,,,,RELEASE FOOT TENDON,4705.22,1882.09,867.38,4705.22,3999.44,SKIPPED,4705.22,4705.22,3999.44,3999.44,3999.44,1982.78,867.38,867.38,SKIPPED,SKIPPED,2023.24,2023.24,3999.44
3611204,360,28665,,,,,,,TREAT TOE DISLOCATION,3169.32,1267.73,92.9,2693.92,2693.92,SKIPPED,1127.08,1127.08,2693.92,2693.92,2693.92,1335.55,92.9,92.9,SKIPPED,SKIPPED,1362.81,1362.81,2693.92
3611305,360,45378,,,,,,,#COLONOSCOPY DX,6050.27,2420.11,269.69,5142.73,5142.73,SKIPPED,3372.4,3372.4,5142.73,5142.73,5142.73,2549.59,269.69,269.69,SKIPPED,SKIPPED,2601.62,2601.62,5142.73
3611306,360,19020,,,,,,,MASTOTOMY W/EXP ABSC,6501.61,2600.64,414.14,6403.14,5526.37,SKIPPED,6403.14,6403.14,5526.37,5526.37,5526.37,2739.78,414.14,414.14,SKIPPED,SKIPPED,2795.69,2795.69,5526.37
3611308,360,46250,,,,,,,HEMORROIDECTOMY EXT,7992.47,3196.99,748.53,7992.47,6793.6,SKIPPED,7992.47,7992.47,6793.6,6793.6,6793.6,3368.02,748.53,748.53,SKIPPED,SKIPPED,3436.76,3436.76,6793.6
3611309,360,46260,,,,,,,HEMORRHOID INT/EXT C,9394.75,3757.9,748.53,9394.75,7985.54,SKIPPED,9394.75,9394.75,7985.54,7985.54,7985.54,3958.95,748.53,748.53,SKIPPED,SKIPPED,4039.74,4039.74,7985.54
3611310,360,G0105,,,,,,,#COLONSCOPY SCRN HI,5076,2030.4,269.69,4314.6,4314.6,SKIPPED,3372.4,3372.4,4314.6,4314.6,4314.6,2139.03,269.69,269.69,SKIPPED,SKIPPED,2182.68,2182.68,4314.6
3611312,360,25112,,,,,,,"EX GANG WRIST, RECUR",7358.07,2943.23,510.13,6412.22,6254.36,SKIPPED,6412.22,6412.22,6254.36,6254.36,6254.36,3100.69,510.13,510.13,SKIPPED,SKIPPED,3163.97,3163.97,6254.36
3611314,360,19083,,,,,,,PREOP PLCE WIRE BREA,3214.35,1285.74,414.14,3214.35,2732.2,SKIPPED,3214.35,3214.35,2732.2,2732.2,2732.2,1354.53,414.14,414.14,SKIPPED,SKIPPED,1382.17,1382.17,2732.2
3611315,360,G0121,,,,,,,#COLONSCOPY SCRN NO PROF,5528.96,2211.58,269.69,4699.62,4699.62,SKIPPED,3372.4,3372.4,4699.62,4699.62,4699.62,2329.9,269.69,269.69,SKIPPED,SKIPPED,2377.45,2377.45,4699.62
3611316,360,46270,,,,,,,TRT ANAL FISTUAL SUB,7787.7,3115.08,748.53,7787.7,6619.54,SKIPPED,7787.7,7787.7,6619.54,6619.54,6619.54,3281.74,748.53,748.53,SKIPPED,SKIPPED,3348.71,3348.71,6619.54
3611317,360,46040,,,,,,,I&D PERIRECTAL ABSCE,6323.25,2529.3,361.12,5374.76,5374.76,SKIPPED,4447.85,4447.85,5374.76,5374.76,5374.76,2664.62,361.12,361.12,SKIPPED,SKIPPED,2719,2719,5374.76
3611319,360,45300,,,,,,,#PROCTO RIGID DX,2652.86,1061.14,75.35,2254.93,2254.93,SKIPPED,453.15,453.15,2254.93,2254.93,2254.93,1117.92,75.35,75.35,SKIPPED,SKIPPED,1140.73,1140.73,2254.93
3611320,360,45388,,,,,,,#COLONSCOPY W/POLYPE,6026.14,2410.46,361.12,5122.22,5122.22,SKIPPED,4447.85,4447.85,5122.22,5122.22,5122.22,2539.42,361.12,361.12,SKIPPED,SKIPPED,2591.24,2591.24,5122.22
3611321,360,25111,,,,,,,EX GANGLION WRIST,7294.41,2917.76,510.13,6412.22,6200.25,SKIPPED,6412.22,6412.22,6200.25,6200.25,6200.25,3073.87,510.13,510.13,SKIPPED,SKIPPED,3136.6,3136.6,6200.25
3611322,360,45905,,,,,,,DILATATION ANAL SPHI,6593.15,2637.26,361.12,5604.18,5604.18,SKIPPED,4447.85,4447.85,5604.18,5604.18,5604.18,2778.35,361.12,361.12,SKIPPED,SKIPPED,2835.05,2835.05,5604.18
3611323,360,49520,,,,,,,"RPR HERNIA ING RDCE,",12441.71,4976.68,867.38,12441.71,10575.45,SKIPPED,12441.71,12441.71,10575.45,10575.45,10575.45,5242.94,867.38,867.38,SKIPPED,SKIPPED,5349.94,5349.94,10575.45
3611324,360,19120,,,,,,,EX CYST BREAST,8293.46,3317.38,807.26,8293.46,7049.44,SKIPPED,8293.46,8293.46,7049.44,7049.44,7049.44,3494.87,807.26,807.26,SKIPPED,SKIPPED,3566.19,3566.19,7049.44
3611325,360,45380,,,,,,,#COLONSCOPY W/BX,6338.66,2535.46,361.12,5387.86,5387.86,SKIPPED,4447.85,4447.85,5387.86,5387.86,5387.86,2671.11,361.12,361.12,SKIPPED,SKIPPED,2725.62,2725.62,5387.86
3611326,360,19125,,,,,,,EX BREAST LESION SNG,8425.33,3370.13,807.26,8425.33,7161.53,SKIPPED,8425.33,8425.33,7161.53,7161.53,7161.53,3550.43,807.26,807.26,SKIPPED,SKIPPED,3622.89,3622.89,7161.53
3611327,360,44970,,,,,,,#APPENDECTOMY LAP,13107.21,5242.88,0,13107.21,11141.13,SKIPPED,13107.21,13107.21,11141.13,11141.13,11141.13,5523.38,0,0,0,3932.16,5636.1,5636.1,11141.13
3611328,361,12032,,,,,,,RPR INT SCLD TRNK EX,1283.02,513.21,129.16,1090.57,1090.57,SKIPPED,769.02,769.02,1090.57,1090.57,1090.57,540.67,129.16,129.16,SKIPPED,SKIPPED,551.7,551.7,1090.57
3611329,360,19126,,,,,,,EX BRST LESION EA AD,4131.26,1652.5,0,3511.57,3511.57,SKIPPED,0,0,3511.57,3511.57,3511.57,1740.91,0,0,0,1239.38,1776.44,1776.44,3511.57
3611330,360,45382,,,,,,,#COLONSCOPY W/CNTR B,4269.8,1707.92,361.12,4269.8,3629.33,SKIPPED,4269.8,4269.8,3629.33,3629.33,3629.33,1799.29,361.12,361.12,SKIPPED,SKIPPED,1836.01,1836.01,3629.33
3611331,975,54161,,,,,,,CIRCUMCISION ADULT PROF,595.8,238.32,0,595.8,506.43,SKIPPED,595.8,595.8,506.43,506.43,506.43,215.33,291.94,291.94,SKIPPED,SKIPPED,219.72,219.72,0
3611333,360,19100,,,,,,,BX BRST PCUT W/O IMA,1330.98,532.39,414.14,1330.98,1131.33,SKIPPED,1330.98,1330.98,1131.33,1131.33,1131.33,560.87,414.14,414.14,SKIPPED,SKIPPED,572.32,572.32,1131.33
3611334,360,42821,,,,,,,T&A AGE 12 OR >,8447.03,3378.81,748.53,8447.03,7179.98,SKIPPED,8447.03,8447.03,7179.98,7179.98,7179.98,3559.58,748.53,748.53,SKIPPED,SKIPPED,3632.22,3632.22,7179.98
3611335,360,45384,,,,,,,#COLONSCOPY W/POLYP,6129.32,2451.73,361.12,5209.92,5209.92,SKIPPED,4447.85,4447.85,5209.92,5209.92,5209.92,2582.9,361.12,361.12,SKIPPED,SKIPPED,2635.61,2635.61,5209.92
3611336,360,44389,,,,,,,#COLONSCOPY STOMA W/,4312.83,1725.13,361.12,4312.83,3665.91,SKIPPED,4312.83,4312.83,3665.91,3665.91,3665.91,1817.43,361.12,361.12,SKIPPED,SKIPPED,1854.52,1854.52,3665.91
3611337,361,11200,,,,,,,RMV SKIN TAG LESION<,1509.35,603.74,0,1282.95,1282.95,SKIPPED,802.51,802.51,1282.95,1282.95,1282.95,636.04,0,0,0,452.8,649.02,649.02,1282.95
3611338,360,44392,,,,,,,#COLONSCOPY STOMA W/,4608.99,1843.6,361.12,4447.85,3917.64,SKIPPED,4447.85,4447.85,3917.64,3917.64,3917.64,1942.23,361.12,361.12,SKIPPED,SKIPPED,1981.87,1981.87,3917.64
3611339,360,49565,,,,,,,RPR HERNIA INCISION,1006.82,402.73,424.27,1051.35,855.8,SKIPPED,1006.82,1006.82,855.8,855.8,855.8,424.27,1006.82,1051.35,SKIPPED,SKIPPED,432.93,432.93,855.8
3611340,360,45385,,,,,,,#COLONSCOPY W/POLYP,5988.23,2395.29,361.12,5090,5090,SKIPPED,4447.85,4447.85,5090,5090,5090,2523.44,361.12,361.12,SKIPPED,SKIPPED,2574.94,2574.94,5090
3611341,361,10061,,,,,,,I&D ABSCESS COMPLICATED,1808.86,723.54,92.39,1537.53,1537.53,SKIPPED,535.23,535.23,1537.53,1537.53,1537.53,762.25,92.39,92.39,SKIPPED,SKIPPED,777.81,777.81,1537.53
3611342,361,11104,,,,,,,BX SKIN SUBQ SINGLE,719.89,287.96,0,611.91,611.91,SKIPPED,431.54,431.54,611.91,611.91,611.91,303.36,70.63,70.63,0,215.97,309.55,309.55,611.91
3611343,361,10120,,,,,,,I&RMVE FB SUBQ SMPLE,1543.67,617.47,85.46,1312.12,1312.12,SKIPPED,516.42,516.42,1312.12,1312.12,1312.12,650.5,85.46,85.46,SKIPPED,SKIPPED,663.78,663.78,1312.12
3611345,360,43235,,,,,,,#EGD DX,5007.67,2003.07,269.69,4256.52,4256.52,SKIPPED,3531.58,3531.58,4256.52,4256.52,4256.52,2110.23,269.69,269.69,SKIPPED,SKIPPED,2153.3,2153.3,4256.52
3611346,360,42820,,,,,,,T&A UNDER AGE 12,7629.44,3051.78,1051.35,7629.44,6485.02,SKIPPED,7629.44,7629.44,6485.02,6485.02,6485.02,3215.05,1051.35,1051.35,SKIPPED,SKIPPED,3280.66,3280.66,6485.02
3611350,360,43239,,,,,,,#EGD W/BX,5560.05,2224.02,269.69,4726.04,4726.04,SKIPPED,3531.58,3531.58,4726.04,4726.04,4726.04,2343,269.69,269.69,SKIPPED,SKIPPED,2390.82,2390.82,4726.04
3611351,360,49321,,,,,,,LAP ABD DIAGNOSTIC,11606.97,4642.79,1051.35,11606.97,9865.92,SKIPPED,11606.97,11606.97,9865.92,9865.92,9865.92,4891.18,1051.35,1051.35,SKIPPED,SKIPPED,4991,4991,9865.92
3611352,360,43247,,,,,,,#GI UPPER W/RMVE FB,4269.28,1707.71,269.69,3628.89,3628.89,SKIPPED,3531.58,3531.58,3628.89,3628.89,3628.89,1799.07,269.69,269.69,SKIPPED,SKIPPED,1835.79,1835.79,3628.89
3611353,361,10060,,,,,,,I&D ABSCESS SMPLE SN,1236.38,494.55,0,1050.92,1050.92,SKIPPED,347.13,347.13,1050.92,1050.92,1050.92,521.01,60.34,60.34,0,370.91,531.64,531.64,1050.92
3611355,360,43255,,,,,,,#EGD W/CNTRL BLEED,4781.2,1912.48,414.14,4781.2,4064.02,SKIPPED,4781.2,4781.2,4064.02,4064.02,4064.02,2014.8,414.14,414.14,SKIPPED,SKIPPED,2055.92,2055.92,4064.02
3611356,360,12034,,,,,,,CLSURE WOUNDS 12.6 T,1543.67,617.47,129.16,1476.3,1312.12,SKIPPED,1476.3,1476.3,1312.12,1312.12,1312.12,650.5,129.16,129.16,SKIPPED,SKIPPED,663.78,663.78,1312.12
3611360,360,43249,,,,,,,#EGD W/ESO DILATE,5884.23,2353.69,414.14,5884.23,5001.6,SKIPPED,5884.23,5884.23,5001.6,5001.6,5001.6,2479.62,414.14,414.14,SKIPPED,SKIPPED,2530.22,2530.22,5001.6
3611361,360,12051,,,,,,,RPR INT FCE EAR ELID,1276.84,510.74,129.16,1085.31,1085.31,SKIPPED,769.02,769.02,1085.31,1085.31,1085.31,538.06,129.16,129.16,SKIPPED,SKIPPED,549.04,549.04,1085.31
3611362,360,45171,,,,,,,EX RECTAL TUMOR TRAN,3746.89,1498.76,748.53,3746.89,3184.86,SKIPPED,3746.89,3746.89,3184.86,3184.86,3184.86,1578.94,748.53,748.53,SKIPPED,SKIPPED,1611.16,1611.16,3184.86
3611365,360,43246,,,,,,,#EGD W/PLCE GASTRO T,7818.66,3127.46,414.14,6780.1,6645.86,SKIPPED,6780.1,6780.1,6645.86,6645.86,6645.86,3294.78,414.14,414.14,SKIPPED,SKIPPED,3362.02,3362.02,6645.86
3611366,361,46606,,,,,,,ANOSCOPY W/BX SGL/MU,5074.41,2029.76,0,4313.25,4313.25,SKIPPED,877.23,877.23,4313.25,4313.25,4313.25,2138.36,170.92,170.92,0,1522.32,2182,2182,4313.25
3611367,360,42826,,,,,,,TONSILLECTOMY 12 & O,7756.61,3102.64,748.53,7756.61,6593.12,SKIPPED,7756.61,7756.61,6593.12,6593.12,6593.12,3268.63,748.53,748.53,SKIPPED,SKIPPED,3335.34,3335.34,6593.12
3611369,360,46221,,,,,,,HEMMORRHOIDECTOMY/BA,2283.52,913.41,148.98,1940.99,1940.99,SKIPPED,855,855,1940.99,1940.99,1940.99,962.27,148.98,148.98,SKIPPED,SKIPPED,981.91,981.91,1940.99
3611370,360,43250,,,,,,,#EGD W/RMVE TUMOR CA,3935.74,1574.3,414.14,3935.74,3345.38,SKIPPED,3935.74,3935.74,3345.38,3345.38,3345.38,1658.52,414.14,414.14,SKIPPED,SKIPPED,1692.37,1692.37,3345.38
3611371,361,49568,,,,,,,RPR HER VENT/IMP MES,5350.46,2140.18,0,4547.89,4547.89,SKIPPED,0,0,4547.89,4547.89,4547.89,2254.69,0,0,0,1605.14,2300.7,2300.7,4547.89
3611375,360,43251,,,,,,,#EGD W/RMVE TUMOR SN,6706.37,2682.55,414.14,6706.37,5700.41,SKIPPED,6706.37,6706.37,5700.41,5700.41,5700.41,2826.07,414.14,414.14,SKIPPED,SKIPPED,2883.74,2883.74,5700.41
3611376,360,46255,,,,,,,HEMORROIDECTOMY INT,5397.63,2159.05,748.53,5397.63,4587.99,SKIPPED,5397.63,5397.63,4587.99,4587.99,4587.99,2274.56,748.53,748.53,SKIPPED,SKIPPED,2320.98,2320.98,4587.99
3611382,360,13101,,,,,,,RPR CMPLX TRNK 2.6-7,2458.95,983.58,200.91,2318.95,2090.11,SKIPPED,2318.95,2318.95,2090.11,2090.11,2090.11,1036.2,200.91,200.91,SKIPPED,SKIPPED,1057.35,1057.35,2090.11
3611385,360,11441,,,,,,,#EX BN LZ FC EAR .6-,1982.68,793.07,91.23,1685.28,1685.28,SKIPPED,521.55,521.55,1685.28,1685.28,1685.28,835.5,91.23,91.23,SKIPPED,SKIPPED,852.55,852.55,1685.28
3611386,360,55250,,,,,,,#VASECTOMY UNILAT/BI,6365.17,2546.07,510.13,6365.17,5410.39,SKIPPED,6365.17,6365.17,5410.39,5410.39,5410.39,2682.28,510.13,510.13,SKIPPED,SKIPPED,2737.02,2737.02,5410.39
3611388,360,24105,,,,,,,EX BURSE OLECRANON,9036.54,3614.62,867.38,9036.54,7681.06,SKIPPED,9036.54,9036.54,7681.06,7681.06,7681.06,3808,867.38,867.38,SKIPPED,SKIPPED,3885.71,3885.71,7681.06
3611390,360,11442,,,,,,,#EX BN LZ FC EAR 1.1,3324.5,1329.8,98.74,2825.82,2825.82,SKIPPED,569.43,569.43,2825.82,2825.82,2825.82,1400.95,98.74,98.74,SKIPPED,SKIPPED,1429.54,1429.54,2825.82
3611391,975,43246,,,,,,,# EGD W/PLCE GASTRO T PROF,654.76,261.9,0,654.76,556.55,SKIPPED,654.76,654.76,556.55,556.55,556.55,217.35,320.83,320.83,SKIPPED,SKIPPED,221.79,221.79,0
3611392,975,12032,,,,,,,RPR INTSCLD TRNK EX PROF,580.14,232.06,0,580.14,493.12,SKIPPED,580.14,580.14,493.12,493.12,493.12,206.11,284.27,284.27,SKIPPED,SKIPPED,210.32,210.32,0
3611395,360,11443,,,,,,,#EX BN LZ FC EAR 2.1,3879.97,1551.99,109.42,3297.97,3297.97,SKIPPED,629.28,629.28,3297.97,3297.97,3297.97,1635.02,109.42,109.42,SKIPPED,SKIPPED,1668.39,1668.39,3297.97
3611400,360,11444,,,,,,,#EX BN LZ FC EAR 3.1,5024.82,2009.93,414.14,5024.82,4271.1,SKIPPED,5024.82,5024.82,4271.1,4271.1,4271.1,2117.46,414.14,414.14,SKIPPED,SKIPPED,2160.67,2160.67,4271.1
3611405,360,11446,,,,,,,#EX BN LZ FC EAR >4.,6383.67,2553.47,582.36,6383.67,5426.12,SKIPPED,6383.67,6383.67,5426.12,5426.12,5426.12,2690.08,582.36,582.36,SKIPPED,SKIPPED,2744.98,2744.98,5426.12
3611410,360,11420,,,,,,,#EX BN LZ SP NK H/F,3909.32,1563.73,71.02,3322.92,3322.92,SKIPPED,401.85,401.85,3322.92,3322.92,3322.92,1647.39,71.02,71.02,SKIPPED,SKIPPED,1681.01,1681.01,3322.92
3611415,360,11421,,,,,,,#EX BN LZ SP NK H/F,4094,1637.6,83.44,3479.9,3479.9,SKIPPED,480.51,480.51,3479.9,3479.9,3479.9,1725.21,83.44,83.44,SKIPPED,SKIPPED,1760.42,1760.42,3479.9
3611425,360,11423,,,,,,,#EX BN LZSP NK H/F 2,5808.24,2323.3,100.18,4937,4937,SKIPPED,574.56,574.56,4937,4937,4937,2447.59,100.18,100.18,SKIPPED,SKIPPED,2497.54,2497.54,4937
3611430,360,11424,,,,,,,#EX BN LZSP NK H/F 3,6382.2,2552.88,414.14,6382.2,5424.87,SKIPPED,6382.2,6382.2,5424.87,5424.87,5424.87,2689.46,414.14,414.14,SKIPPED,SKIPPED,2744.35,2744.35,5424.87
3611435,360,11426,,,,,,,#EX BN LZ SP NK H/F,7406.05,2962.42,582.36,7406.05,6295.14,SKIPPED,7406.05,7406.05,6295.14,6295.14,6295.14,3120.91,582.36,582.36,SKIPPED,SKIPPED,3184.6,3184.6,6295.14
3611445,360,11401,,,,,,,#EX BN LZ TRK AM LG,1530.65,612.26,84.3,1301.05,1301.05,SKIPPED,478.8,478.8,1301.05,1301.05,1301.05,645.02,84.3,84.3,SKIPPED,SKIPPED,658.18,658.18,1301.05
3611450,360,11402,,,,,,,#EX BN LZ TRK AM LG1,2313.01,925.2,92.1,1966.06,1966.06,SKIPPED,526.68,526.68,1966.06,1966.06,1966.06,974.7,92.1,92.1,SKIPPED,SKIPPED,994.59,994.59,1966.06
3611455,360,11403,,,,,,,#EX BN LZ TRK AM LG2,4024.18,1609.67,99.9,3420.55,3420.55,SKIPPED,572.85,572.85,3420.55,3420.55,3420.55,1695.79,99.9,99.9,SKIPPED,SKIPPED,1730.4,1730.4,3420.55
3611460,360,11404,,,,,,,#EX BN LZ TRK AM LG3,5632.96,2253.18,414.14,5632.96,4788.02,SKIPPED,5632.96,5632.96,4788.02,4788.02,4788.02,2373.73,414.14,414.14,SKIPPED,SKIPPED,2422.17,2422.17,4788.02
3611465,360,11406,,,,,,,#EX BN LZ TRK AM LG,6731.17,2692.47,414.14,6403.14,5721.49,SKIPPED,6403.14,6403.14,5721.49,5721.49,5721.49,2836.51,414.14,414.14,SKIPPED,SKIPPED,2894.4,2894.4,5721.49
3611475,360,45331,,,,,,,#SIG FLEX W/BX,5563.14,2225.26,269.69,4728.67,4728.67,SKIPPED,3372.4,3372.4,4728.67,4728.67,4728.67,2344.31,269.69,269.69,SKIPPED,SKIPPED,2392.15,2392.15,4728.67
3611480,360,37609,,,,,,,BX/LIG ARTERY TEMPOR,8929.45,3571.78,414.14,7590.03,7590.03,SKIPPED,6403.14,6403.14,7590.03,7590.03,7590.03,3762.87,414.14,414.14,SKIPPED,SKIPPED,3839.66,3839.66,7590.03
3611481,975,49565,,,,,,,REREPAIR VENTRL HERN REDUCE PROF,2314.49,925.8,0,2314.49,1967.32,SKIPPED,2314.49,2314.49,1967.32,1967.32,1967.32,833.1,1134.1,1134.1,SKIPPED,SKIPPED,850.1,850.1,0
3611482,975,49568,,,,,,,HERNIA REPAIR W/MESH PROF,811.28,324.51,0,689.59,689.59,SKIPPED,0,0,689.59,689.59,689.59,285.37,397.53,397.53,0,243.38,291.19,291.19,0
3611483,975,19120,,,,,,,REMOVAL OF BREAST LESION PROF,1231.81,492.72,0,1231.81,1047.04,SKIPPED,1231.81,1231.81,1047.04,1047.04,1047.04,452.67,603.59,603.59,SKIPPED,SKIPPED,461.91,461.91,0
3611485,360,47562,,,,,,,CHOLECYSTECTOMY LAP,14089.11,5635.64,1051.35,14089.11,11975.74,SKIPPED,14089.11,14089.11,11975.74,11975.74,11975.74,5937.15,1051.35,1051.35,SKIPPED,SKIPPED,6058.32,6058.32,11975.74
3611490,360,47563,,,,,,,CHOLECYSTECTOMY LAP,15351.87,6140.75,1051.35,15351.87,13049.09,SKIPPED,15351.87,15351.87,13049.09,13049.09,13049.09,6469.27,1051.35,1051.35,SKIPPED,SKIPPED,6601.3,6601.3,13049.09
3611495,360,54161,,,,,,,CIRCUMCISION ADULT,8403.48,3361.39,510.13,8054.48,7142.96,SKIPPED,8054.48,8054.48,7142.96,7142.96,7142.96,3541.23,510.13,510.13,SKIPPED,SKIPPED,3613.5,3613.5,7142.96
3611500,360,11640,,,,,,,EX MG LZ FC EAR =<.5,3191.35,1276.54,112.31,2712.65,2712.65,SKIPPED,651.51,651.51,2712.65,2712.65,2712.65,1344.83,112.31,112.31,SKIPPED,SKIPPED,1372.28,1372.28,2712.65
3611505,360,11641,,,,,,,EX MG LZ FC EAR .6-1,2598.45,1039.38,125.3,2208.68,2208.68,SKIPPED,733.59,733.59,2208.68,2208.68,2208.68,1094.98,125.3,125.3,SKIPPED,SKIPPED,1117.33,1117.33,2208.68
3611510,360,11642,,,,,,,EX MG LZ FC EAR 1.1-,2882.28,1152.91,137.14,2449.94,2449.94,SKIPPED,807.12,807.12,2449.94,2449.94,2449.94,1214.59,137.14,137.14,SKIPPED,SKIPPED,1239.38,1239.38,2449.94
3611515,360,11643,,,,,,,EX MG LZ FC EAR 2.1-,3915.48,1566.19,150.14,3328.16,3328.16,SKIPPED,884.07,884.07,3328.16,3328.16,3328.16,1649.99,150.14,150.14,SKIPPED,SKIPPED,1683.66,1683.66,3328.16
3611520,360,11644,,,,,,,EX MG LZ FC EAR 3.1-,5453,2181.2,414.14,5453,4635.05,SKIPPED,5453,5453,4635.05,4635.05,4635.05,2297.89,414.14,414.14,SKIPPED,SKIPPED,2344.79,2344.79,4635.05
3611525,360,11646,,,,,,,EX MG LZ FC EAR >4,7367.31,2946.92,582.36,7367.31,6262.21,SKIPPED,7367.31,7367.31,6262.21,6262.21,6262.21,3104.58,582.36,582.36,SKIPPED,SKIPPED,3167.94,3167.94,6262.21
3611540,360,11622,,,,,,,EX MG LZ SP NK H/F 1,3191.03,1276.41,131.94,2712.38,2712.38,SKIPPED,778.05,778.05,2712.38,2712.38,2712.38,1344.7,131.94,131.94,SKIPPED,SKIPPED,1372.14,1372.14,2712.38
3611545,360,11623,,,,,,,EX MG LZ SP NK H/F 2,5375.39,2150.16,144.94,4569.08,4569.08,SKIPPED,853.29,853.29,4569.08,4569.08,4569.08,2265.19,144.94,144.94,SKIPPED,SKIPPED,2311.42,2311.42,4569.08
3611550,360,11626,,,,,,,EX MG LZ SP NK H/F >,7598.36,3039.34,582.36,7598.36,6458.61,SKIPPED,7598.36,7598.36,6458.61,6458.61,6458.61,3201.94,582.36,582.36,SKIPPED,SKIPPED,3267.29,3267.29,6458.61
3611555,360,11624,,,,,,,EX MG LZ SP NK H/F 3,5825.25,2330.1,414.14,5825.25,4951.46,SKIPPED,5825.25,5825.25,4951.46,4951.46,4951.46,2454.76,414.14,414.14,SKIPPED,SKIPPED,2504.86,2504.86,4951.46
3611560,360,11600,,,,,,,EX MG LZ TRK AM LG =,4295.54,1718.22,108.85,3651.21,3651.21,SKIPPED,624.15,624.15,3651.21,3651.21,3651.21,1810.14,108.85,108.85,SKIPPED,SKIPPED,1847.08,1847.08,3651.21
3611565,360,11601,,,,,,,EX MG LZ TRK AM LG .,1990.31,796.12,121.26,1691.76,1691.76,SKIPPED,711.36,711.36,1691.76,1691.76,1691.76,838.71,121.26,121.26,SKIPPED,SKIPPED,855.83,855.83,1691.76
3611570,360,11602,,,,,,,EX MG LZ TRK AM LG 1,1666.14,666.46,129.16,1416.22,1416.22,SKIPPED,766.08,766.08,1416.22,1416.22,1416.22,702.11,129.16,129.16,SKIPPED,SKIPPED,716.44,716.44,1416.22
3611575,360,11603,,,,,,,EX MG LZ TRK AM LG 2,2916.47,1166.59,140.32,2479,2479,SKIPPED,829.35,829.35,2479,2479,2479,1229,140.32,140.32,SKIPPED,SKIPPED,1254.08,1254.08,2479
3611580,360,11604,,,,,,,EX MG LZ TRK AM LG 3,4094,1637.6,246.58,3479.9,3479.9,SKIPPED,2721.04,2721.04,3479.9,3479.9,3479.9,1725.21,246.58,246.58,SKIPPED,SKIPPED,1760.42,1760.42,3479.9
3611585,360,11606,,,,,,,EX MG LZ TRK AM LG >,6082.69,2433.08,414.14,6082.69,5170.29,SKIPPED,6082.69,6082.69,5170.29,5170.29,5170.29,2563.25,414.14,414.14,SKIPPED,SKIPPED,2615.56,2615.56,5170.29
3611586,975,10120,,,,,,,REMOVE FOREIGN BODY PROF,308.76,123.5,0,308.76,262.45,SKIPPED,308.76,308.76,262.45,262.45,262.45,113.63,151.29,151.29,SKIPPED,SKIPPED,115.95,115.95,0
3611587,975,11104,,,,,,,BX SKIN SUBQ SINGLE PROF,147.28,58.91,0,147.28,125.19,SKIPPED,147.28,147.28,125.19,125.19,125.19,51.18,72.17,72.17,0,44.18,52.22,52.22,0
3611590,360,19101,,,,,,,INCIS BX BRST,8149.13,3259.65,807.26,8149.13,6926.76,SKIPPED,8149.13,8149.13,6926.76,6926.76,6926.76,3434.05,807.26,807.26,SKIPPED,SKIPPED,3504.13,3504.13,6926.76
3611595,360,49553,,,,,,,RPR HERNIA FEM INCAR,9551.73,3820.69,867.38,9551.73,8118.97,SKIPPED,9551.73,9551.73,8118.97,8118.97,8118.97,4025.1,867.38,867.38,SKIPPED,SKIPPED,4107.24,4107.24,8118.97
3611605,360,49507,,,,,,,RPR HERNIA ING 5+ IN,13696.74,5478.7,867.38,13696.74,11642.23,SKIPPED,13696.74,13696.74,11642.23,11642.23,11642.23,5771.81,867.38,867.38,SKIPPED,SKIPPED,5889.6,5889.6,11642.23
3611610,360,49505,,,,,,,RPR HERNIA ING 5+ RE,12007.4,4802.96,867.38,12007.4,10206.29,SKIPPED,12007.4,12007.4,10206.29,10206.29,10206.29,5059.92,867.38,867.38,SKIPPED,SKIPPED,5163.18,5163.18,10206.29
3611620,360,49585,,,,,,,RPR HERNIA UMB 5+ RE,9351.46,3740.58,867.38,9351.46,7948.74,SKIPPED,9351.46,9351.46,7948.74,7948.74,7948.74,3940.71,867.38,867.38,SKIPPED,SKIPPED,4021.13,4021.13,7948.74
3611630,360,49560,,,,,,,RPR HERNIA VENT REDU,9224.27,3689.71,867.38,9224.27,7840.63,SKIPPED,9224.27,9224.27,7840.63,7840.63,7840.63,3887.11,867.38,867.38,SKIPPED,SKIPPED,3966.44,3966.44,7840.63
3611645,360,49582,,,,,,,RPR HERNIA UMB <5 IN,9725.34,3890.14,867.38,9725.34,8266.54,SKIPPED,9725.34,9725.34,8266.54,8266.54,8266.54,4098.26,867.38,867.38,SKIPPED,SKIPPED,4181.9,4181.9,8266.54
3611650,360,45330,,,,,,,#SIG FLEX DX,6506.3,2602.52,116.35,5530.36,5530.36,SKIPPED,658.35,658.35,5530.36,5530.36,5530.36,2741.76,116.35,116.35,SKIPPED,SKIPPED,2797.71,2797.71,5530.36
3611655,360,49000,,,,,,,EXPLORATORY LAPAROTO,7735.04,3094.02,0,6574.78,6574.78,SKIPPED,3796.39,3796.39,6574.78,6574.78,6574.78,3259.55,0,0,0,2320.51,3326.07,3326.07,6574.78
3611665,260,Q0081,,,,,,,IV INFUSION EA + HR,223.65,89.46,0,190.1,190.1,SKIPPED,169.97,169.97,190.1,190.1,190.1,94.25,109.59,109.59,0,67.1,96.17,96.17,190.1
3611670,360,14060,,,,,,,AJ TS XF EL NS ER LP,4838.56,1935.42,582.36,4838.56,4112.78,SKIPPED,4838.56,4838.56,4112.78,4112.78,4112.78,2038.97,582.36,582.36,SKIPPED,SKIPPED,2080.58,2080.58,4112.78
3611675,360,15120,,,,,,,S/GR FC EL NK GEN H/,8048.33,3219.33,1051.35,8048.33,6841.08,SKIPPED,8048.33,8048.33,6841.08,6841.08,6841.08,3391.56,1051.35,1051.35,SKIPPED,SKIPPED,3460.78,3460.78,6841.08
3611680,360,57410,,,,,,,#PLV EXAM UNDER ANES,2327.09,930.84,867.38,2327.09,1978.03,SKIPPED,2327.09,2327.09,1978.03,1978.03,1978.03,980.64,867.38,867.38,SKIPPED,SKIPPED,1000.65,1000.65,1978.03
3611715,360,96372,,,,,,,INJECTION ANTIBOTIC,175.29,70.12,0,175.29,149,SKIPPED,175.29,175.29,149,149,149,73.86,0,0,0,52.59,75.37,75.37,149
3611720,360,66984,,,,,,,#CATARACT RMV/IOL IN,9919.26,3967.7,748.53,9125.18,8431.37,SKIPPED,9125.18,9125.18,8431.37,8431.37,8431.37,4179.97,748.53,748.53,SKIPPED,SKIPPED,4265.28,4265.28,8431.37
3611725,360,66821,,,,,,,#YAG LASER SURGERY,3242.23,1296.89,204.91,2755.9,2755.9,SKIPPED,2317.9,2317.9,2755.9,2755.9,2755.9,1366.28,204.91,204.91,SKIPPED,SKIPPED,1394.16,1394.16,2755.9
3611731,975,54700,,,,,,,DRAINAGE OF SCROTUM PROF,643.79,257.52,0,643.79,547.22,SKIPPED,643.79,643.79,547.22,547.22,547.22,232.37,315.46,315.46,SKIPPED,SKIPPED,237.11,237.11,0
3611732,360,54700,,,,,,,DRAINAGE OF SCROTUM,6838.24,2735.3,510.13,6838.24,5812.5,SKIPPED,6838.24,6838.24,5812.5,5812.5,5812.5,2881.63,510.13,510.13,SKIPPED,SKIPPED,2940.44,2940.44,5812.5
3611740,360,47605,,,,,,,CHOLECYSTMY W/CHOLAN,22148.3,8859.32,0,18826.06,18826.06,SKIPPED,5545.44,5545.44,18826.06,18826.06,18826.06,9333.29,0,0,0,6644.49,9523.77,9523.77,18826.06
3611760,975,38500,,,,,,,#BX/EX LYMPH NODE SU,606.75,242.7,0,606.75,515.74,SKIPPED,606.75,606.75,515.74,515.74,515.74,277.22,297.31,297.31,SKIPPED,SKIPPED,282.88,282.88,0
3611766,360,63030,,,,,,,LOW BACK DISK SURGERY,18598.92,7439.57,1051.35,18598.92,15809.08,SKIPPED,18598.92,18598.92,15809.08,15809.08,15809.08,7837.59,1051.35,1051.35,SKIPPED,SKIPPED,7997.54,7997.54,15809.08
3611767,278,,,,,,,,TRANSITION SCREW,6563,2625.2,0,5578.55,5578.55,SKIPPED,4987.88,4987.88,5578.55,5578.55,5578.55,2765.65,3215.87,3215.87,0,1968.9,2822.09,2822.09,5578.55
3611768,278,,,,,,,,CANC CUBES 30 CC,1268,507.2,0,1077.8,1077.8,SKIPPED,963.68,963.68,1077.8,1077.8,1077.8,534.34,621.32,621.32,0,380.4,545.24,545.24,1077.8
3611769,360,46947,,,,,,,HEMORRHOID BY STAPLING,9596.57,3838.63,0,9596.57,8157.08,SKIPPED,9596.57,9596.57,8157.08,8157.08,8157.08,4044,0,0,0,2878.97,4126.53,4126.53,8157.08
3611770,975,46220,,,,,,,REMOVAL SKIN TAG ANAL,1684.49,673.8,0,1684.49,1431.82,SKIPPED,1684.49,1684.49,1431.82,1431.82,1431.82,132.34,825.4,825.4,SKIPPED,SKIPPED,135.04,135.04,0
3611771,275,C1785,,,,,,,PACEMAKER GENERATOR,28472.85,11389.14,0,24201.92,24201.92,SKIPPED,21639.37,21639.37,24201.92,24201.92,24201.92,11998.46,13951.7,13951.7,0,8541.86,12243.33,12243.33,24201.92
3611772,275,C1898,,,,,,,PACEMAKER ATRIAL LEAD,4563.3,1825.32,0,3878.8,3878.8,SKIPPED,3468.11,3468.11,3878.8,3878.8,3878.8,1922.98,2236.02,2236.02,0,1368.99,1962.22,1962.22,3878.8
3611773,275,C1898,,,,,,,PACEMAKER VENT LEAD,4563.3,1825.32,0,3878.8,3878.8,SKIPPED,3468.11,3468.11,3878.8,3878.8,3878.8,1922.98,2236.02,2236.02,0,1368.99,1962.22,1962.22,3878.8
3611774,272,C1894,,,,,,,SAFESHEATH HLS 1007M,525,210,0,446.25,446.25,SKIPPED,399,399,446.25,446.25,446.25,221.24,257.25,257.25,0,157.5,225.75,225.75,446.25
3611775,272,C1894,,,,,,,SURGICAL CABLE PACEMAKER,525,210,0,446.25,446.25,SKIPPED,399,399,446.25,446.25,446.25,221.24,257.25,257.25,0,157.5,225.75,225.75,446.25
3611776,272,C1894,,,,,,,PACEMAKER CABLE,525,210,0,446.25,446.25,SKIPPED,399,399,446.25,446.25,446.25,221.24,257.25,257.25,0,157.5,225.75,225.75,446.25
3611777,360,28308,,,,,,,INCISION OF METATARSAL,5397.11,2158.84,867.38,5397.11,4587.54,SKIPPED,5397.11,5397.11,4587.54,4587.54,4587.54,2274.34,867.38,867.38,SKIPPED,SKIPPED,2320.76,2320.76,4587.54
3611778,360,28111,,,,,,,PART REMOVAL METATARSAL,9298.66,3719.46,867.38,9298.66,7903.86,SKIPPED,9298.66,9298.66,7903.86,7903.86,7903.86,3918.45,867.38,867.38,SKIPPED,SKIPPED,3998.42,3998.42,7903.86
3611779,360,28755,,,,,,,FUSION BIG TOE JOINT,8201.79,3280.72,1051.35,8201.79,6971.52,SKIPPED,8201.79,8201.79,6971.52,6971.52,6971.52,3456.23,1051.35,1051.35,SKIPPED,SKIPPED,3526.77,3526.77,6971.52
3611780,360,27826,,,,,,,TREAT LOWER LEG FRACTURE,17320.62,6928.25,1051.35,17320.62,14722.53,SKIPPED,17320.62,17320.62,14722.53,14722.53,14722.53,7298.91,1051.35,1051.35,SKIPPED,SKIPPED,7447.87,7447.87,14722.53
3611781,360,27658,,,,,,,REPAIR LEG TENDON EACH,8951.18,3580.47,867.38,8951.18,7608.5,SKIPPED,8951.18,8951.18,7608.5,7608.5,7608.5,3772.03,867.38,867.38,SKIPPED,SKIPPED,3849.01,3849.01,7608.5
3611782,275,C1786,,,,,,,PACEMAKER SINGLE RATE RES,19477.5,7791,0,16555.88,16555.88,SKIPPED,14802.9,14802.9,16555.88,16555.88,16555.88,8207.82,9543.98,9543.98,0,5843.25,8375.33,8375.33,16555.88
3611783,272,C1894,,,,,,,INTRO SHEATH NON LASER,334.95,133.98,0,284.71,284.71,SKIPPED,254.56,254.56,284.71,284.71,284.71,141.15,164.13,164.13,0,100.48,144.03,144.03,284.71
3611784,360,33207,,,,,,,INSERT HEART PM VENTRICUL,24286.03,9714.41,1051.35,24286.03,20643.13,SKIPPED,24286.03,24286.03,20643.13,20643.13,20643.13,10234.13,1051.35,1051.35,SKIPPED,SKIPPED,10442.99,10442.99,20643.13
3611785,360,28306,,,,,,,INCISION METATARSAL,7097.3,2838.92,1051.35,7097.3,6032.7,SKIPPED,7097.3,7097.3,6032.7,6032.7,6032.7,2990.8,1051.35,1051.35,SKIPPED,SKIPPED,3051.84,3051.84,6032.7
3611786,360,28810,,,,,,,AMPUTATION TOE/METATARSAL,8296.53,3318.61,867.38,8296.53,7052.05,SKIPPED,8296.53,8296.53,7052.05,7052.05,7052.05,3496.16,867.38,867.38,SKIPPED,SKIPPED,3567.51,3567.51,7052.05
3611787,360,60220,,,,,,,PARTIAL REMOVAL THYROID,18057.53,7223.01,1051.35,18057.53,15348.9,SKIPPED,18057.53,18057.53,15348.9,15348.9,15348.9,7609.45,1051.35,1051.35,SKIPPED,SKIPPED,7764.74,7764.74,15348.9
3611788,975,46947,,,,,,,HEMORRHOIDECTOMY/STAPLING,914.17,365.67,0,914.17,777.04,SKIPPED,914.17,914.17,777.04,777.04,777.04,424.46,447.94,447.94,0,274.25,433.12,433.12,0
3611789,360,21550,,,,,,,BIOPSY NECK/CHEST,5352.07,2140.83,414.14,5352.07,4549.26,SKIPPED,5352.07,5352.07,4549.26,4549.26,4549.26,2255.36,414.14,414.14,SKIPPED,SKIPPED,2301.39,2301.39,4549.26
3611790,360,46060,,,,,,,INCISION RECTAL ABSCESS,7831.11,3132.44,748.53,7831.11,6656.44,SKIPPED,7831.11,7831.11,6656.44,6656.44,6656.44,3300.03,748.53,748.53,SKIPPED,SKIPPED,3367.38,3367.38,6656.44
3611791,361,27687,,,,,,,REVISION CALF TENDON,7381.25,2952.5,867.38,7381.25,6274.06,SKIPPED,7381.25,7381.25,6274.06,6274.06,6274.06,3110.46,867.38,867.38,SKIPPED,SKIPPED,3173.94,3173.94,6274.06
3611793,360,64448,,,,,,,N BLOCK INJ FEM CONT INF,2241.7,896.68,269.69,2241.7,1905.44,SKIPPED,2241.7,2241.7,1905.44,1905.44,1905.44,944.65,269.69,269.69,SKIPPED,SKIPPED,963.93,963.93,1905.44
3611794,360,46220,,,,,,,EXCISE ANAL EXT TAG/PAPIL,6782.36,2712.94,361.12,5765.01,5765.01,SKIPPED,4447.85,4447.85,5765.01,5765.01,5765.01,2858.08,361.12,361.12,SKIPPED,SKIPPED,2916.41,2916.41,5765.01
3611795,360,28062,,,,,,,REMOVAL OF FOOT FASCIA,10134.75,4053.9,867.38,10134.75,8614.54,SKIPPED,10134.75,10134.75,8614.54,8614.54,8614.54,4270.78,867.38,867.38,SKIPPED,SKIPPED,4357.94,4357.94,8614.54
3611796,360,27043,,,,,,,"EXC TUMOR HIP PELVIS,3CM",10184.46,4073.78,582.36,10184.46,8656.79,SKIPPED,10184.46,10184.46,8656.79,8656.79,8656.79,4291.73,582.36,582.36,SKIPPED,SKIPPED,4379.32,4379.32,8656.79
3611797,360,21933,,,,,,,EXC BACK TUM DEEP 5CM,9230.47,3692.19,582.36,9230.47,7845.9,SKIPPED,9230.47,9230.47,7845.9,7845.9,7845.9,3889.72,582.36,582.36,SKIPPED,SKIPPED,3969.1,3969.1,7845.9
3611798,360,,,,,,,,TREAT ANKLE FRACTURE,13184.66,5273.86,0,11206.96,11206.96,SKIPPED,10020.34,10020.34,11206.96,11206.96,11206.96,5556.01,0,0,0,3955.4,5669.4,5669.4,11206.96
3611799,360,,,,,,,,DRAINAGE OF HYDROCELE,3150.84,1260.34,0,2678.21,2678.21,SKIPPED,2394.64,2394.64,2678.21,2678.21,2678.21,1327.76,0,0,0,945.25,1354.86,1354.86,2678.21
3611800,360,47001,,,,,,,NEEDLE BIOPSY LIVER ADD ON,5989.69,2395.88,0,5091.24,5091.24,SKIPPED,0,0,5091.24,5091.24,5091.24,2524.06,0,0,0,1796.91,2575.57,2575.57,5091.24
3611801,360,11004,,,,,,,DEBRIDE SKIN SUBCUT,9188.5,3675.4,0,7810.22,7810.22,SKIPPED,2845.16,2845.16,7810.22,7810.22,7810.22,3872.04,0,0,0,2756.55,3951.06,3951.06,7810.22
3611802,360,20220,,,,,,,BONE BIOPSY TROCAR/NEEDLE,2750.42,1100.17,414.14,2750.42,2337.86,SKIPPED,2750.42,2750.42,2337.86,2337.86,2337.86,1159.03,414.14,414.14,SKIPPED,SKIPPED,1182.68,1182.68,2337.86
3611803,360,63650,,,,,,,IMPLANT NEUROELECTRODES,10254.29,4101.72,1051.35,10254.29,8716.15,SKIPPED,10254.29,10254.29,8716.15,8716.15,8716.15,4321.15,1051.35,1051.35,SKIPPED,SKIPPED,4409.34,4409.34,8716.15
3611804,360,63688,,,,,,,REVISE/REMOVE NEURORECEIVER,10187.55,4075.02,1051.35,10187.55,8659.42,SKIPPED,10187.55,10187.55,8659.42,8659.42,8659.42,4293.04,1051.35,1051.35,SKIPPED,SKIPPED,4380.65,4380.65,8659.42
3611815,360,21501,,,,,,,DRAIN NECK/CHEST LESION,7579.72,3031.89,582.36,7579.72,6442.76,SKIPPED,7579.72,7579.72,6442.76,6442.76,6442.76,3194.09,582.36,582.36,SKIPPED,SKIPPED,3259.28,3259.28,6442.76
3611817,360,27610,,,,,,,ARTHROTOMY ANKLE,9695.74,3878.3,867.38,9695.74,8241.38,SKIPPED,9695.74,9695.74,8241.38,8241.38,8241.38,4085.79,867.38,867.38,SKIPPED,SKIPPED,4169.17,4169.17,8241.38
3611822,360,28005,,,,,,,TREAT FOOT BONE LESION,7017.9,2807.16,867.38,7017.9,5965.22,SKIPPED,7017.9,7017.9,5965.22,5965.22,5965.22,2957.35,867.38,867.38,SKIPPED,SKIPPED,3017.7,3017.7,5965.22
3611827,360,28110,,,,,,,PART RMVE METATARSAL,7528.53,3011.41,867.38,7528.53,6399.25,SKIPPED,7528.53,7528.53,6399.25,6399.25,6399.25,3172.52,867.38,867.38,SKIPPED,SKIPPED,3237.27,3237.27,6399.25
3611828,360,28112,,,,,,,PART REMOVAL OF METATARSAL,6915.7,2766.28,867.38,6915.7,5878.34,SKIPPED,6915.7,6915.7,5878.34,5878.34,5878.34,2914.28,867.38,867.38,SKIPPED,SKIPPED,2973.75,2973.75,5878.34
3611830,360,28119,,,,,,,OSTECTOMY CALCANEUS,10443.52,4177.41,867.38,10443.52,8876.99,SKIPPED,10443.52,10443.52,8876.99,8876.99,8876.99,4400.9,867.38,867.38,SKIPPED,SKIPPED,4490.71,4490.71,8876.99
3611832,360,28200,,,,,,,REPAIR FOOT TENDON,7531.6,3012.64,867.38,7531.6,6401.86,SKIPPED,7531.6,7531.6,6401.86,6401.86,6401.86,3173.82,867.38,867.38,SKIPPED,SKIPPED,3238.59,3238.59,6401.86
3611841,360,28525,,,,,,,TREAT TOE FRACTURE,10159.68,4063.87,867.38,10159.68,8635.73,SKIPPED,10159.68,10159.68,8635.73,8635.73,8635.73,4281.29,867.38,867.38,SKIPPED,SKIPPED,4368.66,4368.66,8635.73
3611843,278,C1778,,,,,,,INFINION LEAD SC-2316-50,10850,4340,0,9222.5,9222.5,SKIPPED,8246,8246,9222.5,9222.5,9222.5,4572.19,5316.5,5316.5,0,3255,4665.5,4665.5,9222.5
3611844,278,C1820,,,,,,,SPECTRA IPG SC-1132,101294,40517.6,0,86099.9,86099.9,SKIPPED,76983.44,76983.44,86099.9,86099.9,86099.9,42685.29,49634.06,49634.06,0,30388.2,43556.42,43556.42,86099.9
3611845,278,L9900,,,,,,,CLIK ANCHOR SC-4316,988,395.2,0,839.8,839.8,SKIPPED,750.88,750.88,839.8,839.8,839.8,416.34,484.12,484.12,0,296.4,424.84,424.84,839.8
3611846,278,L9900,,,,,,,FIXATE ANCHOR FB-101-01,2238,895.2,0,1902.3,1902.3,SKIPPED,1700.88,1700.88,1902.3,1902.3,1902.3,943.09,1096.62,1096.62,0,671.4,962.34,962.34,1902.3
3611847,272,L9900,,,,,,,OR CABLE 1 X 16 SC-4116,1500,600,0,1275,1275,SKIPPED,1140,1140,1275,1275,1275,632.1,735,735,0,450,645,645,1275
3611848,272,L9900,,,,,,,CLIK ANCHOR WRENCH SC-4276,187.5,75,0,159.38,159.38,SKIPPED,142.5,142.5,159.38,159.38,159.38,79.02,91.88,91.88,0,56.25,80.63,80.63,159.38
3611849,272,C1820,,,,,,,CHARGING KIT SC-6412-3,9166,3666.4,0,7791.1,7791.1,SKIPPED,6966.16,6966.16,7791.1,7791.1,7791.1,3862.55,4491.34,4491.34,0,2749.8,3941.38,3941.38,7791.1
3611850,278,C1787,,,,,,,SPECTRA REMOTE SC-5532-1,4475,1790,0,3803.75,3803.75,SKIPPED,3401,3401,3803.75,3803.75,3803.75,1885.76,2192.75,2192.75,0,1342.5,1924.25,1924.25,3803.75
3611851,278,C1883,,,,,,,INFINION 2X8 SPLITTER 30 CM SC-3400-30,4675,1870,0,3973.75,3973.75,SKIPPED,3553,3553,3973.75,3973.75,3973.75,1970.04,2290.75,2290.75,0,1402.5,2010.25,2010.25,3973.75
3611852,278,C1778,,,,,,,INFINION TRIAL LEAD SC-2316-50E,9750,3900,0,8287.5,8287.5,SKIPPED,7410,7410,8287.5,8287.5,8287.5,4108.65,4777.5,4777.5,0,2925,4192.5,4192.5,8287.5
3611853,272,C1778,,,,,,,SPECTRA TRIAL KIT DC-6500-03,287.5,115,0,244.38,244.38,SKIPPED,218.5,218.5,244.38,244.38,244.38,121.16,140.88,140.88,0,86.25,123.63,123.63,244.38
3611854,360,63685,,,,,,,INSERTION/REPLACE SPINAL NEUROSTIMULATOR,18622.26,7448.9,1051.35,18622.26,15828.92,SKIPPED,18622.26,18622.26,15828.92,15828.92,15828.92,7847.42,1051.35,1051.35,SKIPPED,SKIPPED,8007.57,8007.57,15828.92
3611855,278,L9900,,,,,,,INFINION LEAD KIT 50 CM SC-2218-5,7700,3080,0,6545,6545,SKIPPED,5852,5852,6545,6545,6545,3244.78,3773,3773,0,2310,3311,3311,6545
3611856,278,L9900,,,,,,,FIXATE TISSUE BAND F-B201-01,4475,1790,0,3803.75,3803.75,SKIPPED,3401,3401,3803.75,3803.75,3803.75,1885.76,2192.75,2192.75,0,1342.5,1924.25,1924.25,3803.75
3611857,272,L9900,,,,,,,OR CABLE SC-4108,1500,600,0,1275,1275,SKIPPED,1140,1140,1275,1275,1275,632.1,735,735,0,450,645,645,1275
3611858,278,L9900,,,,,,,INTRODUCER SC-4365,225,90,0,191.25,191.25,SKIPPED,171,171,191.25,191.25,191.25,94.82,110.25,110.25,0,67.5,96.75,96.75,191.25
3611859,272,L9900,,,,,,,MEDICAL SURG ADHESIVE SC-4320,147,58.8,0,124.95,124.95,SKIPPED,111.72,111.72,124.95,124.95,124.95,61.95,72.03,72.03,0,44.1,63.21,63.21,124.95
3611860,278,L9900,,,,,,,EPIMED CURVED NEEDLE SC-4210,1180,472,0,1003,1003,SKIPPED,896.8,896.8,1003,1003,1003,497.25,578.2,578.2,0,354,507.4,507.4,1003
3611861,278,C2621,,,,,,,SYNCRA CRTR01 PACEMAKER BATTERY,21000,8400,0,17850,17850,SKIPPED,15960,15960,17850,17850,17850,8849.4,10290,10290,0,6300,9030,9030,17850
3611862,360,19281,,,,,,,PERQ DEVICE BREAST 1ST IMAG,305.68,122.27,0,305.68,259.83,SKIPPED,305.68,305.68,259.83,259.83,259.83,128.81,0,0,0,91.7,131.44,131.44,259.83
3611863,360,63655,,,,,,,IMPLANT NEUROELECTRODES,13764.42,5505.77,1051.35,13764.42,11699.76,SKIPPED,13764.42,13764.42,11699.76,11699.76,11699.76,5800.33,1051.35,1051.35,SKIPPED,SKIPPED,5918.7,5918.7,11699.76
3611865,278,,,,,,,,MESH - PC09X,1041,416.4,0,884.85,884.85,SKIPPED,791.16,791.16,884.85,884.85,884.85,438.68,510.09,510.09,0,312.3,447.63,447.63,884.85
3611866,278,,,,,,,,MESH - PC012X,1427,570.8,0,1212.95,1212.95,SKIPPED,1084.52,1084.52,1212.95,1212.95,1212.95,601.34,699.23,699.23,0,428.1,613.61,613.61,1212.95
3611867,278,,,,,,,,MESH - PC06VP,1370,548,0,1164.5,1164.5,SKIPPED,1041.2,1041.2,1164.5,1164.5,1164.5,577.32,671.3,671.3,0,411,589.1,589.1,1164.5
3611868,278,,,,,,,,MESH - TECR1510,308,123.2,0,261.8,261.8,SKIPPED,234.08,234.08,261.8,261.8,261.8,129.79,150.92,150.92,0,92.4,132.44,132.44,261.8
3611869,278,,,,,,,,MESH - PCO4VP,1143,457.2,0,971.55,971.55,SKIPPED,868.68,868.68,971.55,971.55,971.55,481.66,560.07,560.07,0,342.9,491.49,491.49,971.55
3611870,278,,,,,,,,MESH - PCO1510X,1427,570.8,0,1212.95,1212.95,SKIPPED,1084.52,1084.52,1212.95,1212.95,1212.95,601.34,699.23,699.23,0,428.1,613.61,613.61,1212.95
3611871,278,,,,,,,,MESH - PCO151005X,1813,725.2,0,1541.05,1541.05,SKIPPED,1377.88,1377.88,1541.05,1541.05,1541.05,764,888.37,888.37,0,543.9,779.59,779.59,1541.05
3611873,278,,,,,,,,MESH - PCO 2015X,2289,915.6,0,1945.65,1945.65,SKIPPED,1739.64,1739.64,1945.65,1945.65,1945.65,964.58,1121.61,1121.61,0,686.7,984.27,984.27,1945.65
3611875,360,42830,,,,,,,REMOVAL OF ADENOIDS YOUNGER THAN AGE 12,11059.42,4423.77,748.53,10445.54,9400.51,SKIPPED,10445.54,10445.54,9400.51,9400.51,9400.51,4660.44,748.53,748.53,SKIPPED,SKIPPED,4755.55,4755.55,9400.51
3611876,278,,,,,,,,35cm LEAD KIT SC-3138-35,2783,1113.2,0,2365.55,2365.55,SKIPPED,2115.08,2115.08,2365.55,2365.55,2365.55,1172.76,1363.67,1363.67,0,834.9,1196.69,1196.69,2365.55
3611877,278,,,,,,,,50CM LEAD KIT SC2218-50E,4764,1905.6,0,4049.4,4049.4,SKIPPED,3620.64,3620.64,4049.4,4049.4,4049.4,2007.55,2334.36,2334.36,0,1429.2,2048.52,2048.52,4049.4
3611878,272,,,,,,,,"4"" INSERTION NEEDLE SC4200",451.5,180.6,0,383.78,383.78,SKIPPED,343.14,343.14,383.78,383.78,383.78,190.27,221.24,221.24,0,135.45,194.15,194.15,383.78
3611879,975,47562,,,,,,,CHOLECYSTECTOMY LAP PROF,1977.97,791.19,0,1977.97,1681.27,SKIPPED,1977.97,1977.97,1681.27,1681.27,1681.27,716.6,969.21,969.21,SKIPPED,SKIPPED,731.22,731.22,0
3611880,975,43248,,,,,,,UPPER GI ENDOSCOPY PROF,546.09,218.44,0,546.09,464.18,SKIPPED,546.09,546.09,464.18,464.18,464.18,180.98,267.58,267.58,SKIPPED,SKIPPED,184.67,184.67,0
3611881,975,43239,,,,,,,EGD W/BX PROF,451.34,180.54,0,451.34,383.64,SKIPPED,451.34,451.34,383.64,383.64,383.64,150.76,221.16,221.16,SKIPPED,SKIPPED,153.84,153.84,0
3611882,360,16020,,,,,,,DRESS/DEBRID P-THICK BURNS,662.41,264.96,0,662.41,563.05,SKIPPED,662.41,662.41,563.05,563.05,563.05,279.14,44.31,44.31,0,198.72,284.84,284.84,563.05
3611883,975,16020,,,,,,,DRESS/DEBRID P-THICK BURNS PROF,162.95,65.18,0,162.95,138.51,SKIPPED,162.95,162.95,138.51,138.51,138.51,59.25,79.85,79.85,0,48.88,60.46,60.46,0
3611885,975,45385,,,,,,,COLONSCOPY W/POLYP PROF,933.93,373.57,0,933.93,793.84,SKIPPED,933.93,933.93,793.84,793.84,793.84,277.69,457.63,457.63,SKIPPED,SKIPPED,283.36,283.36,0
3611886,975,49585,,,,,,,RPR HERNIA UMB 5+ IN PROF,1330.98,532.39,0,1330.98,1131.33,SKIPPED,1330.98,1330.98,1131.33,1131.33,1131.33,487.6,652.18,652.18,SKIPPED,SKIPPED,497.55,497.55,0
3611887,975,12042,,,,,,,CLSR LYR NK/HD/FT 2.6-7.5 PROF,598.9,239.56,0,598.9,509.06,SKIPPED,598.9,598.9,509.06,509.06,509.06,212.94,293.46,293.46,SKIPPED,SKIPPED,217.29,217.29,0
3611888,975,11426,,,,,,,EX BN LZ SP NK H/F PROF,822.16,328.86,0,822.16,698.84,SKIPPED,822.16,822.16,698.84,698.84,698.84,295.74,402.86,402.86,SKIPPED,SKIPPED,301.78,301.78,0
3611889,975,45380,,,,,,,COLONOSCOPY W/BX PROF,786.65,314.66,0,786.65,668.65,SKIPPED,786.65,786.65,668.65,668.65,668.65,218.58,385.46,385.46,SKIPPED,SKIPPED,223.04,223.04,0
3611890,975,G0105,,,,,,,COLONOSCOPY SCRN PROF,657.85,263.14,0,657.85,559.17,SKIPPED,657.85,657.85,559.17,559.17,559.17,201.07,322.35,322.35,SKIPPED,SKIPPED,205.17,205.17,0
3611891,975,49505,,,,,,,SURGICAL ASSIST-RPR HERNIA ING 5+ RE PRO,249.7,99.88,0,580.2,212.24,SKIPPED,249.7,249.7,212.24,212.24,212.24,568.6,122.35,122.35,SKIPPED,SKIPPED,580.2,580.2,0
3611892,975,45384,,,,,,,CHOLECYSTECTOMY LAP PROF,823.77,329.51,0,823.77,700.2,SKIPPED,823.77,823.77,700.2,700.2,700.2,248.01,403.65,403.65,SKIPPED,SKIPPED,253.07,253.07,0
3611893,975,43235,,,,,,,EGD DX PROF,403.36,161.34,0,403.36,342.86,SKIPPED,403.36,403.36,342.86,342.86,342.86,133.76,197.65,197.65,SKIPPED,SKIPPED,136.49,136.49,0
3611894,975,47001,,,,,,,NEEDLE BIOPSY LIVER ADD ON - PROF,313.31,125.32,0,266.31,266.31,SKIPPED,0,0,266.31,266.31,266.31,110.8,153.52,153.52,0,93.99,113.06,113.06,0
3611895,360,23071,,,,,,,EXC SHOULDER LES SC 3CM/>,8175.53,3270.21,414.14,6949.2,6949.2,SKIPPED,6403.14,6403.14,6949.2,6949.2,6949.2,3445.17,414.14,414.14,SKIPPED,SKIPPED,3515.48,3515.48,6949.2
3611896,975,23071,,,,,,,EXC SHOULDER LES SC 3CM/> - PROF,1253.4,501.36,0,1253.4,1065.39,SKIPPED,1253.4,1253.4,1065.39,1065.39,1065.39,457.77,614.17,614.17,SKIPPED,SKIPPED,467.11,467.11,0
3611897,975,49652,,,,,,,LAP VENT/ABD HERNIA RPR PROF,2091.22,836.49,0,2091.22,1777.54,SKIPPED,2091.22,2091.22,1777.54,1777.54,1777.54,806.6,1024.7,1024.7,SKIPPED,SKIPPED,823.06,823.06,0
3611898,975,49654,,,,,,,LAP INC HERNIA REPAIR PROF,2378.15,951.26,0,2378.15,2021.43,SKIPPED,2378.15,2378.15,2021.43,2021.43,2021.43,914.82,1165.29,1165.29,SKIPPED,SKIPPED,933.49,933.49,0
3611899,975,11423,,,,,,,EX BN LZSP NK H/F2 PROF,372.38,148.95,0,372.38,316.52,SKIPPED,372.38,372.38,316.52,316.52,316.52,169.55,182.47,182.47,SKIPPED,SKIPPED,173.01,173.01,0
3611900,975,45378,,,,,,,COLONOSCOPY DX PROF,657.85,263.14,0,657.85,559.17,SKIPPED,657.85,657.85,559.17,559.17,559.17,201.07,322.35,322.35,SKIPPED,SKIPPED,205.17,205.17,0
3611901,975,37609,,,,,,,BX/LIG ARTERY TERMPOR PROF,494.52,197.81,0,494.52,420.34,SKIPPED,494.52,494.52,420.34,420.34,420.34,221.43,242.31,242.31,SKIPPED,SKIPPED,225.95,225.95,0
3611902,975,19125,,,,,,,EX BREAST LESION SNG PROF,1368.23,547.29,0,1368.23,1163,SKIPPED,1368.23,1368.23,1163,1163,1163,501.35,670.43,670.43,SKIPPED,SKIPPED,511.58,511.58,0
3611903,975,G0121,,,,,,,#COLONSCOPY SCRN PROF FEE,657.85,263.14,0,657.85,559.17,SKIPPED,657.85,657.85,559.17,559.17,559.17,201.29,322.35,322.35,SKIPPED,SKIPPED,205.4,205.4,0
3611904,975,11450,,,,,,,REMOVAL SWEAT GLAND LESION PROF,747.78,299.11,0,747.78,635.61,SKIPPED,747.78,747.78,635.61,635.61,635.61,284.58,366.41,366.41,SKIPPED,SKIPPED,290.39,290.39,0
3611905,975,11406,,,,,,,#EX BN LZ TRK AM LG PROF,735.33,294.13,0,735.33,625.03,SKIPPED,735.33,735.33,625.03,625.03,625.03,269.04,360.31,360.31,SKIPPED,SKIPPED,274.53,274.53,0
3611906,975,27327,,,,,,,REMOVAL OF THIGH LESION PROF,935.39,374.16,0,935.39,795.08,SKIPPED,935.39,935.39,795.08,795.08,795.08,343.74,458.34,458.34,SKIPPED,SKIPPED,350.75,350.75,0
3611907,975,10061,,,,,,,DRAINAGE OF SKIN ABCESS PROF,535.24,214.1,0,535.23,454.95,SKIPPED,535.23,535.23,454.95,454.95,454.95,200.8,262.27,262.27,SKIPPED,SKIPPED,204.9,204.9,0
3611908,975,15852,,,,,,,DRESSING CHANGE NOT FOR BURN PROF,142.72,57.09,0,142.72,121.31,SKIPPED,142.72,142.72,121.31,121.31,121.31,50.44,69.93,69.93,0,42.82,51.47,51.47,0
3611909,975,47563,,,,,,,LAPARO CHOLECYSTEMOMY PROF,2148.72,859.49,0,2148.72,1826.41,SKIPPED,2148.72,2148.72,1826.41,1826.41,1826.41,779.68,1052.87,1052.87,SKIPPED,SKIPPED,795.59,795.59,0
3611910,975,10060,,,,,,,DRAINAGE OF SKIN ABCESS PROF,287.06,114.82,0,287.06,244,SKIPPED,287.06,287.06,244,244,244,115.12,140.66,140.66,0,86.12,117.47,117.47,0
3611911,360,22551,,,,,,,NECK SPINE FUSE & REMOVE BEL C2,17813.9,7125.56,1051.35,17813.9,15141.82,SKIPPED,17813.9,17813.9,15141.82,15141.82,15141.82,7506.78,1051.35,1051.35,SKIPPED,SKIPPED,7659.98,7659.98,15141.82
3611912,360,22845,,,,,,,INSERT SPINE FIXATION DEVICE,6002.16,2400.86,0,5101.84,5101.84,SKIPPED,0,0,5101.84,5101.84,5101.84,2529.31,0,0,0,1800.65,2580.93,2580.93,5101.84
3611913,360,20931,,,,,,,SP BONE ALGRFT STRUCT ADD-ON,7994.08,3197.63,0,6794.97,6794.97,SKIPPED,0,0,6794.97,6794.97,6794.97,3368.7,0,0,0,2398.22,3437.45,3437.45,6794.97
3611914,360,22842,,,,,,,INSERT SPINE FIXAION DEVICE,6106.01,2442.4,0,5190.11,5190.11,SKIPPED,0,0,5190.11,5190.11,5190.11,2573.07,0,0,0,1831.8,2625.58,2625.58,5190.11
3611915,360,63042,,,,,,,LAMINOTOMY SINGLE LUMBAR,18890.52,7556.21,1051.35,18890.52,16056.94,SKIPPED,18890.52,18890.52,16056.94,16056.94,16056.94,7960.46,1051.35,1051.35,SKIPPED,SKIPPED,8122.92,8122.92,16056.94
3611916,360,22851,,,,,,,APPLY SPINE PROSTH DEVICE,7717.74,3087.1,0,6560.08,6560.08,SKIPPED,5865.48,5865.48,6560.08,6560.08,6560.08,3252.26,0,0,0,2315.32,3318.63,3318.63,6560.08
3611917,360,63044,,,,,,,LAMINOTOMY ADDL LUMBAR,5550.55,2220.22,0,4717.97,4717.97,SKIPPED,0,0,4717.97,4717.97,4717.97,2339.01,0,0,0,1665.16,2386.74,2386.74,4717.97
3611918,360,20975,,,,,,,ELECTRICAL BONE STIMULATION,7725.66,3090.26,0,6566.81,6566.81,SKIPPED,0,0,6566.81,6566.81,6566.81,3255.59,0,0,0,2317.7,3322.03,3322.03,6566.81
3611919,360,38220,,,,,,,BONE MARROW ASPIRATION,1492.33,596.93,97.87,1268.48,1268.48,SKIPPED,591.66,591.66,1268.48,1268.48,1268.48,628.87,97.87,97.87,SKIPPED,SKIPPED,641.7,641.7,1268.48
3611920,360,20930,,,,,,,SP BONE ALGRFT MORSEL ADD-ON,6829.01,2731.6,0,5804.66,5804.66,SKIPPED,0,0,5804.66,5804.66,5804.66,2877.74,0,0,0,2048.7,2936.47,2936.47,5804.66
3611921,975,44389,,,,,,,COLONOSCOPY WITH BIOPSY PROF,563.1,225.24,0,563.1,478.64,SKIPPED,563.1,563.1,478.64,478.64,478.64,187,275.92,275.92,SKIPPED,SKIPPED,190.82,190.82,0
3611923,975,G0105,,,,,,,COLORECTAL SCRN; HIRISK IND PROF,657.85,263.14,0,657.85,559.17,SKIPPED,657.85,657.85,559.17,559.17,559.17,201.07,322.35,322.35,SKIPPED,SKIPPED,205.17,205.17,0
3611925,975,45380,,,,,,,COLONOSCOPY AND BIOPSY PROF,786.65,314.66,0,786.65,668.65,SKIPPED,786.65,786.65,668.65,668.65,668.65,218.58,385.46,385.46,SKIPPED,SKIPPED,223.04,223.04,0
3611926,975,G0121,,,,,,,COLON CA SCRN NOT HIRISK IND PROF,657.85,263.14,0,657.85,559.17,SKIPPED,657.85,657.85,559.17,559.17,559.17,201.29,322.35,322.35,SKIPPED,SKIPPED,205.4,205.4,0
3611927,975,49505,,,,,,,PRP I/HERN INIT RECUD>5YR PROF,1560.68,624.27,0,1560.68,1326.58,SKIPPED,1560.68,1560.68,1326.58,1326.58,1326.58,568.6,764.73,764.73,SKIPPED,SKIPPED,580.2,580.2,0
3611928,975,11626,,,,,,,EXC S/N/H/F/G MAL MRG>4CM PROF,890.37,356.15,0,890.37,756.81,SKIPPED,890.37,890.37,756.81,756.81,756.81,317.04,436.28,436.28,SKIPPED,SKIPPED,323.51,323.51,0
3611929,975,15100,,,,,,,SKIN SPLT GRFT TRNK/ARM/LEG PROF,2159.43,863.77,0,2159.43,1835.52,SKIPPED,2159.43,2159.43,1835.52,1835.52,1835.52,777.2,1058.12,1058.12,SKIPPED,SKIPPED,793.06,793.06,0
3611930,975,49520,,,,,,,REREPAIR ING HERNIA REDUCE PROF,1895.85,758.34,0,1895.85,1611.47,SKIPPED,1895.85,1895.85,1611.47,1611.47,1611.47,688.07,928.97,928.97,SKIPPED,SKIPPED,702.11,702.11,0
3611931,360,46608,,,,,,,ANOSCOPY REMOVE FOR BODY,3999.26,1599.7,269.69,3399.37,3399.37,SKIPPED,3372.4,3372.4,3399.37,3399.37,3399.37,1685.29,269.69,269.69,SKIPPED,SKIPPED,1719.68,1719.68,3399.37
3611932,975,46608,,,,,,,ANOSCOPY REMOVE FOR BODY PROF,245.11,98.04,0,245.11,208.34,SKIPPED,245.11,245.11,208.34,208.34,208.34,90.62,120.1,120.1,SKIPPED,SKIPPED,92.47,92.47,0
3611933,360,22830,,,,,,,EXPLORATION OF SPINAL FUSION,8381.77,3352.71,0,7124.5,7124.5,SKIPPED,4023.11,4023.11,7124.5,7124.5,7124.5,3532.08,0,0,0,2514.53,3604.16,3604.16,7124.5
3611934,975,46604,,,,,,,ANOSCOPY WITH DILATION PROF,201.69,80.68,0,201.69,171.44,SKIPPED,201.69,201.69,171.44,171.44,171.44,72.06,98.83,98.83,SKIPPED,SKIPPED,73.53,73.53,0
3611935,360,63047,,,,,,,REMOVE SPINE LAMINA 1 LMBR,17556.47,7022.59,1051.35,17556.47,14923,SKIPPED,17556.47,17556.47,14923,14923,14923,7398.29,1051.35,1051.35,SKIPPED,SKIPPED,7549.28,7549.28,14923
3611936,360,22840,,,,,,,INSERT SPINE FIXATION DEVICE,6011.4,2404.56,0,5109.69,5109.69,SKIPPED,0,0,5109.69,5109.69,5109.69,2533.2,0,0,0,1803.42,2584.9,2584.9,5109.69
3611937,975,22552,,,,,,,ADDL NECK SPINE FUSION,956.67,382.67,0,813.17,813.17,SKIPPED,0,0,813.17,813.17,813.17,417.73,468.77,468.77,0,287,426.26,426.26,0
3611938,360,63048,,,,,,,REMOVE SPINAL LAMINA ADD-ON,8847.32,3538.93,0,7520.22,7520.22,SKIPPED,0,0,7520.22,7520.22,7520.22,3728.26,0,0,0,2654.2,3804.35,3804.35,7520.22
3611939,360,20936,,,,,,,SP BONE AGRFT LOCAL ADD-ON,5867.22,2346.89,0,4987.14,4987.14,SKIPPED,0,0,4987.14,4987.14,4987.14,2472.44,0,0,0,1760.17,2522.9,2522.9,4987.14
3611940,360,20975,,,,,,,ELECTRICAL BONE STIMULATION,7725.66,3090.26,0,6566.81,6566.81,SKIPPED,0,0,6566.81,6566.81,6566.81,3255.59,0,0,0,2317.7,3322.03,3322.03,6566.81
3611941,975,29898,,,,,,,ANKLE ARTHROSCOPY/SURGERY PROF,1714.25,685.7,0,1714.25,1457.11,SKIPPED,1714.25,1714.25,1457.11,1457.11,1457.11,616.08,839.98,839.98,SKIPPED,SKIPPED,628.65,628.65,0
3611942,360,21554,,,,,,,EXC NECK TUMOR DEP 5CM/>,10423.27,4169.31,582.36,10423.27,8859.78,SKIPPED,10423.27,10423.27,8859.78,8859.78,8859.78,4392.37,582.36,582.36,SKIPPED,SKIPPED,4482.01,4482.01,8859.78
3611943,975,21554,,,,,,,EXC NECK TUMOR DEEP 5CM/> PROF,2195.09,878.04,0,2195.09,1865.83,SKIPPED,2195.09,2195.09,1865.83,1865.83,1865.83,795.2,1075.59,1075.59,SKIPPED,SKIPPED,811.43,811.43,0
3611944,360,10140,,,,,,,DRAINANGE OF HEMATOMA/ FLUID,5474.56,2189.82,88.06,4653.38,4653.38,SKIPPED,497.61,497.61,4653.38,4653.38,4653.38,2306.98,88.06,88.06,SKIPPED,SKIPPED,2354.06,2354.06,4653.38
3611945,975,10140,,,,,,,DRAINAGE OF HEMATOMA/FLUID PROF,355.26,142.1,0,355.26,301.97,SKIPPED,355.26,355.26,301.97,301.97,301.97,128.98,174.08,174.08,SKIPPED,SKIPPED,131.61,131.61,0
3611946,360,97605,,,,,,,NEG PRESS WOUND TX >/=50CM,443.7,177.48,0,443.7,377.14,SKIPPED,443.7,443.7,377.14,377.14,377.14,186.97,0,0,0,133.11,190.79,190.79,377.14
3611947,975,97605,,,,,,,NEG PRESS WOUND TX >/=50CM PROF,82.16,32.86,0,82.16,69.84,SKIPPED,82.16,82.16,69.84,69.84,69.84,27.87,40.26,40.26,0,24.65,28.44,28.44,0
3611948,360,22846,,,,,,,INSERT SPINE FIXATION DEVICE,5935.42,2374.17,0,5045.11,5045.11,SKIPPED,3777.63,3777.63,5045.11,5045.11,5045.11,2501.19,0,0,0,1780.63,2552.23,2552.23,5045.11
3611949,975,21501,,,,,,,DRAIN NECK/CHEST LESION PROF,965.02,386.01,0,965.02,820.27,SKIPPED,965.02,965.02,820.27,820.27,820.27,364.3,472.86,472.86,SKIPPED,SKIPPED,371.73,371.73,0
3611950,975,11402,,,,,,,#EXC BN LZ TRK AM LG 1 PROF,339.72,135.89,0,339.72,288.76,SKIPPED,339.72,339.72,288.76,288.76,288.76,126.29,166.46,166.46,SKIPPED,SKIPPED,128.87,128.87,0
3611951,975,44970,,,,,,,LAPAROSCOPY APPENDECTOMY PROF,1804.18,721.67,0,1804.18,1533.55,SKIPPED,1804.18,1804.18,1533.55,1533.55,1533.55,653.96,884.05,884.05,0,541.25,667.31,667.31,0
3611952,975,11624,,,,,,,EXC S/N/H/F/G MAL MRG 3.1-4 PROF,724.46,289.78,0,724.46,615.79,SKIPPED,724.46,724.46,615.79,615.79,615.79,258.36,354.99,354.99,SKIPPED,SKIPPED,263.63,263.63,0
3611953,975,11643,,,,,,,EXC F/E/E/N/L MAL+MRG 2.1-3 PROF,696.58,278.63,0,696.58,592.09,SKIPPED,696.58,696.58,592.09,592.09,592.09,247.1,341.32,341.32,SKIPPED,SKIPPED,252.14,252.14,0
3611954,975,15120,,,,,,,SKIN SPLT A-GRAFT FAC/NECK/HF/G PROF,2119.1,847.64,0,2119.1,1801.24,SKIPPED,2119.1,2119.1,1801.24,1801.24,1801.24,750.18,1038.36,1038.36,SKIPPED,SKIPPED,765.49,765.49,0
3611955,975,45330,,,,,,,DIAGNOSTIC SIGMOIDOSCOPY PROF,192.31,76.92,0,192.31,163.46,SKIPPED,192.31,192.31,163.46,163.46,163.46,60.98,94.23,94.23,SKIPPED,SKIPPED,62.22,62.22,0
3611956,975,47600,,,,,,,REMOVAL OF GALLBLADDER PROF,3219.06,1287.62,0,3219.06,2736.2,SKIPPED,3219.06,3219.06,2736.2,2736.2,2736.2,1158.31,1577.34,1577.34,0,965.72,1181.95,1181.95,0
3611957,360,64721,,,,,,,CARPEL TUNNEL SURGERY,7300.58,2920.23,510.13,7300.58,6205.49,SKIPPED,7300.58,7300.58,6205.49,6205.49,6205.49,3076.46,510.13,510.13,SKIPPED,SKIPPED,3139.25,3139.25,6205.49
3611958,360,63046,,,,,,,REMOVE SPINE LAMINA 1 THRC,16783.77,6713.51,1051.35,16783.77,14266.2,SKIPPED,16783.77,16783.77,14266.2,14266.2,14266.2,7072.68,1051.35,1051.35,SKIPPED,SKIPPED,7217.02,7217.02,14266.2
3611959,975,11771,,,,,,,REMOVE PILONIDAL CYST EXTEN PROF,1293.86,517.54,0,1293.86,1099.78,SKIPPED,1293.86,1293.86,1099.78,1099.78,1099.78,489.52,633.99,633.99,SKIPPED,SKIPPED,499.51,499.51,0
3611960,360,63663,,,,,,,REVISE SPINE ELTRD PREQ ARAY,19833.84,7933.54,1051.35,19833.84,16858.76,SKIPPED,19833.84,19833.84,16858.76,16858.76,16858.76,8357.98,1051.35,1051.35,SKIPPED,SKIPPED,8528.55,8528.55,16858.76
3611961,360,64718,,,,,,,REVISE ULNAR NERVE AT ELBOW,9140.4,3656.16,510.13,7769.34,7769.34,SKIPPED,7649.88,7649.88,7769.34,7769.34,7769.34,3851.76,510.13,510.13,SKIPPED,SKIPPED,3930.37,3930.37,7769.34
3611962,278,,,,,,,,BOSTON SCIENTIFIC OR CABLE SC-4100A,750,300,0,637.5,637.5,SKIPPED,570,570,637.5,637.5,637.5,316.05,367.5,367.5,0,225,322.5,322.5,637.5
3611963,278,,,,,,,,BOSTON SCIENTIFIC TUNNELING TOOL SC-4252,750,300,0,637.5,637.5,SKIPPED,570,570,637.5,637.5,637.5,316.05,367.5,367.5,0,225,322.5,322.5,637.5
3611964,278,,,,,,,,BOSTON SCIENTIFIC 25CM EXT KIT SC-313825,2650,1060,0,2252.5,2252.5,SKIPPED,2014,2014,2252.5,2252.5,2252.5,1116.71,1298.5,1298.5,0,795,1139.5,1139.5,2252.5
3611965,975,11646,,,,,,,EXC F/E/E/N/L MAL+MRG. >4CM PROF,1200.72,480.29,0,1200.72,1020.61,SKIPPED,1200.72,1200.72,1020.61,1020.61,1020.61,424.08,588.35,588.35,SKIPPED,SKIPPED,432.73,432.73,0
3611966,975,57105,,,,,,,BIOPSY OF VAGINA PROF,380.06,152.02,0,380.06,323.05,SKIPPED,380.06,380.06,323.05,323.05,323.05,161.92,186.23,186.23,SKIPPED,SKIPPED,165.22,165.22,0
3611967,975,11421,,,,,,,EXC H/F/NK SP B9 MARG 0.6-1 PROF,330.34,132.14,0,330.34,280.79,SKIPPED,330.34,330.34,280.79,280.79,280.79,119.31,161.87,161.87,SKIPPED,SKIPPED,121.74,121.74,0
3611968,975,45905,,,,,,,DILATION OF ANAL SPHINCTER PROF,484.58,193.83,0,484.58,411.89,SKIPPED,484.58,484.58,411.89,411.89,411.89,185.17,237.44,237.44,SKIPPED,SKIPPED,188.95,188.95,0
3611969,975,46250,,,,,,,REMOVE EXT HEM GROUPS 2+ PROF,896.94,358.78,0,896.94,762.4,SKIPPED,896.94,896.94,762.4,762.4,762.4,351.64,439.5,439.5,SKIPPED,SKIPPED,358.82,358.82,0
3611970,360,29881,,,,,,,ARTHROSCOPIC KNEE W/MENISECTOMY MED/LAT,9879.87,3951.95,867.38,9879.87,8397.89,SKIPPED,9879.87,9879.87,8397.89,8397.89,8397.89,4163.37,867.38,867.38,SKIPPED,SKIPPED,4248.34,4248.34,8397.89
3611971,975,11043,,,,,,,DEB MUSC/FASCIA 20 SQ CM/<,373.46,149.38,0,373.46,317.44,SKIPPED,373.46,373.46,317.44,317.44,317.44,166.79,183,183,SKIPPED,SKIPPED,170.19,170.19,0
3611972,360,29826,,,,,,,SHOULDER SCOPE BONE SHAVING,5565.68,2226.27,0,4730.83,4730.83,SKIPPED,0,0,4730.83,4730.83,4730.83,2345.38,0,0,0,1669.7,2393.24,2393.24,4730.83
3611973,361,29877,,,,,,,ARTHROSCOPY KNEE W DEBRIDMENT,10290.6,4116.24,867.38,10290.6,8747.01,SKIPPED,10290.6,10290.6,8747.01,8747.01,8747.01,4336.46,867.38,867.38,SKIPPED,SKIPPED,4424.96,4424.96,8747.01
3611974,360,29880,,,,,,,ARTHROSCOPY KNEE,10048.32,4019.33,867.38,10048.32,8541.07,SKIPPED,10048.32,10048.32,8541.07,8541.07,8541.07,4234.36,867.38,867.38,SKIPPED,SKIPPED,4320.78,4320.78,8541.07
3611975,360,29827,,,,,,,ARTHROSCOPY SHOLDER ROTATOR CUFF REPAIR,11654.16,4661.66,1051.35,11654.16,9906.04,SKIPPED,11654.16,11654.16,9906.04,9906.04,9906.04,4911.06,1051.35,1051.35,SKIPPED,SKIPPED,5011.29,5011.29,9906.04
3611977,360,29824,,,,,,,ARTHORSCOPY SHOULDER DISTAL CLAVICULECTO,5583.38,2233.35,867.38,5583.38,4745.87,SKIPPED,5583.38,5583.38,4745.87,4745.87,4745.87,2352.83,867.38,867.38,SKIPPED,SKIPPED,2400.85,2400.85,4745.87
3611978,360,27447,,,,,,,TOTAL KNEE ARTHROPLASTY,16988.15,6795.26,0,16988.15,14439.93,SKIPPED,16988.15,16988.15,14439.93,14439.93,14439.93,7158.8,0,0,0,5096.44,7304.9,7304.9,14439.93
3611980,360,27130,,,,,,,ARTHROPLASTY TOTAL HIP,18846.14,7538.46,0,16019.22,16019.22,SKIPPED,6675.65,6675.65,16019.22,16019.22,16019.22,7941.76,0,0,0,5653.84,8103.84,8103.84,16019.22
3611981,360,29888,,,,,,,ACL RECONSTRUCTION KNEE GRAFT,16045.22,6418.09,1051.35,16045.22,13638.44,SKIPPED,16045.22,16045.22,13638.44,13638.44,13638.44,6761.45,1051.35,1051.35,SKIPPED,SKIPPED,6899.44,6899.44,13638.44
3611982,360,29873,,,,,,,ARTHROSCOPY KNEE W/LATERAL RELEASE,8539.77,3415.91,867.38,8539.77,7258.8,SKIPPED,8539.77,8539.77,7258.8,7258.8,7258.8,3598.66,867.38,867.38,SKIPPED,SKIPPED,3672.1,3672.1,7258.8
3611983,278,,,,,,,,6.5MM CANNULATED SCREW,1350,540,0,1147.5,1147.5,SKIPPED,1026,1026,1147.5,1147.5,1147.5,568.89,661.5,661.5,0,405,580.5,580.5,1147.5
3611984,278,,,,,,,,2.8 MM GUIDE WIRE,153,61.2,0,130.05,130.05,SKIPPED,116.28,116.28,130.05,130.05,130.05,64.47,74.97,74.97,0,45.9,65.79,65.79,130.05
3611985,975,43251,,,,,,,EGD W/ RMVE TUMORS SN,483.03,193.21,0,483.03,410.58,SKIPPED,483.03,483.03,410.58,410.58,410.58,213.73,236.68,236.68,SKIPPED,SKIPPED,218.09,218.09,0
3611986,975,29888,,,,,,,ACL RECONSTRUCTION KNEE GRAFT PROF,2722.8,1089.12,0,2722.8,2314.38,SKIPPED,2722.8,2722.8,2314.38,2314.38,2314.38,1064.35,1334.17,1334.17,SKIPPED,SKIPPED,1086.07,1086.07,0
3611987,975,29824,,,,,,,ARTHORSCOPY SHOULDER DISTAL CLAVI. PROF,1935.52,774.21,0,1935.52,1645.19,SKIPPED,1935.52,1935.52,1645.19,1645.19,1645.19,740.52,948.4,948.4,SKIPPED,SKIPPED,755.63,755.63,0
3611988,975,27130,,,,,,,ARTHROPLASTY TOTAL HIP PROF,3918.16,1567.26,0,3918.16,3330.44,SKIPPED,3918.16,3918.16,3330.44,3330.44,3330.44,1392.47,1919.9,1919.9,0,1175.45,1420.89,1420.89,0
3611989,975,29881,,,,,,,ARTHROSCOPIC KNEE W/ MENISEC MED/LAT PRO,1548.35,619.34,0,1548.35,1316.1,SKIPPED,1548.35,1548.35,1316.1,1316.1,1316.1,592.34,758.69,758.69,SKIPPED,SKIPPED,604.43,604.43,0
3611990,975,29880,,,,,,,ARTHROSCOPY KNEE PROF,1610.4,644.16,0,1610.4,1368.84,SKIPPED,1610.4,1610.4,1368.84,1368.84,1368.84,614.69,789.1,789.1,SKIPPED,SKIPPED,627.23,627.23,0
3611991,975,29877,,,,,,,ARTHROSCOPY KNEE W/ DEBRIDMENT PROF,2142.28,856.91,0,2142.28,1820.94,SKIPPED,2142.28,2142.28,1820.94,1820.94,1820.94,678.93,1049.72,1049.72,SKIPPED,SKIPPED,692.79,692.79,0
3611992,975,29873,,,,,,,ARTHROSCOPY KNEE W/ LAT RELEASE PROF,1492.2,596.88,0,1492.2,1268.37,SKIPPED,1492.2,1492.2,1268.37,1268.37,1268.37,589.26,731.18,731.18,SKIPPED,SKIPPED,601.29,601.29,0
3611993,975,29827,,,,,,,ARTHROSCOPY SHOULDER ROTATOR CUFF PROF,3087.85,1235.14,0,3087.85,2624.67,SKIPPED,3087.85,3087.85,2624.67,2624.67,2624.67,1164.16,1513.05,1513.05,SKIPPED,SKIPPED,1187.92,1187.92,0
3611996,975,29826,,,,,,,SHOULDER SCOPE BONE SHAVING PROF,511.26,204.5,0,434.57,434.57,SKIPPED,0,0,434.57,434.57,434.57,186.54,250.52,250.52,0,153.38,190.35,190.35,0
3611997,975,27447,,,,,,,TOTAL KNEE ARTHROPLASTY PROF,3915.22,1566.09,0,3915.22,3327.94,SKIPPED,3915.22,3915.22,3327.94,3327.94,3327.94,1391.14,1918.46,1918.46,0,1174.57,1419.53,1419.53,0
3611998,975,25605,,,,,,,TREAT FRACTURE RADIUS/ULNA PROF,1461.24,584.5,0,1461.24,1242.05,SKIPPED,1461.24,1461.24,1242.05,1242.05,1242.05,563.95,716.01,716.01,SKIPPED,SKIPPED,575.46,575.46,0
3611999,360,25605,,,,,,,TREAT FRACTURE RADIUS/ULNA,2250.29,900.12,510.13,2250.29,1912.75,SKIPPED,2250.29,2250.29,1912.75,1912.75,1912.75,948.27,510.13,510.13,SKIPPED,SKIPPED,967.62,967.62,1912.75
3612000,360,27236,,,,,,,TRT FEMORAL FX,21977.17,8790.87,0,18680.59,18680.59,SKIPPED,5881.26,5881.26,18680.59,18680.59,18680.59,9261.18,0,0,0,6593.15,9450.18,9450.18,18680.59
3612001,975,27236,,,,,,,TRT FEMORAL FX PROF,3442.45,1376.98,0,3442.45,2926.08,SKIPPED,3442.45,3442.45,2926.08,2926.08,2926.08,1296.21,1686.8,1686.8,0,1032.74,1322.66,1322.66,0
3612003,270,,,,,,,,KNEE ARTHROSCOPE PACK,147.14,58.86,0,125.07,125.07,SKIPPED,111.83,111.83,125.07,125.07,125.07,62,72.1,72.1,0,44.14,63.27,63.27,125.07
3612004,270,,,,,,,,SHOULDER ARTHROSCOPE PACK,191.86,76.74,0,163.08,163.08,SKIPPED,145.81,145.81,163.08,163.08,163.08,80.85,94.01,94.01,0,57.56,82.5,82.5,163.08
3612005,270,,,,,,,,TOTAL JOINT PACK,218.26,87.3,0,185.52,185.52,SKIPPED,165.88,165.88,185.52,185.52,185.52,91.97,106.95,106.95,0,65.48,93.85,93.85,185.52
3612006,270,,,,,,,,MINOR PACK,124.96,49.98,0,106.22,106.22,SKIPPED,94.97,94.97,106.22,106.22,106.22,52.66,61.23,61.23,0,37.49,53.73,53.73,106.22
3612007,270,,,,,,,,GREAT WHITE 4.2MM,131.04,52.42,0,111.38,111.38,SKIPPED,99.59,99.59,111.38,111.38,111.38,55.22,64.21,64.21,0,39.31,56.35,56.35,111.38
3612008,270,,,,,,,,OVAL BURR 5MM,128.96,51.58,0,109.62,109.62,SKIPPED,98.01,98.01,109.62,109.62,109.62,54.34,63.19,63.19,0,38.69,55.45,55.45,109.62
3612009,270,,,,,,,,UNIVERSAL CANNULA SET,39.52,15.81,0,33.59,33.59,SKIPPED,30.04,30.04,33.59,33.59,33.59,16.65,19.36,19.36,0,11.86,16.99,16.99,33.59
3612010,270,,,,,,,,ORTHO PUMP TUBING,108,43.2,0,91.8,91.8,SKIPPED,82.08,82.08,91.8,91.8,91.8,45.51,52.92,52.92,0,32.4,46.44,46.44,91.8
3612011,270,,,,,,,,CHIN & HEAD STRAP,30,12,0,25.5,25.5,SKIPPED,22.8,22.8,25.5,25.5,25.5,12.64,14.7,14.7,0,9,12.9,12.9,25.5
3612012,270,,,,,,,,SM-LG ABDUCTOR PILLOW,60,24,0,51,51,SKIPPED,45.6,45.6,51,51,51,25.28,29.4,29.4,0,18,25.8,25.8,51
3612015,278,,,,,,,,COBALT HV BONE CEMENT 40G,387.5,155,0,329.38,329.38,SKIPPED,294.5,294.5,329.38,329.38,329.38,163.3,189.88,189.88,0,116.25,166.63,166.63,329.38
3612017,278,,,,,,,,COBALT GMV BONE CEMENT 40G,810,324,0,688.5,688.5,SKIPPED,615.6,615.6,688.5,688.5,688.5,341.33,396.9,396.9,0,243,348.3,348.3,688.5
3612018,278,,,,,,,,GRAFT FOR ACL ANTERIOR,4405,1762,0,3744.25,3744.25,SKIPPED,3347.8,3347.8,3744.25,3744.25,3744.25,1856.27,2158.45,2158.45,0,1321.5,1894.15,1894.15,3744.25
3612019,278,,,,,,,,GRAFT for ACL POSTERIOR,4405,1762,0,3744.25,3744.25,SKIPPED,3347.8,3347.8,3744.25,3744.25,3744.25,1856.27,2158.45,2158.45,0,1321.5,1894.15,1894.15,3744.25
3612020,278,,,,,,,,DVR Plate STD,1888,755.2,0,1604.8,1604.8,SKIPPED,1434.88,1434.88,1604.8,1604.8,1604.8,795.6,925.12,925.12,0,566.4,811.84,811.84,1604.8
3612021,270,,,,,,,,2.0 PEGS(all lenghts),164,65.6,0,139.4,139.4,SKIPPED,124.64,124.64,139.4,139.4,139.4,69.11,80.36,80.36,0,49.2,70.52,70.52,139.4
3612022,278,,,,,,,,3.5 SCREW,205,82,0,174.25,174.25,SKIPPED,155.8,155.8,174.25,174.25,174.25,86.39,100.45,100.45,0,61.5,88.15,88.15,174.25
3612023,278,,,,,,,,2.5 PARTIAL PEG,205,82,0,174.25,174.25,SKIPPED,155.8,155.8,174.25,174.25,174.25,86.39,100.45,100.45,0,61.5,88.15,88.15,174.25
3612024,975,19300,,,,,,,REMOVAL OF BREAS TISSUE PROF,1164.42,465.77,0,1164.42,989.76,SKIPPED,1164.42,1164.42,989.76,989.76,989.76,472.22,570.57,570.57,SKIPPED,SKIPPED,481.86,481.86,0
3612025,975,28055,,,,,,,NEURECTOMY PROF,1099.69,439.88,0,1099.69,934.74,SKIPPED,1099.69,1099.69,934.74,934.74,934.74,420.63,538.85,538.85,SKIPPED,SKIPPED,429.21,429.21,0
3612026,975,20220,,,,,,,BONE BIOPSY TROCAR/NEEDLE PROF,173.84,69.54,0,173.84,147.76,SKIPPED,173.84,173.84,147.76,147.76,147.76,95.48,85.18,85.18,SKIPPED,SKIPPED,97.43,97.43,0
3612027,975,28035,,,,,,,DECOMPRESSION OF TIBIA PROF,1034.83,413.93,0,1034.83,879.61,SKIPPED,1034.83,1034.83,879.61,879.61,879.61,389.88,507.07,507.07,SKIPPED,SKIPPED,397.84,397.84,0
3612028,360,92960,,,,,,,CARDIOVERSION EXTERN,1205.28,482.11,0,1205.28,1024.49,SKIPPED,1205.28,1205.28,1024.49,1024.49,1024.49,507.9,0,0,0,361.58,518.27,518.27,1024.49
3612029,975,92960,,,,,,,CARDIOVERSION EXTERN PROF,339.84,135.94,0,339.84,288.86,SKIPPED,339.84,339.84,288.86,288.86,288.86,119.18,166.52,166.52,0,101.95,121.61,121.61,0
3612030,975,19126,,,,,,,EX BREAST LESION EA ADD PROF,387.02,154.81,0,328.97,328.97,SKIPPED,0,0,328.97,328.97,328.97,172.24,189.64,189.64,0,116.11,175.75,175.75,0
3612031,975,24105,,,,,,,EX BURSA OLECRANON PROF,986.2,394.48,0,986.2,838.27,SKIPPED,986.2,986.2,838.27,838.27,838.27,396.17,483.24,483.24,SKIPPED,SKIPPED,404.26,404.26,0
3612032,975,21931,,,,,,,EXC BACK LES SC=3 CM PROF,1340.1,536.04,0,1340.1,1139.08,SKIPPED,1340.1,1340.1,1139.08,1139.08,1139.08,510.97,656.65,656.65,SKIPPED,SKIPPED,521.4,521.4,0
3612033,360,63685,,,,,,,INSERTION/REPLACE SPINAL NEUROSTIMULATOR,12879,5151.6,1051.35,12879,10947.15,SKIPPED,12879,12879,10947.15,10947.15,10947.15,5427.21,1051.35,1051.35,SKIPPED,SKIPPED,5537.97,5537.97,10947.15
3612034,360,63663,,,,,,,REVISE SPINE ELTRD PREQ ARAY,14090.58,5636.23,1051.35,14090.58,11976.99,SKIPPED,14090.58,14090.58,11976.99,11976.99,11976.99,5937.77,1051.35,1051.35,SKIPPED,SKIPPED,6058.95,6058.95,11976.99
3612035,975,11403,,,,,,,# EX RN L2 TRK AM LG2 PROF,416.65,166.66,0,416.65,354.15,SKIPPED,416.65,416.65,354.15,354.15,354.15,161.63,204.16,204.16,SKIPPED,SKIPPED,164.93,164.93,0
3612036,975,12031,,,,,,,"LAYER CLS SCALP, AXI, T PROF",365.81,146.32,0,365.81,310.94,SKIPPED,365.81,365.81,310.94,310.94,310.94,164.52,179.25,179.25,SKIPPED,SKIPPED,167.88,167.88,0
3612037,360,49656,,,,,,,LAP INC HERNIA REPAIR REC,17381.05,6952.42,1051.35,17381.05,14773.89,SKIPPED,17381.05,17381.05,14773.89,14773.89,14773.89,7324.37,1051.35,1051.35,SKIPPED,SKIPPED,7473.85,7473.85,14773.89
3612038,975,49656,,,,,,,LAP INC HERNIA REPAIR REC PROF,2460.83,984.33,0,2460.83,2091.71,SKIPPED,2460.83,2460.83,2091.71,2091.71,2091.71,993.27,1205.81,1205.81,SKIPPED,SKIPPED,1013.54,1013.54,0
3612039,975,11446,,,,,,,# EX BN LZ FC EAR >4 PROF,935.27,374.11,0,935.27,794.98,SKIPPED,935.27,935.27,794.98,794.98,794.98,348.62,458.28,458.28,SKIPPED,SKIPPED,355.73,355.73,0
3612040,975,19281,,,,,,,PERG DEVICE BREAST 1ST IMAG PROF,299.91,119.96,0,299.91,254.92,SKIPPED,299.91,299.91,254.92,254.92,254.92,108.93,146.96,146.96,0,89.97,111.15,111.15,0
3612041,360,33208,,,,,,,INSRT HEART PM ATRIAL & VENT,25573.84,10229.54,1051.35,25573.84,21737.76,SKIPPED,25573.84,25573.84,21737.76,21737.76,21737.76,10776.82,1051.35,1051.35,SKIPPED,SKIPPED,10996.75,10996.75,21737.76
3612042,975,43250,,,,,,,#EDG W/ TUMOR REMOVAL PROF,527.34,210.94,0,527.34,448.24,SKIPPED,527.34,527.34,448.24,448.24,448.24,184.62,258.4,258.4,SKIPPED,SKIPPED,188.39,188.39,0
3612043,975,46606,,,,,,,ANOSCOPY W/ BX SGL/MU PRO,182.93,73.17,0,182.93,155.49,SKIPPED,182.93,182.93,155.49,155.49,155.49,81.75,89.64,89.64,0,54.88,83.42,83.42,0
3612044,975,49507,,,,,,,RPR HERNIA ING 5+IN PROF,1673.77,669.51,0,1673.77,1422.7,SKIPPED,1673.77,1673.77,1422.7,1422.7,1422.7,638.47,820.15,820.15,SKIPPED,SKIPPED,651.5,651.5,0
3612045,360,45335,,,,,,,SIGMOIDOSCOPY W/ SUBMUC INJ,3023.94,1209.58,269.69,3023.94,2570.35,SKIPPED,3023.94,3023.94,2570.35,2570.35,2570.35,1274.28,269.69,269.69,SKIPPED,SKIPPED,1300.29,1300.29,2570.35
3612046,975,45335,,,,,,,SIGMOIDOSCOPY W/ SUBMUC INJ PROF,161.56,64.62,0,161.56,137.33,SKIPPED,161.56,161.56,137.33,137.33,137.33,71.97,79.16,79.16,SKIPPED,SKIPPED,73.44,73.44,0
3612047,975,44392,,,,,,,#COLONOSCOPY STOMA W/ PROF,487.26,194.9,0,487.26,414.17,SKIPPED,487.26,487.26,414.17,414.17,414.17,215.9,238.76,238.76,SKIPPED,SKIPPED,220.31,220.31,0
3612048,975,46600,,,,,,,#ANOSCOPY DIAG W / WO PROF,98.65,39.46,0,98.65,83.85,SKIPPED,98.65,98.65,83.85,83.85,83.85,44.35,48.34,48.34,0,29.6,45.26,45.26,0
3612049,360,45005,,,,,,,DRAINAGE OF RECTAL ABSCESS,5249.03,2099.61,361.12,4461.68,4461.68,SKIPPED,4447.85,4447.85,4461.68,4461.68,4461.68,2211.94,361.12,361.12,SKIPPED,SKIPPED,2257.08,2257.08,4461.68
3612050,975,45005,,,,,,,DRAINAGE OF RECTAL ABSCESS PROF,384.64,153.86,0,384.64,326.94,SKIPPED,384.64,384.64,326.94,326.94,326.94,183.5,188.47,188.47,SKIPPED,SKIPPED,187.25,187.25,0
3612051,975,44394,,,,,,,COLONSCOPY W/ RMVE T PROF,554.67,221.87,0,554.67,471.47,SKIPPED,554.67,554.67,471.47,471.47,471.47,245.83,271.79,271.79,SKIPPED,SKIPPED,250.85,250.85,0
3612052,975,28122,,,,,,,PARTIAL EXC FOOT BONE PROF,1058.76,423.5,0,1058.76,899.95,SKIPPED,1058.76,1058.76,899.95,899.95,899.95,480.65,518.79,518.79,SKIPPED,SKIPPED,490.46,490.46,0
3612053,975,28008,,,,,,,INCSION FOOT FASCIA PROF,706.57,282.63,0,706.57,600.58,SKIPPED,706.57,706.57,600.58,600.58,600.58,324.3,346.22,346.22,SKIPPED,SKIPPED,330.92,330.92,0
3612054,975,11443,,,,,,,EXC FACE-MM B9+MARG 2.1-3CM,624.9,249.96,0,624.9,531.16,SKIPPED,624.9,624.9,531.16,531.16,531.16,194.65,306.2,306.2,SKIPPED,SKIPPED,198.62,198.62,0
3612055,975,11442,,,,,,,EXC FACE-MM B9+MARG 1.1-2CM,522.77,209.11,0,522.77,444.35,SKIPPED,522.77,522.77,444.35,444.35,444.35,159.42,256.16,256.16,SKIPPED,SKIPPED,162.67,162.67,0
3612056,975,12051,,,,,,,INTMD RPR FACE/MM 2.5CM/<,410.07,164.03,0,410.07,348.56,SKIPPED,410.07,410.07,348.56,348.56,348.56,183.9,200.93,200.93,SKIPPED,SKIPPED,187.65,187.65,0
3612057,360,22901,,,,,,,EXC ABD TUM DEEP 5CM/>,8451.06,3380.42,582.36,8451.06,7183.4,SKIPPED,8451.06,8451.06,7183.4,7183.4,7183.4,3561.28,582.36,582.36,SKIPPED,SKIPPED,3633.96,3633.96,7183.4
3612058,975,22901,,,,,,,EXC ABD TUM DEEP 5CM/> PROF,1891.14,756.46,0,1891.14,1607.47,SKIPPED,1891.14,1891.14,1607.47,1607.47,1607.47,725.85,926.66,926.66,SKIPPED,SKIPPED,740.66,740.66,0
3612059,975,11424,,,,,,,EXC H-F-NK-SP B9-MARG 3.1-4,509.78,203.91,0,509.78,433.31,SKIPPED,509.78,509.78,433.31,433.31,433.31,193.33,249.79,249.79,SKIPPED,SKIPPED,197.28,197.28,0
3612060,975,28298,,,,,,,CORRECTION OF BUNION PROF,1468.61,587.44,0,1468.61,1248.32,SKIPPED,1468.61,1468.61,1248.32,1248.32,1248.32,551.08,719.62,719.62,SKIPPED,SKIPPED,562.33,562.33,0
3612061,975,38525,,,,,,,BIO/RMEV LYMPH NODES PROF,1260.38,504.15,0,1260.38,1071.32,SKIPPED,1260.38,1260.38,1071.32,1071.32,1071.32,478.06,617.59,617.59,SKIPPED,SKIPPED,487.82,487.82,0
3612062,975,49560,,,,,,,RPR HERNIA VENT RED. PROF,2136.38,854.55,0,2136.38,1815.92,SKIPPED,2136.38,2136.38,1815.92,1815.92,1815.92,800.24,1046.83,1046.83,SKIPPED,SKIPPED,816.57,816.57,0
3612063,975,28120,,,,,,,PART REMV OF ANKLE/HEEL PROF,1444.91,577.96,0,1444.91,1228.17,SKIPPED,1444.91,1444.91,1228.17,1228.17,1228.17,545.05,708.01,708.01,SKIPPED,SKIPPED,556.17,556.17,0
3612064,360,S2117,,,,,,,ARTHROERISIS SUBTALAR,4281.61,1712.64,0,4281.61,3639.37,SKIPPED,4281.61,4281.61,3639.37,3639.37,3639.37,1804.27,0,0,0,1284.48,1841.09,1841.09,3639.37
3612065,975,S2117,,,,,,,ARTHROERISIS SUBTALAR PROF,812.64,325.06,0,812.64,690.74,SKIPPED,812.64,812.64,690.74,690.74,690.74,0,398.19,398.19,0,243.79,0,0,0
3612066,975,55250,,,,,,,#VASECTOMY UNILAT/BILAT PROF,664.84,265.94,0,664.84,565.11,SKIPPED,664.84,664.84,565.11,565.11,565.11,249.67,325.77,325.77,SKIPPED,SKIPPED,254.77,254.77,0
3612067,360,45388,,,,,,,COLONOSCOPY W/ ABLATION,4580.18,1832.07,361.12,4447.85,3893.15,SKIPPED,4447.85,4447.85,3893.15,3893.15,3893.15,1930.09,361.12,361.12,SKIPPED,SKIPPED,1969.48,1969.48,3893.15
3612068,975,45388,,,,,,,COLONOSCOPY W/ ABLATION PROF,783.03,313.21,0,783.03,665.58,SKIPPED,783.03,783.03,665.58,665.58,665.58,294.5,383.68,383.68,SKIPPED,SKIPPED,300.51,300.51,0
3612069,975,21552,,,,,,,EXC NECK LES SC=3CM PROF,1285.43,514.17,0,1285.43,1092.62,SKIPPED,1285.43,1285.43,1092.62,1092.62,1092.62,486.47,629.86,629.86,SKIPPED,SKIPPED,496.4,496.4,0
3612070,360,60210,,,,,,,PARTIAL THYROID EXCISION,17634.86,7053.94,1051.35,17634.86,14989.63,SKIPPED,17634.86,17634.86,14989.63,14989.63,14989.63,7431.33,1051.35,1051.35,SKIPPED,SKIPPED,7582.99,7582.99,14989.63
3612071,975,49553,,,,,,,RPR FEM HERNIA INIT BLOCKED PROF,1743.54,697.42,0,1743.54,1482.01,SKIPPED,1743.54,1743.54,1482.01,1482.01,1482.01,687.77,854.33,854.33,SKIPPED,SKIPPED,701.81,701.81,0
3612072,360,46230,,,,,,,REMOVAL OF HEMROID TAGS,5425.25,2170.1,748.53,5425.25,4611.46,SKIPPED,5425.25,5425.25,4611.46,4611.46,4611.46,2286.2,748.53,748.53,SKIPPED,SKIPPED,2332.86,2332.86,4611.46
3612073,975,46230,,,,,,,REMOVAL OF HEMROID TAGS PROF,414.1,165.64,0,414.1,351.98,SKIPPED,414.1,414.1,351.98,351.98,351.98,188.86,202.91,202.91,SKIPPED,SKIPPED,192.71,192.71,0
3612074,975,46275,,,,,,,REMOVAL ANAL FIST INTER PROF,1536.57,614.63,0,1536.57,1306.08,SKIPPED,1536.57,1536.57,1306.08,1306.08,1306.08,465.29,752.92,752.92,SKIPPED,SKIPPED,474.79,474.79,0
3612075,975,46040,,,,,,,I&D PERIRECTAL ABSCESS PROF,1524.76,609.9,0,1524.76,1296.05,SKIPPED,1524.76,1524.76,1296.05,1296.05,1296.05,466.78,747.13,747.13,SKIPPED,SKIPPED,476.31,476.31,0
3612076,975,46270,,,,,,,TRT ANAL FISTUAL SUB PROF.,1447.98,579.19,0,1447.98,1230.78,SKIPPED,1447.98,1447.98,1230.78,1230.78,1230.78,440.58,709.51,709.51,SKIPPED,SKIPPED,449.57,449.57,0
3612077,975,28296,,,,,,,CORR BUNION W/METAT OSTEO BONE,1811.96,724.78,0,1811.96,1540.17,SKIPPED,1811.96,1811.96,1540.17,1540.17,1540.17,563.52,887.86,887.86,SKIPPED,SKIPPED,575.02,575.02,0
3612078,975,28080,,,,,,,REMOVAL OF FOOT LESION PROF,1108.13,443.25,0,1108.13,941.91,SKIPPED,1108.13,1108.13,941.91,941.91,941.91,413.03,542.98,542.98,SKIPPED,SKIPPED,421.46,421.46,0
3612079,360,44620,,,,,,,RPR BOWEL OPENING,12969.05,5187.62,0,11023.69,11023.69,SKIPPED,4285.64,4285.64,11023.69,11023.69,11023.69,5465.16,0,0,0,3890.72,5576.69,5576.69,11023.69
3612080,975,44620,,,,,,,RPR BOWEL OPENING PROF,2533.85,1013.54,0,2533.85,2153.77,SKIPPED,2533.85,2533.85,2153.77,2153.77,2153.77,936.56,1241.59,1241.59,0,760.16,955.67,955.67,0
3612083,360,44204,,,,,,,LAPARO PARTIAL COLECTOMY,9603.52,3841.41,0,8162.99,8162.99,SKIPPED,7601.33,7601.33,8162.99,8162.99,8162.99,4046.92,0,0,0,2881.06,4129.51,4129.51,8162.99
3612084,360,69436,,,,,,,CREATE EARDRUM OPENING,6050.27,2420.11,361.12,5406.36,5142.73,SKIPPED,5406.36,5406.36,5142.73,5142.73,5142.73,2549.59,361.12,361.12,SKIPPED,SKIPPED,2601.62,2601.62,5142.73
3612085,360,14040,,,,,,,TRANSFER OF TISSUE,7515.94,3006.38,582.36,7450.04,6388.55,SKIPPED,7450.04,7450.04,6388.55,6388.55,6388.55,3167.21,582.36,582.36,SKIPPED,SKIPPED,3231.85,3231.85,6388.55
3612086,975,14040,,,,,,,TRANSFER OF TISSUE PROF,2155.67,862.27,0,2155.67,1832.32,SKIPPED,2155.67,2155.67,1832.32,1832.32,1832.32,677.26,1056.28,1056.28,SKIPPED,SKIPPED,691.08,691.08,0
3612087,975,36561,,,,,,,INSERT CTRL VENOUS 5YR> PROF,1041.66,416.66,0,1041.66,885.41,SKIPPED,1041.66,1041.66,885.41,885.41,885.41,361.8,510.41,510.41,SKIPPED,SKIPPED,369.18,369.18,0
3612088,975,28288,,,,,,,PARTIAL REMOVAL OF FOOT BONE,1248.57,499.43,0,1248.57,1061.28,SKIPPED,1248.57,1248.57,1061.28,1061.28,1061.28,476.51,611.8,611.8,SKIPPED,SKIPPED,486.23,486.23,0
3612089,975,45331,,,,,,,#SIG FLEX WITH BX,175.12,70.05,0,175.12,148.85,SKIPPED,175.12,175.12,148.85,148.85,148.85,78.12,85.81,85.81,SKIPPED,SKIPPED,79.71,79.71,0
3612090,975,28234,,,,,,,INCISION OF FOOT LESION,746.16,298.46,0,746.16,634.24,SKIPPED,746.16,746.16,634.24,634.24,634.24,293.3,365.62,365.62,SKIPPED,SKIPPED,299.29,299.29,0
3612091,975,38510,,,,,,,BX /REMOVAL LYMPH NODES,1226.34,490.54,0,1226.34,1042.39,SKIPPED,1226.34,1226.34,1042.39,1042.39,1042.39,455.76,600.91,600.91,SKIPPED,SKIPPED,465.06,465.06,0
3612092,360,47480,,,,,,,INCISION OF GALLBLADDER,7682.76,3073.1,0,6530.35,6530.35,SKIPPED,4323.16,4323.16,6530.35,6530.35,6530.35,3237.52,0,0,0,2304.83,3303.59,3303.59,6530.35
3612093,975,47480,,,,,,,INCISION OF GALLBLADDER,2541.23,1016.49,0,2541.23,2160.05,SKIPPED,2541.23,2541.23,2160.05,2160.05,2160.05,952.1,1245.2,1245.2,0,762.37,971.53,971.53,0
3612094,975,47605,,,,,,,CHOLECYSTMY W/ CHOLAN PROF,3267.56,1307.02,0,3267.56,2777.43,SKIPPED,3267.56,3267.56,2777.43,2777.43,2777.43,1221.5,1601.1,1601.1,0,980.27,1246.43,1246.43,0
3612095,975,63650,,,,,,,IMPLANT NEUROELECTRODES PROF,1209.31,483.72,0,1209.31,1027.91,SKIPPED,1209.31,1209.31,1027.91,1027.91,1027.91,454.41,592.56,592.56,SKIPPED,SKIPPED,463.68,463.68,0
3612096,975,56405,,,,,,,I&D VULVA/PERINEAL ABS,256.22,102.49,0,242.82,217.79,SKIPPED,242.82,242.82,217.79,217.79,217.79,140.54,125.55,125.55,SKIPPED,SKIPPED,143.41,143.41,0
3612097,360,49440,,,,,,,PLACE GASTROSTOMY TUBE PERC.,3765.94,1506.38,414.14,3765.94,3201.05,SKIPPED,3765.94,3765.94,3201.05,3201.05,3201.05,1586.96,414.14,414.14,SKIPPED,SKIPPED,1619.35,1619.35,3201.05
3612098,975,49440,,,,,,,PLACE GASTROSTOMY TUBE PERC. PROF.,660.54,264.22,0,660.54,561.46,SKIPPED,660.54,660.54,561.46,561.46,561.46,221.01,323.66,323.66,SKIPPED,SKIPPED,225.52,225.52,0
3612099,278,,,,,,,,PERCISION M8 ADAPTER SC-9218-15,2725,1090,0,2316.25,2316.25,SKIPPED,2071,2071,2316.25,2316.25,2316.25,1148.32,1335.25,1335.25,0,817.5,1171.75,1171.75,2316.25
3612100,975,12052,,,,,,,RP IMD FC EAR 2.6-5,488.43,195.37,0,488.43,415.17,SKIPPED,488.43,488.43,415.17,415.17,415.17,216.52,239.33,239.33,SKIPPED,SKIPPED,220.94,220.94,0
3612101,975,11622,,,,,,,EX MG LZ SP NK H/F 1,494.11,197.64,0,494.11,419.99,SKIPPED,494.11,494.11,419.99,419.99,419.99,183.95,242.11,242.11,SKIPPED,SKIPPED,187.7,187.7,0
3612102,975,11606,,,,,,,EX MG LZ TRK AM LG>4CM,923.48,369.39,0,923.48,784.96,SKIPPED,923.48,923.48,784.96,784.96,784.96,343.79,452.51,452.51,SKIPPED,SKIPPED,350.81,350.81,0
3612103,975,11644,,,,,,,EX MG LZ FC EAR 3.1-4,823.77,329.51,0,823.77,700.2,SKIPPED,823.77,823.77,700.2,700.2,700.2,306.59,403.65,403.65,SKIPPED,SKIPPED,312.85,312.85,0
3612104,975,11642,,,,,,,EX MG LZ FC EAR 1.1-2,530.68,212.27,0,530.68,451.08,SKIPPED,530.68,530.68,451.08,451.08,451.08,197.74,260.03,260.03,SKIPPED,SKIPPED,201.78,201.78,0
3612105,360,19112,,,,,,,EXC BREAST DUCT FISTULA,6462.35,2584.94,807.26,6462.35,5493,SKIPPED,6462.35,6462.35,5493,5493,5493,2723.23,807.26,807.26,SKIPPED,SKIPPED,2778.81,2778.81,5493
3612106,975,19112,,,,,,,EXC BREAST DUCT FISTULA,893.71,357.48,0,893.71,759.65,SKIPPED,893.71,893.71,759.65,759.65,759.65,351.62,437.92,437.92,SKIPPED,SKIPPED,358.8,358.8,0
3612107,975,19101,,,,,,,INCIS BX BREAST,638.96,255.58,0,638.96,543.12,SKIPPED,638.96,638.96,543.12,543.12,543.12,243.33,313.09,313.09,SKIPPED,SKIPPED,248.3,248.3,0
3612110,975,45300,,,,,,,#PROCTO RIGID DX,162.56,65.02,0,162.56,138.18,SKIPPED,162.56,162.56,138.18,138.18,138.18,51.96,79.65,79.65,SKIPPED,SKIPPED,53.02,53.02,0
3612111,278,,,,,,,,ENHANCED STERRING KIT SC-4395-50,510,204,0,433.5,433.5,SKIPPED,387.6,387.6,433.5,433.5,433.5,214.91,249.9,249.9,0,153,219.3,219.3,433.5
3612112,975,28825,,,,,,,AMP TOE; INTERPHAL JNT,888.57,355.43,0,888.57,755.28,SKIPPED,888.57,888.57,755.28,755.28,755.28,190.15,435.4,435.4,SKIPPED,SKIPPED,194.03,194.03,0
3612113,975,28306,,,,,,,INCISION METATARSAL,1173.12,469.25,0,1173.12,997.15,SKIPPED,1173.12,1173.12,997.15,997.15,997.15,441.73,574.83,574.83,SKIPPED,SKIPPED,450.74,450.74,0
3612114,975,28289,,,,,,,RPR HALLUX RIGIDUS,1592.71,637.08,0,1592.71,1353.8,SKIPPED,1592.71,1592.71,1353.8,1353.8,1353.8,503.12,780.43,780.43,SKIPPED,SKIPPED,513.39,513.39,0
3612115,360,28022,,,,,,,EXPLORATION OF FOOT JOINT,7604.51,3041.8,867.38,7604.51,6463.83,SKIPPED,7604.51,7604.51,6463.83,6463.83,6463.83,3204.54,867.38,867.38,SKIPPED,SKIPPED,3269.94,3269.94,6463.83
3612116,975,28022,,,,,,,EXPLORATION OF FOOT JOINT,945.57,378.23,0,945.57,803.73,SKIPPED,945.57,945.57,803.73,803.73,803.73,358.42,463.33,463.33,SKIPPED,SKIPPED,365.73,365.73,0
3612117,360,41100,,,,,,,BX OF TONGUE,3204.72,1281.89,98.16,2724.01,2724.01,SKIPPED,547.2,547.2,2724.01,2724.01,2724.01,1350.47,98.16,98.16,SKIPPED,SKIPPED,1378.03,1378.03,2724.01
3612118,975,41100,,,,,,,BX ON TONGUE,317.74,127.1,0,317.74,270.08,SKIPPED,317.74,317.74,270.08,270.08,270.08,117.82,155.69,155.69,SKIPPED,SKIPPED,120.22,120.22,0
3612119,360,23930,,,,,,,DRAIN ARM LESION,6941.04,2776.42,582.36,6403.14,5899.88,SKIPPED,6403.14,6403.14,5899.88,5899.88,5899.88,2924.96,582.36,582.36,SKIPPED,SKIPPED,2984.65,2984.65,5899.88
3612120,975,23930,,,,,,,DRAIN ARM LESION,620.61,248.24,0,620.61,527.52,SKIPPED,620.61,620.61,527.52,527.52,527.52,234.65,304.1,304.1,SKIPPED,SKIPPED,239.44,239.44,0
3612121,975,97597,,,,,,,RMVL DEVITAL TISSUE 20cm OR LESS,57.81,23.12,0,57.81,49.14,SKIPPED,57.81,57.81,49.14,49.14,49.14,39.82,28.33,28.33,0,17.34,40.63,40.63,0
3612122,975,46610,,,,,,,"ANOSCOPY, REMOVAL OF LESION PROF",243.89,97.56,0,243.89,207.31,SKIPPED,243.89,243.89,207.31,207.31,207.31,86.91,119.51,119.51,SKIPPED,SKIPPED,88.68,88.68,0
3612129,975,27685,,,,,,,LENGTH/SHORT TENDON LEG,1283.28,513.31,0,1283.28,1090.79,SKIPPED,1283.28,1283.28,1090.79,1090.79,1090.79,510.42,628.81,628.81,SKIPPED,SKIPPED,520.84,520.84,0
3612130,975,28730,,,,,,,FUSION OF FOOT BONE,2033.33,813.33,0,2033.33,1728.33,SKIPPED,2033.33,2033.33,1728.33,1728.33,1728.33,801.66,996.33,996.33,SKIPPED,SKIPPED,818.02,818.02,0
3612131,975,44204,,,,,,,LAPARO PARTIAL COLECTOMY,4302.91,1721.16,0,4302.91,3657.47,SKIPPED,4302.91,4302.91,3657.47,3657.47,3657.47,1660.6,2108.43,2108.43,0,1290.87,1694.49,1694.49,0
3612132,975,11420,,,,,,,#EX BN LZ SP NK H/F,223.81,89.52,0,223.81,190.24,SKIPPED,223.81,223.81,190.24,190.24,190.24,90.13,109.67,109.67,SKIPPED,SKIPPED,91.97,91.97,0
3612133,975,11200,,,,,,,RMV SKIN TAG LESION<,199.82,79.93,0,199.82,169.85,SKIPPED,199.82,199.82,169.85,169.85,169.85,82.82,97.91,97.91,0,59.95,84.51,84.51,0
3612134,975,28293,,,,,,,CORRECTION OF BUNION,1981.2,792.48,0,1684.02,1684.02,SKIPPED,1505.71,1505.71,1684.02,1684.02,1684.02,791.3,970.79,970.79,0,594.36,807.45,807.45,0
3612135,975,11404,,,,,,,#EX BN LZ TRK AM LG3,444.65,177.86,0,444.65,377.95,SKIPPED,444.65,444.65,377.95,377.95,377.95,178.31,217.88,217.88,SKIPPED,SKIPPED,181.95,181.95,0
3612136,975,10080,,,,,,,DRAIN OF PILONIDAL CYST,281.43,112.57,0,281.43,239.22,SKIPPED,281.43,281.43,239.22,239.22,239.22,114.34,137.9,137.9,0,84.43,116.67,116.67,0
3612137,360,49653,,,,,,,LAP VENT/ABD HERN PROC COMP,15457.07,6182.83,1051.35,15457.07,13138.51,SKIPPED,15457.07,15457.07,13138.51,13138.51,13138.51,6513.61,1051.35,1051.35,SKIPPED,SKIPPED,6646.54,6646.54,13138.51
3612138,975,49653,,,,,,,LAP VENT/ABD HERN PROC COMP,2582.11,1032.84,0,2582.11,2194.79,SKIPPED,2582.11,2582.11,2194.79,2194.79,2194.79,1009.93,1265.23,1265.23,SKIPPED,SKIPPED,1030.54,1030.54,0
3612139,278,,,,,,,,FLEXIBLE HINGE TOE IMPLANT KIT,3470,1388,0,2949.5,2949.5,SKIPPED,2637.2,2637.2,2949.5,2949.5,2949.5,1462.26,1700.3,1700.3,0,1041,1492.1,1492.1,2949.5
3612140,975,28060,,,,,,,PARTIAL REMOVAL FOOT FASCIA,857.92,343.17,0,857.92,729.23,SKIPPED,857.92,857.92,729.23,729.23,729.23,396.72,420.38,420.38,SKIPPED,SKIPPED,404.82,404.82,0
3612141,975,21555,,,,,,,EX TUMOR SOFT NCK/TH,841.45,336.58,0,841.45,715.23,SKIPPED,841.45,841.45,715.23,715.23,715.23,335.2,412.31,412.31,SKIPPED,SKIPPED,342.04,342.04,0
3612142,360,40812,,,,,,,EXCISE/REPAIR MOUTH LESION,6120.88,2448.35,0,5202.75,5202.75,SKIPPED,949.05,949.05,5202.75,5202.75,5202.75,2579.34,160.53,160.53,0,1836.26,2631.98,2631.98,5202.75
3612143,975,40812,,,,,,,EXCISE/REPAIR MOUTH LESION,555.88,222.35,0,555.88,472.5,SKIPPED,555.88,555.88,472.5,472.5,472.5,204.28,272.38,272.38,0,166.76,208.45,208.45,0
3612144,975,11441,,,,,,,EXC FACE-MM B9+MARG 0.6-1 CM,450.27,180.11,0,450.27,382.73,SKIPPED,450.27,450.27,382.73,382.73,382.73,144.69,220.63,220.63,SKIPPED,SKIPPED,147.64,147.64,0
3612145,975,11601,,,,,,,EX MG LZ TRK AM LG.,410.88,164.35,0,410.88,349.25,SKIPPED,410.88,410.88,349.25,349.25,349.25,161.67,201.33,201.33,SKIPPED,SKIPPED,164.97,164.97,0
3612146,360,19285,,,,,,,PERQ DEV BREAST 1st US IMG.,309.56,123.82,0,309.56,263.13,SKIPPED,309.56,309.56,263.13,263.13,263.13,130.45,0,0,0,92.87,133.11,133.11,263.13
3612147,975,19285,,,,,,,PERQ DEV BREAST 1st US IMG.,288.53,115.41,0,288.53,245.25,SKIPPED,288.53,288.53,245.25,245.25,245.25,92.89,141.38,141.38,0,86.56,94.79,94.79,0
3612148,360,62362,,,,,,,IMPLANT SPINT INFUSION PUMP,14999.68,5999.87,1051.35,14999.68,12749.73,SKIPPED,14999.68,14999.68,12749.73,12749.73,12749.73,6320.86,1051.35,1051.35,SKIPPED,SKIPPED,6449.86,6449.86,12749.73
3612149,360,46050,,,,,,,INCISION OF ANAL ABSCESS,3391.11,1356.44,269.69,3372.4,2882.44,SKIPPED,3372.4,3372.4,2882.44,2882.44,2882.44,1429.02,269.69,269.69,SKIPPED,SKIPPED,1458.18,1458.18,2882.44
3612150,975,46050,,,,,,,INCISION OF ANAL ABSCESS,232.43,92.97,0,232.43,197.57,SKIPPED,232.43,232.43,197.57,197.57,197.57,109.7,113.89,113.89,SKIPPED,SKIPPED,111.94,111.94,0
3612151,975,28810,,,,,,,AMPUTATION TOE/METATARSAL,1204.49,481.8,0,1204.49,1023.82,SKIPPED,1204.49,1204.49,1023.82,1023.82,1023.82,463.52,590.2,590.2,SKIPPED,SKIPPED,472.98,472.98,0
3612152,360,43282,,,,,,,LAP PARAESOPH HER RPR W/ MESH,17701.32,7080.53,0,17701.32,15046.12,SKIPPED,17701.32,17701.32,15046.12,15046.12,15046.12,7459.34,0,0,0,5310.4,7611.57,7611.57,15046.12
3612153,975,43282,,,,,,,LAP PARAESOPH HER RPR W/ MESH,4854.51,1941.8,0,4854.51,4126.33,SKIPPED,4854.51,4854.51,4126.33,4126.33,4126.33,1863.72,2378.71,2378.71,0,1456.35,1901.76,1901.76,0
3612154,360,43653,,,,,,,LAPAROSCOPY GASTROSTOMY,8653.68,3461.47,1051.35,8653.68,7355.63,SKIPPED,8653.68,8653.68,7355.63,7355.63,7355.63,3646.66,1051.35,1051.35,SKIPPED,SKIPPED,3721.08,3721.08,7355.63
3612155,975,43653,,,,,,,LAPAROSCOPY GASTROSTOMY,1587.2,634.88,0,1587.2,1349.12,SKIPPED,1587.2,1587.2,1349.12,1349.12,1349.12,629.38,777.73,777.73,SKIPPED,SKIPPED,642.22,642.22,0
3612156,360,27654,,,,,,,REPAIR OF ACHILLES TENDON,7136.8,2854.72,1051.35,7136.8,6066.28,SKIPPED,7136.8,7136.8,6066.28,6066.28,6066.28,3007.44,1051.35,1051.35,SKIPPED,SKIPPED,3068.82,3068.82,6066.28
3612157,975,27654,,,,,,,REPAIR OF ACHILLES TENDON,1964.3,785.72,0,1964.3,1669.66,SKIPPED,1964.3,1964.3,1669.66,1669.66,1669.66,782.77,962.51,962.51,SKIPPED,SKIPPED,798.74,798.74,0
3612158,360,44120,,,,,,,RMV SMALL INTESTINE,16181.66,6472.66,0,13754.41,13754.41,SKIPPED,6046.61,6046.61,13754.41,13754.41,13754.41,6818.95,0,0,0,4854.5,6958.11,6958.11,13754.41
3612159,975,44120,,,,,,,RMV SMALL INTESTINE,3413.62,1365.45,0,3413.62,2901.58,SKIPPED,3413.62,3413.62,2901.58,2901.58,2901.58,1319.19,1672.67,1672.67,0,1024.09,1346.11,1346.11,0
3612160,360,44130,,,,,,,BOWEL TO BOWEL FUSION,16603.8,6641.52,0,14113.23,14113.23,SKIPPED,6483.04,6483.04,14113.23,14113.23,14113.23,6996.84,0,0,0,4981.14,7139.63,7139.63,14113.23
3612161,975,44130,,,,,,,BOWEL TO BOWEL FUSION,3662.75,1465.1,0,3662.75,3113.34,SKIPPED,3662.75,3662.75,3113.34,3113.34,3113.34,1422.41,1794.75,1794.75,0,1098.82,1451.44,1451.44,0
3612162,975,36556,,,,,,,INSERT NON-TUNNERL CV CATH,236.33,94.53,0,236.33,200.88,SKIPPED,236.33,236.33,200.88,200.88,200.88,91.88,115.8,115.8,SKIPPED,SKIPPED,93.76,93.76,0
3612163,975,46255,,,,,,,RMV INT/EXT HEM 1 GROUP,979.36,391.74,0,979.36,832.46,SKIPPED,979.36,979.36,832.46,832.46,832.46,392.29,479.89,479.89,SKIPPED,SKIPPED,400.3,400.3,0
3612164,272,,,,,,,,ETHICT ENDO-LINEAR CUTTER RELOAD,205.6,82.24,0,174.76,174.76,SKIPPED,156.26,156.26,174.76,174.76,174.76,86.64,100.74,100.74,0,61.68,88.41,88.41,174.76
3612165,272,,,,,,,,ENDO LINEAR CUTTER 75MM,137.2,54.88,0,116.62,116.62,SKIPPED,104.27,104.27,116.62,116.62,116.62,57.82,67.23,67.23,0,41.16,59,59,116.62
3612166,975,27652,,,,,,,RPR ACHILLES TND W/GRAFT,1910.84,764.34,0,1910.84,1624.21,SKIPPED,1910.84,1910.84,1624.21,1624.21,1624.21,726.78,936.31,936.31,SKIPPED,SKIPPED,741.61,741.61,0
3612167,975,11772,,,,,,,REMOVE PILONIDAL CYST COMPL,1581.58,632.63,0,1581.58,1344.34,SKIPPED,1581.58,1581.58,1344.34,1344.34,1344.34,634.87,774.97,774.97,SKIPPED,SKIPPED,647.83,647.83,0
3612168,975,11641,,,,,,,EX MG LZ FC EAR .6-1,430.58,172.23,0,430.58,365.99,SKIPPED,430.58,430.58,365.99,365.99,365.99,168.91,210.98,210.98,SKIPPED,SKIPPED,172.36,172.36,0
3612169,360,27634,,,,,,,EXC LEG/ANKLE TUM DEP 5 CM/>,7443.57,2977.43,582.36,7443.57,6327.03,SKIPPED,7443.57,7443.57,6327.03,6327.03,6327.03,3136.73,582.36,582.36,SKIPPED,SKIPPED,3200.74,3200.74,6327.03
3612170,975,27634,,,,,,,EXC LEG/ANKLE TUM DEP 5 CM/>,1899.6,759.84,0,1899.6,1614.66,SKIPPED,1899.6,1899.6,1614.66,1614.66,1614.66,736.22,930.8,930.8,SKIPPED,SKIPPED,751.25,751.25,0
3612171,975,11603,,,,,,,EXC TR-EXT MAL+MARG 2.1-3 CM,541.81,216.72,0,541.81,460.54,SKIPPED,541.81,541.81,460.54,460.54,460.54,209.87,265.49,265.49,SKIPPED,SKIPPED,214.15,214.15,0
3612172,975,26535,,,,,,,REVISE FINGER JOINT,1151.01,460.4,0,1151.01,978.36,SKIPPED,1151.01,1151.01,978.36,978.36,978.36,480.69,563.99,563.99,SKIPPED,SKIPPED,490.5,490.5,0
3612173,360,28750,,,,,,,FUSION OF BIG TOE JOINT,8414.47,3365.79,1051.35,8414.47,7152.3,SKIPPED,8414.47,8414.47,7152.3,7152.3,7152.3,3545.86,1051.35,1051.35,SKIPPED,SKIPPED,3618.22,3618.22,7152.3
3612174,975,28750,,,,,,,FUSION OF BIG TOE JOINT,2234.48,893.79,0,2234.48,1899.31,SKIPPED,2234.48,2234.48,1899.31,1899.31,1899.31,634.87,1094.9,1094.9,SKIPPED,SKIPPED,647.83,647.83,0
3612175,360,26530,,,,,,,REVISE KNUCKLE JOINT,6437.55,2575.02,1051.35,6437.55,5471.92,SKIPPED,6437.55,6437.55,5471.92,5471.92,5471.92,2712.79,1051.35,1051.35,SKIPPED,SKIPPED,2768.15,2768.15,5471.92
3612176,975,26530,,,,,,,REVISE KNUCKLE JOINT,1464.87,585.95,0,1464.87,1245.14,SKIPPED,1464.87,1464.87,1245.14,1245.14,1245.14,594.41,717.79,717.79,SKIPPED,SKIPPED,606.54,606.54,0
3612177,360,28011,,,,,,,INCISION OF TOE TENDONS,2769.19,1107.68,510.13,2769.19,2353.81,SKIPPED,2769.19,2769.19,2353.81,2353.81,2353.81,1166.94,510.13,510.13,SKIPPED,SKIPPED,1190.75,1190.75,2353.81
3612178,975,28011,,,,,,,INCISION OF TOE TENDONS,889.29,355.72,0,889.29,755.9,SKIPPED,889.29,889.29,755.9,755.9,755.9,307.51,435.75,435.75,SKIPPED,SKIPPED,313.79,313.79,0
3612179,975,46260,,,,,,,REMOVE IN/EX HEM GROUPS 2+,1312.9,525.16,0,1312.9,1115.96,SKIPPED,1312.9,1312.9,1115.96,1115.96,1115.96,530.54,643.32,643.32,SKIPPED,SKIPPED,541.37,541.37,0
3612180,975,46221,,,,,,,LIGATION OF HEMORRHOID(S,724.72,289.89,0,724.72,616.01,SKIPPED,724.72,724.72,616.01,616.01,616.01,214.5,355.11,355.11,SKIPPED,SKIPPED,218.88,218.88,0
3612181,360,28899,,,,,,,FOOT/TOES SURGERY PROCEDURE,3320.76,1328.3,0,2822.65,2822.65,SKIPPED,1020.78,1020.78,2822.65,2822.65,2822.65,1399.37,0,0,0,996.23,1427.93,1427.93,2822.65
3612182,975,28899,,,,,,,FOOT/TOES SURGERY PROCEDURE,984.97,393.99,0,984.97,837.22,SKIPPED,984.97,984.97,837.22,837.22,837.22,0,482.64,482.64,0,295.49,0,0,0
3612183,360,28605,,,,,,,TRT FOOT DISLOCATION,4530.87,1812.35,87.17,3851.24,3851.24,SKIPPED,1020.78,1020.78,3851.24,3851.24,3851.24,1909.3,87.17,87.17,SKIPPED,SKIPPED,1948.27,1948.27,3851.24
3612184,975,28605,,,,,,,TRT FOOT DISLOCATION,883.67,353.47,0,883.67,751.12,SKIPPED,883.67,883.67,751.12,751.12,751.12,335.7,433,433,SKIPPED,SKIPPED,342.55,342.55,0
3612185,360,95971,,,,,,,ANALYZE NEUROSTIM SIMPLE,1020.23,408.09,0,867.2,867.2,SKIPPED,199.45,199.45,867.2,867.2,867.2,429.93,0,0,0,306.07,438.7,438.7,867.2
3612186,360,28313,,,,,,,RPR DEFORMITY OF TOE,2836.71,1134.68,867.38,2836.71,2411.2,SKIPPED,2836.71,2836.71,2411.2,2411.2,2411.2,1195.39,867.38,867.38,SKIPPED,SKIPPED,1219.79,1219.79,2411.2
3612187,975,28313,,,,,,,RPR DEFORMITY OF TOE,850.69,340.28,0,850.69,723.09,SKIPPED,850.69,850.69,723.09,723.09,723.09,393.55,416.84,416.84,SKIPPED,SKIPPED,401.58,401.58,0
3612188,360,11044,,,,,,,DEB BONE 20 SQ CM/<,4717.56,1887.02,414.14,4717.56,4009.93,SKIPPED,4717.56,4717.56,4009.93,4009.93,4009.93,1987.98,414.14,414.14,SKIPPED,SKIPPED,2028.55,2028.55,4009.93
3612189,975,11044,,,,,,,DEB BONE 20 SQ CM/<,676.62,270.65,0,676.62,575.13,SKIPPED,676.62,676.62,575.13,575.13,575.13,243.61,331.54,331.54,SKIPPED,SKIPPED,248.58,248.58,0
3612190,272,,,,,,,,17(6.5in) INSERTION NEEDLE SC-4206,537.5,215,0,456.88,456.88,SKIPPED,408.5,408.5,456.88,456.88,456.88,226.51,263.38,263.38,0,161.25,231.13,231.13,456.88
3612191,975,28415,,,,,,,TREAT HEEL FRACTURE,3056.21,1222.48,0,3056.21,2597.78,SKIPPED,3056.21,3056.21,2597.78,2597.78,2597.78,1235.09,1497.54,1497.54,SKIPPED,SKIPPED,1260.3,1260.3,0
3612192,360,28735,,,,,,,FUSION OF FOOT BONES,8272.41,3308.96,1051.35,8272.41,7031.55,SKIPPED,8272.41,8272.41,7031.55,7031.55,7031.55,3486,1051.35,1051.35,SKIPPED,SKIPPED,3557.14,3557.14,7031.55
3612193,975,28735,,,,,,,FUSION OF FOOT BONES,2169.75,867.9,0,2169.75,1844.29,SKIPPED,2169.75,2169.75,1844.29,1844.29,1844.29,857.15,1063.18,1063.18,SKIPPED,SKIPPED,874.64,874.64,0
3612194,360,28415,,,,,,,TREAT HEEL FRACTURE,12222.09,4888.84,1051.35,12222.09,10388.78,SKIPPED,12222.09,12222.09,10388.78,10388.78,10388.78,5150.39,1051.35,1051.35,SKIPPED,SKIPPED,5255.5,5255.5,10388.78
3612195,278,,,,,,,,CALC PERIMETER PLATE AR-8954PR-S,2874,1149.6,0,2442.9,2442.9,SKIPPED,2184.24,2184.24,2442.9,2442.9,2442.9,1211.1,1408.26,1408.26,0,862.2,1235.82,1235.82,2442.9
3612196,360,64722,,,,,,,RELIEVE NERVE(S) PRESSURE,4760.69,1904.28,510.13,4760.69,4046.59,SKIPPED,4760.69,4760.69,4046.59,4046.59,4046.59,2006.16,510.13,510.13,SKIPPED,SKIPPED,2047.1,2047.1,4046.59
3612197,975,64722,,,,,,,RELIEVE NERVE(S) PRESSURE,1013.91,405.56,0,1013.91,861.82,SKIPPED,1013.91,1013.91,861.82,861.82,861.82,392.67,496.82,496.82,SKIPPED,SKIPPED,400.68,400.68,0
3612198,360,24073,,,,,,,EX ARM/ELBOW TUM DEEP>5CM,6130.8,2452.32,582.36,6130.8,5211.18,SKIPPED,6130.8,6130.8,5211.18,5211.18,5211.18,2583.52,582.36,582.36,SKIPPED,SKIPPED,2636.24,2636.24,5211.18
3612199,975,24073,,,,,,,EX ARM/ELBOW TUM DEEP> 5CM,1908.03,763.21,0,1908.03,1621.83,SKIPPED,1908.03,1908.03,1621.83,1621.83,1621.83,754.34,934.93,934.93,SKIPPED,SKIPPED,769.73,769.73,0
3612200,360,28515,,,,,,,TRT TOE FX,619.13,247.65,84.59,526.26,526.26,SKIPPED,502.74,502.74,526.26,526.26,526.26,260.91,84.59,84.59,SKIPPED,SKIPPED,266.23,266.23,526.26
3612201,975,28515,,,,,,,TRT TOE FX,440.51,176.2,0,440.51,374.43,SKIPPED,440.51,440.51,374.43,374.43,374.43,157.31,215.85,215.85,SKIPPED,SKIPPED,160.52,160.52,0
3612202,975,13101,,,,,,,RPR CMPLX TRNK 2.6-7,606.24,242.5,0,606.24,515.3,SKIPPED,606.24,606.24,515.3,515.3,515.3,270.39,297.06,297.06,SKIPPED,SKIPPED,275.91,275.91,0
3612203,360,24071,,,,,,,EXC ARM/ELBOW LES SC 3 CM/>,5017.74,2007.1,582.36,5017.74,4265.08,SKIPPED,5017.74,5017.74,4265.08,4265.08,4265.08,2114.48,582.36,582.36,SKIPPED,SKIPPED,2157.63,2157.63,4265.08
3612204,975,24071,,,,,,,EXC ARM/ELBOW LES SC 3 CM/>,1118.72,447.49,0,1118.72,950.91,SKIPPED,1118.72,1118.72,950.91,950.91,950.91,442.39,548.17,548.17,SKIPPED,SKIPPED,451.42,451.42,0
3612205,278,,,,,,,,ARGYLE SWAN NECK CURL CATH-LEFT,672,268.8,0,571.2,571.2,SKIPPED,510.72,510.72,571.2,571.2,571.2,283.18,329.28,329.28,0,201.6,288.96,288.96,571.2
3612206,278,,,,,,,,ARGYLE SWAN NECK CURL CATH-RIGHT,672,268.8,0,571.2,571.2,SKIPPED,510.72,510.72,571.2,571.2,571.2,283.18,329.28,329.28,0,201.6,288.96,288.96,571.2
3612207,278,,,,,,,,SWAN NECK CURL CATH PERITONEAL KIT-LEFT,1017,406.8,0,864.45,864.45,SKIPPED,772.92,772.92,864.45,864.45,864.45,428.56,498.33,498.33,0,305.1,437.31,437.31,864.45
3612208,278,,,,,,,,SWAN NECK CURL CATH PERITONEAL KIT-RIGHT,1017,406.8,0,864.45,864.45,SKIPPED,772.92,772.92,864.45,864.45,864.45,428.56,498.33,498.33,0,305.1,437.31,437.31,864.45
3612209,272,,,,,,,,RHIZO COSMAN,77.7,31.08,0,66.04,66.04,SKIPPED,59.05,59.05,66.04,66.04,66.04,32.74,38.07,38.07,0,23.31,33.41,33.41,66.04
3612210,272,,,,,,,,RHIZO CANNULA RFK 10CM - 18 GAGE,79.8,31.92,0,67.83,67.83,SKIPPED,60.65,60.65,67.83,67.83,67.83,33.62,39.1,39.1,0,23.94,34.31,34.31,67.83
3612211,272,,,,,,,,RHIZO CANNULA RFK 15 CM - 18 GAGE,79.8,31.92,0,67.83,67.83,SKIPPED,60.65,60.65,67.83,67.83,67.83,33.62,39.1,39.1,0,23.94,34.31,34.31,67.83
3612212,272,,,,,,,,RHIZO CANNULA CC 10 CM -18 GAGE,79.8,31.92,0,67.83,67.83,SKIPPED,60.65,60.65,67.83,67.83,67.83,33.62,39.1,39.1,0,23.94,34.31,34.31,67.83
3612213,272,,,,,,,,RHIZO CANNULA RFK 5 CM-16 GAGE,79.8,31.92,0,67.83,67.83,SKIPPED,60.65,60.65,67.83,67.83,67.83,33.62,39.1,39.1,0,23.94,34.31,34.31,67.83
3612214,360,27340,,,,,,,REMOVE KNEE CAP BURSA,8406.03,3362.41,867.38,8406.03,7145.13,SKIPPED,8406.03,8406.03,7145.13,7145.13,7145.13,3542.3,867.38,867.38,SKIPPED,SKIPPED,3614.59,3614.59,7145.13
3612215,975,27340,,,,,,,REMOVE KNEE CAP BURSA,1020.23,408.09,0,1020.23,867.2,SKIPPED,1020.23,1020.23,867.2,867.2,867.2,412.24,499.91,499.91,SKIPPED,SKIPPED,420.65,420.65,0
3612216,360,97607,,,,,,,NEG PRESS WND TX =50 SQ CM,634.66,253.86,0,634.66,539.46,SKIPPED,634.66,634.66,539.46,539.46,539.46,267.44,0,0,0,190.4,272.9,272.9,539.46
3612217,975,97607,,,,,,,NEG PRESS WND TX =50 SQ CM,65.82,26.33,0,65.82,55.95,SKIPPED,65.82,65.82,55.95,55.95,55.95,24.14,32.25,32.25,0,19.75,24.63,24.63,0
3612218,278,,,,,,,,PROCLAIM 5 ELITE(SPINAL CORD STIM),104100,41640,0,88485,88485,SKIPPED,79116,79116,88485,88485,88485,43867.74,51009,51009,0,31230,44763,44763,88485
3612219,270,,,,,,,,PROCLAIM PATIENT CONTROLLER(SPINAL CORD),5762.5,2305,0,4898.12,4898.12,SKIPPED,4379.5,4379.5,4898.12,4898.12,4898.12,2428.32,2823.62,2823.62,0,1728.75,2477.88,2477.88,4898.12
3612220,975,63685,,,,,,,INSERT/REDO SPINE GENERATOR,1017.4,406.96,0,1017.4,864.79,SKIPPED,1017.4,1017.4,864.79,864.79,864.79,392.24,498.53,498.53,SKIPPED,SKIPPED,400.25,400.25,0
3612221,975,27695,,,,,,,RPR ANKLE LIGAMENT(COLLATERAL),1311.43,524.57,0,1311.43,1114.72,SKIPPED,1311.43,1311.43,1114.72,1114.72,1114.72,527.3,642.6,642.6,SKIPPED,SKIPPED,538.06,538.06,0
3612222,975,46922,,,,,,,DESTRUCT LES ANUS SMPLE,323.89,129.56,0,323.89,275.31,SKIPPED,323.89,323.89,275.31,275.31,275.31,150.03,158.71,158.71,SKIPPED,SKIPPED,153.09,153.09,0
3612223,975,43255,,,,,,,#EGD W/ CNTRL BLEED,494.22,197.69,0,494.22,420.09,SKIPPED,494.22,494.22,420.09,420.09,420.09,219.1,242.17,242.17,SKIPPED,SKIPPED,223.57,223.57,0
3612224,360,28305,,,,,,,INCISE/GRAFT MIDFOOT BONES,4360.68,1744.27,1051.35,4360.68,3706.58,SKIPPED,4360.68,4360.68,3706.58,3706.58,3706.58,1837.59,1051.35,1051.35,SKIPPED,SKIPPED,1875.09,1875.09,3706.58
3612225,975,28305,,,,,,,INCISE/GRAFT MIDFOOT BONES,1763.56,705.42,0,1763.56,1499.03,SKIPPED,1763.56,1763.56,1499.03,1499.03,1499.03,744.12,864.14,864.14,SKIPPED,SKIPPED,759.31,759.31,0
3612226,360,28715,,,,,,,FUSION OF FOOT BONES,12386.51,4954.6,1051.35,12386.51,10528.53,SKIPPED,12386.51,12386.51,10528.53,10528.53,10528.53,5219.68,1051.35,1051.35,SKIPPED,SKIPPED,5326.2,5326.2,10528.53
3612227,975,28715,,,,,,,FUSION OF FOOT BONES,2465.78,986.31,0,2465.78,2095.91,SKIPPED,2465.78,2465.78,2095.91,2095.91,2095.91,1027.06,1208.23,1208.23,SKIPPED,SKIPPED,1048.02,1048.02,0
3612228,360,27709,,,,,,,INCISION OF TIBIA & FIBIA,3497.66,1399.06,1051.35,3497.66,2973.01,SKIPPED,3497.66,3497.66,2973.01,2973.01,2973.01,1473.91,1051.35,1051.35,SKIPPED,SKIPPED,1503.99,1503.99,2973.01
3612229,975,27709,,,,,,,INCISION OF TIBIA & FIBIA,3071.5,1228.6,0,3071.5,2610.78,SKIPPED,3071.5,3071.5,2610.78,2610.78,2610.78,1244.83,1505.04,1505.04,SKIPPED,SKIPPED,1270.23,1270.23,0
3612230,360,36825,,,,,,,ARTERY-VEIN AUTOGRAFT,12982.84,5193.14,1051.35,12982.84,11035.41,SKIPPED,12982.84,12982.84,11035.41,11035.41,11035.41,5470.97,1051.35,1051.35,SKIPPED,SKIPPED,5582.62,5582.62,11035.41
3612231,975,36825,,,,,,,ARTERY-VEIN AUTOGRAFT,2168.27,867.31,0,2168.27,1843.03,SKIPPED,2168.27,2168.27,1843.03,1843.03,1843.03,843.12,1062.45,1062.45,SKIPPED,SKIPPED,860.33,860.33,0
3612232,360,36821,,,,,,,AV FUSION DIRECT-ANY SITE,11347.94,4539.18,867.38,11347.94,9645.75,SKIPPED,11347.94,11347.94,9645.75,9645.75,9645.75,4782.02,867.38,867.38,SKIPPED,SKIPPED,4879.61,4879.61,9645.75
3612233,975,36821,,,,,,,AV FUSION DIRECT-ANY SITE,1799.74,719.9,0,1799.74,1529.78,SKIPPED,1799.74,1799.74,1529.78,1529.78,1529.78,703.53,881.87,881.87,SKIPPED,SKIPPED,717.89,717.89,0
3612234,360,28192,,,,,,,RMV FOREIGN BODY (FOOT),4777.44,1910.98,414.14,4777.44,4060.82,SKIPPED,4777.44,4777.44,4060.82,4060.82,4060.82,2013.21,414.14,414.14,SKIPPED,SKIPPED,2054.3,2054.3,4060.82
3612235,975,28192,,,,,,,RMV FOREIGN BODY (FOOT),752.39,300.96,0,752.39,639.53,SKIPPED,752.39,752.39,639.53,639.53,639.53,341.71,368.67,368.67,SKIPPED,SKIPPED,348.68,348.68,0
3612236,360,12041,,,,,,,INTMD WND RPR N-HF/GENIT,708.91,283.56,129.16,708.91,602.57,SKIPPED,708.91,708.91,602.57,602.57,602.57,298.73,129.16,129.16,SKIPPED,SKIPPED,304.83,304.83,602.57
3612237,975,12041,,,,,,,INTMD WND RPR N-HF/GENIT,359.84,143.94,0,359.84,305.86,SKIPPED,359.84,359.84,305.86,305.86,305.86,156.88,176.32,176.32,SKIPPED,SKIPPED,160.08,160.08,0
3612238,278,,,,,,,,2.4mm 5 HOLE T PLATE,1738,695.2,0,1477.3,1477.3,SKIPPED,1320.88,1320.88,1477.3,1477.3,1477.3,732.39,851.62,851.62,0,521.4,747.34,747.34,1477.3
3612239,278,,,,,,,,OCTRODE(SJM),8038,3215.2,0,6832.3,6832.3,SKIPPED,6108.88,6108.88,6832.3,6832.3,6832.3,3387.21,3938.62,3938.62,0,2411.4,3456.34,3456.34,6832.3
3612240,272,,,,,,,,MULTILEAD TRIAL CABLE(SJM),550,220,0,467.5,467.5,SKIPPED,418,418,467.5,467.5,467.5,231.77,269.5,269.5,0,165,236.5,236.5,467.5
3612241,272,,,,,,,,"EXTERNAL PULSE GENERATOR, 2 PORT HEADER",1375,550,0,1168.75,1168.75,SKIPPED,1045,1045,1168.75,1168.75,1168.75,579.42,673.75,673.75,0,412.5,591.25,591.25,1168.75
3612242,360,36589,,,,,,,RMV TUNNELED CV CATH,2268.78,907.51,254.87,2268.78,1928.46,SKIPPED,2268.78,2268.78,1928.46,1928.46,1928.46,956.07,254.87,254.87,SKIPPED,SKIPPED,975.58,975.58,1928.46
3612243,360,46945,,,,,,,REMOVE BY LIGAT INT HEM GRP,3783.1,1513.24,748.53,3215.64,3215.64,SKIPPED,1073.88,1073.88,3215.64,3215.64,3215.64,1594.2,748.53,748.53,SKIPPED,SKIPPED,1626.73,1626.73,3215.64
3612244,975,46945,,,,,,,REMOVE BY LIGAT INT HEM GRP,792,316.8,0,792,673.2,SKIPPED,792,792,673.2,673.2,673.2,376.21,388.08,388.08,SKIPPED,SKIPPED,383.89,383.89,0
3612245,975,11604,,,,,,,EX MG LZ TRK AM LG 3,833.54,333.42,0,833.54,708.51,SKIPPED,833.54,833.54,708.51,708.51,708.51,231.06,408.43,408.43,SKIPPED,SKIPPED,235.78,235.78,0
3612246,360,28270,,,,,,,RELEASE OF FOOT CONTRACTURE,2605.14,1042.06,867.38,2605.14,2214.37,SKIPPED,2605.14,2605.14,2214.37,2214.37,2214.37,1097.81,867.38,867.38,SKIPPED,SKIPPED,1120.21,1120.21,2214.37
3612247,975,28270,,,,,,,RELEASE OF FOOT CONTRACTURE,1285.16,514.06,0,1285.16,1092.39,SKIPPED,1285.16,1285.16,1092.39,1092.39,1092.39,366.43,629.73,629.73,SKIPPED,SKIPPED,373.91,373.91,0
3612248,360,37718,,,,,,,LIGATE/STRIP SHORT LEG VEIN,6260.92,2504.37,867.38,6260.92,5321.78,SKIPPED,6260.92,6260.92,5321.78,5321.78,5321.78,2638.36,867.38,867.38,SKIPPED,SKIPPED,2692.2,2692.2,5321.78
3612249,975,37718,,,,,,,LIGATE/STRIP SHORT LEG VEIN,1172.59,469.04,0,1172.59,996.7,SKIPPED,1172.59,1172.59,996.7,996.7,996.7,417.33,574.57,574.57,SKIPPED,SKIPPED,425.85,425.85,0
3612250,360,37722,,,,,,,LIGATE/STRIP LONG LEG VEIN,7925.34,3170.14,867.38,7925.34,6736.54,SKIPPED,7925.34,7925.34,6736.54,6736.54,6736.54,3339.74,867.38,867.38,SKIPPED,SKIPPED,3407.9,3407.9,6736.54
3612251,975,37722,,,,,,,LIGATE/STRIP LONG LEG VEIN,1290.52,516.21,0,1290.52,1096.94,SKIPPED,1290.52,1290.52,1096.94,1096.94,1096.94,498.87,632.35,632.35,SKIPPED,SKIPPED,509.05,509.05,0
3612252,975,44238,,,,,,,LAPAROSCOPE PROC. INTESTINE,1066.72,426.69,0,1066.72,906.71,SKIPPED,1066.72,1066.72,906.71,906.71,906.71,0,522.69,522.69,0,320.02,0,0,0
3612253,360,44238,,,,,,,LAPAROSCOPE PROC. INTESTINE,6384.22,2553.69,0,6384.22,5426.59,SKIPPED,6384.22,6384.22,5426.59,5426.59,5426.59,2690.31,0,0,0,1915.27,2745.21,2745.21,5426.59
3612254,975,28307,,,,,,,INCISION MEATARSAL,1145.78,458.31,0,1145.78,973.91,SKIPPED,1145.78,1145.78,973.91,973.91,973.91,565.01,561.43,561.43,SKIPPED,SKIPPED,576.54,576.54,0
3612255,360,28190,,,,,,,RMV FOREIGN BODY-FOOT,1669.77,667.91,0,1419.3,1419.3,SKIPPED,902.88,902.88,1419.3,1419.3,1419.3,703.64,145.8,145.8,0,500.93,718,718,1419.3
3612256,975,28190,,,,,,,RMV FOREIGN BODY-FOOT,322.57,129.03,0,322.57,274.18,SKIPPED,322.57,322.57,274.18,274.18,274.18,145.52,158.06,158.06,0,96.77,148.49,148.49,0
3612257,360,11055,,,,,,,TRIM SKIN LESION,265.35,106.14,0,265.35,225.55,SKIPPED,265.35,265.35,225.55,225.55,225.55,111.82,0,0,0,79.6,114.1,114.1,225.55
3612258,975,11055,,,,,,,TRIM SKIN LESION,39.05,15.62,0,39.05,33.19,SKIPPED,39.05,39.05,33.19,33.19,33.19,17.53,19.13,19.13,0,11.72,17.89,17.89,0
3612259,360,36832,,,,,,,AV FISTULA REVISION OPEN,11969.75,4787.9,1051.35,11969.75,10174.29,SKIPPED,11969.75,11969.75,10174.29,10174.29,10174.29,5044.05,1051.35,1051.35,SKIPPED,SKIPPED,5146.99,5146.99,10174.29
3612260,975,36832,,,,,,,AV FISTULA REVISION OPEN,2053.02,821.21,0,2053.02,1745.07,SKIPPED,2053.02,2053.02,1745.07,1745.07,1745.07,803.12,1005.98,1005.98,SKIPPED,SKIPPED,819.51,819.51,0
3612261,360,36818,,,,,,,AV FUSE UPPER ARM CEPHALIC,11532.87,4613.15,1051.35,11532.87,9802.94,SKIPPED,11532.87,11532.87,9802.94,9802.94,9802.94,4859.95,1051.35,1051.35,SKIPPED,SKIPPED,4959.13,4959.13,9802.94
3612262,975,36818,,,,,,,AV FUSE UPPER ARM CEPHALIC,1877.47,750.99,0,1877.47,1595.85,SKIPPED,1877.47,1877.47,1595.85,1595.85,1595.85,732.37,919.96,919.96,SKIPPED,SKIPPED,747.32,747.32,0
3612263,360,49250,,,,,,,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS S,5809.32,2323.73,867.38,5809.32,4937.92,SKIPPED,5809.32,5809.32,4937.92,4937.92,4937.92,2448.05,867.38,867.38,SKIPPED,SKIPPED,2498.01,2498.01,4937.92
3612264,975,49250,,,,,,,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS S,1558.78,623.51,0,1558.78,1324.96,SKIPPED,1558.78,1558.78,1324.96,1324.96,1324.96,644.97,763.8,763.8,SKIPPED,SKIPPED,658.13,658.13,0
3612265,975,15120,,,,,,,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 C,2214.74,885.9,0,2214.74,1882.53,SKIPPED,2214.74,2214.74,1882.53,1882.53,1882.53,750.18,1085.22,1085.22,SKIPPED,SKIPPED,765.49,765.49,0
3612266,360,44180,,,,,,,LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDU,9388.72,3755.49,0,9388.72,7980.41,SKIPPED,9388.72,9388.72,7980.41,7980.41,7980.41,3956.41,0,0,0,2816.62,4037.15,4037.15,7980.41
3612267,975,44180,,,,,,,LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDU,2443.99,977.6,0,2443.99,2077.39,SKIPPED,2443.99,2443.99,2077.39,2077.39,2077.39,995.21,1197.56,1197.56,0,733.2,1015.52,1015.52,0
3612268,975,49321,,,,,,,LAPAROSCOPY SURG W/BX SINGLE/MULTIPLE,914.78,365.91,0,914.78,777.56,SKIPPED,914.78,914.78,777.56,777.56,777.56,374.33,448.24,448.24,SKIPPED,SKIPPED,381.97,381.97,0
3612269,360,19303,,,,,,,MASTECTOMY SIMPLE COMPLETE,8472.75,3389.1,1051.35,8472.75,7201.84,SKIPPED,8472.75,8472.75,7201.84,7201.84,7201.84,3570.41,1051.35,1051.35,SKIPPED,SKIPPED,3643.28,3643.28,7201.84
3612270,975,19303,,,,,,,MASTECTOMY SIMPLE COMPLETE,2664.55,1065.82,0,2664.55,2264.87,SKIPPED,2664.55,2664.55,2264.87,2264.87,2264.87,1037.97,1305.63,1305.63,SKIPPED,SKIPPED,1059.15,1059.15,0
3612271,360,40520,,,,,,,EXC LIP V-EXC W/PRIM DIR LINR CLSR,4839.46,1935.78,748.53,4839.46,4113.54,SKIPPED,4839.46,4839.46,4113.54,4113.54,4113.54,2039.35,748.53,748.53,SKIPPED,SKIPPED,2080.97,2080.97,4113.54
3612272,975,40520,,,,,,,EXC LIP V-EXC W/PRIM DIR LINR CLSR,1279.44,511.78,0,1279.44,1087.52,SKIPPED,1279.44,1279.44,1087.52,1087.52,1087.52,390.85,626.93,626.93,SKIPPED,SKIPPED,398.83,398.83,0
3612273,360,14020,,,,,,,TIS TRNFR S/A/L 10 SQ CM/,5325.56,2130.22,582.36,5325.56,4526.73,SKIPPED,5325.56,5325.56,4526.73,4526.73,4526.73,2244.19,582.36,582.36,SKIPPED,SKIPPED,2289.99,2289.99,4526.73
3612274,975,14020,,,,,,,TIS TRNFR S/A/L 10 SQ CM/,1807.01,722.8,0,1807.01,1535.96,SKIPPED,1807.01,1807.01,1535.96,1535.96,1535.96,613.73,885.43,885.43,SKIPPED,SKIPPED,626.26,626.26,0
3612275,360,37607,,,,,,,LIGATION OF A-V FISTULA,7217.76,2887.1,867.38,7217.76,6135.1,SKIPPED,7217.76,7217.76,6135.1,6135.1,6135.1,3041.57,867.38,867.38,SKIPPED,SKIPPED,3103.64,3103.64,6135.1
3612276,975,37607,,,,,,,LIGATION OF A-V FISTULA,1005.54,402.22,0,1005.54,854.71,SKIPPED,1005.54,1005.54,854.71,854.71,854.71,400.01,492.71,492.71,SKIPPED,SKIPPED,408.17,408.17,0
3612277,360,36819,,,,,,,AV FUSE UPPR ARM BASILIC,13784.24,5513.7,1051.35,13784.24,11716.6,SKIPPED,13784.24,13784.24,11716.6,11716.6,11716.6,5808.68,1051.35,1051.35,SKIPPED,SKIPPED,5927.22,5927.22,11716.6
3612278,975,36819,,,,,,,AV FUSE UPPR ARM BASILIC,1972.97,789.19,0,1972.97,1677.02,SKIPPED,1972.97,1972.97,1677.02,1677.02,1677.02,775.77,966.76,966.76,SKIPPED,SKIPPED,791.6,791.6,0
3612279,360,36830,,,,,,,ARTERY-VEIN NONAUTOGRAFT,13513.33,5405.33,1051.35,13513.33,11486.33,SKIPPED,13513.33,13513.33,11486.33,11486.33,11486.33,5694.52,1051.35,1051.35,SKIPPED,SKIPPED,5810.73,5810.73,11486.33
3612280,975,36830,,,,,,,ARTERY-VEIN NONAUTOGRAFT,1798.05,719.22,0,1798.05,1528.34,SKIPPED,1798.05,1798.05,1528.34,1528.34,1528.34,708.16,881.04,881.04,SKIPPED,SKIPPED,722.61,722.61,0
3612281,360,36833,,,,,,,AV FISTULA REVISION,11912.11,4764.84,1051.35,11912.11,10125.29,SKIPPED,11912.11,11912.11,10125.29,10125.29,10125.29,5019.77,1051.35,1051.35,SKIPPED,SKIPPED,5122.21,5122.21,10125.29
3612282,975,36833,,,,,,,AV FISTULA REVISION,2186.22,874.49,0,2186.22,1858.29,SKIPPED,2186.22,2186.22,1858.29,1858.29,1858.29,858.32,1071.25,1071.25,SKIPPED,SKIPPED,875.84,875.84,0
3612283,360,36581,,,,,,,Replacement of central venous catheter,4567.05,1826.82,867.38,4567.05,3881.99,SKIPPED,4567.05,4567.05,3881.99,3881.99,3881.99,1924.55,867.38,867.38,SKIPPED,SKIPPED,1963.83,1963.83,3881.99
3612284,975,36581,,,,,,,Replacement of central venous catheter,443.69,177.48,0,443.69,377.14,SKIPPED,443.69,443.69,377.14,377.14,377.14,199.53,217.41,217.41,SKIPPED,SKIPPED,203.6,203.6,0
3612285,360,44140,,,,,,,PARTIAL REMOVAL OF COLON,5765.11,2306.04,0,5765.11,4900.34,SKIPPED,5765.11,5765.11,4900.34,4900.34,4900.34,2429.42,0,0,0,1729.53,2479,2479,4900.34
3612286,975,44140,,,,,,,PARTIAL REMOVAL OF COLON,3568.69,1427.48,0,3568.69,3033.39,SKIPPED,3568.69,3568.69,3033.39,3033.39,3033.39,1450.48,1748.66,1748.66,0,1070.61,1480.08,1480.08,0
3612287,360,47100,,,,,,,WEDGE BX OF LIVER,4289.65,1715.86,0,4162.9,3646.2,SKIPPED,4162.9,4162.9,3646.2,3646.2,3646.2,1807.66,0,0,0,1286.9,1844.55,1844.55,3646.2
3612288,975,47100,,,,,,,WEDGE BX OF LIVER,2235.69,894.28,0,2235.69,1900.34,SKIPPED,2235.69,2235.69,1900.34,1900.34,1900.34,922.62,1095.49,1095.49,0,670.71,941.45,941.45,0
3612289,360,44139,,,,,,,MOBILIZATION OF COLON,1199.38,479.75,0,1019.47,1019.47,SKIPPED,601.78,601.78,1019.47,1019.47,1019.47,505.42,0,0,0,359.81,515.73,515.73,1019.47
3612290,975,44139,,,,,,,MOBILIZATION OF COLON,325.66,130.26,0,325.66,276.81,SKIPPED,325.66,325.66,276.81,276.81,276.81,129.65,159.57,159.57,0,97.7,132.3,132.3,0
3612291,360,35005,,,,,,,REPAIR DEFECT OF ARTERY,10050.73,4020.29,0,8543.12,8543.12,SKIPPED,4911.26,4911.26,8543.12,8543.12,8543.12,4235.37,0,0,0,3015.22,4321.81,4321.81,8543.12
3612292,975,35005,,,,,,,REPAIR DEFECT OF ARTERY,3017.9,1207.16,0,3017.9,2565.22,SKIPPED,3017.9,3017.9,2565.22,2565.22,2565.22,1052.68,1478.77,1478.77,0,905.37,1074.16,1074.16,0
3612293,975,32554,,,,,,,THORACENTESIS PROF,218.12,87.25,0,218.12,185.4,SKIPPED,218.12,218.12,185.4,185.4,185.4,97.88,106.88,106.88,0,65.44,99.88,99.88,0
3612294,360,27590,,,,,,,AMPUTATE LEG AT THIGH,7638.54,3055.42,0,6492.76,6492.76,SKIPPED,3931.05,3931.05,6492.76,6492.76,6492.76,3218.88,0,0,0,2291.56,3284.57,3284.57,6492.76
3612295,975,27590,,,,,,,AMPUTATE LEG AT THIGH,2130.94,852.38,0,2130.94,1811.3,SKIPPED,2130.94,2130.94,1811.3,1811.3,1811.3,847.29,1044.16,1044.16,0,639.28,864.58,864.58,0
3612296,360,36831,,,,,,,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,7953.48,3181.39,1051.35,7953.48,6760.46,SKIPPED,7953.48,7953.48,6760.46,6760.46,6760.46,3351.6,1051.35,1051.35,SKIPPED,SKIPPED,3420,3420,6760.46
3612297,975,36831,,,,,,,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,1660.52,664.21,0,1660.52,1411.44,SKIPPED,1660.52,1660.52,1411.44,1411.44,1411.44,653.5,813.65,813.65,SKIPPED,SKIPPED,666.84,666.84,0
3612298,360,36555,,,,,,,INSERT NON-TUNNEL CV CATH,2633.28,1053.31,414.14,2633.28,2238.29,SKIPPED,2633.28,2633.28,2238.29,2238.29,2238.29,1109.66,414.14,414.14,SKIPPED,SKIPPED,1132.31,1132.31,2238.29
3612299,975,36555,,,,,,,INSERT NON-TUNNEL CV CATH,211.08,84.43,0,211.08,179.42,SKIPPED,211.08,211.08,179.42,179.42,179.42,93.3,103.43,103.43,SKIPPED,SKIPPED,95.2,95.2,0
3612300,975,44602,,,,,,,SUTURE SMALL INTEST.,3762.45,1504.98,0,3762.45,3198.08,SKIPPED,3762.45,3762.45,3198.08,3198.08,3198.08,1517.92,1843.6,1843.6,0,1128.74,1548.9,1548.9,0
3612301,975,43840,,,,,,,RPR STOMACH LESION,3612.9,1445.16,0,3612.9,3070.96,SKIPPED,3612.9,3612.9,3070.96,3070.96,3070.96,1469.95,1770.32,1770.32,0,1083.87,1499.95,1499.95,0
3612302,975,43820,,,,,,,FUSION OF STOMACH & BOWEL,3567.33,1426.93,0,3567.33,3032.23,SKIPPED,3567.33,3567.33,3032.23,3032.23,3032.23,1452.78,1747.99,1747.99,0,1070.2,1482.43,1482.43,0
3612303,975,43611,,,,,,,EXC STOMACH LESION,3249.73,1299.89,0,3249.73,2762.27,SKIPPED,3249.73,3249.73,2762.27,2762.27,2762.27,1321,1592.37,1592.37,0,974.92,1347.96,1347.96,0
3612304,975,49203,,,,,,,EXC ABD TUM <5CM,3188.08,1275.23,0,3188.08,2709.87,SKIPPED,3188.08,3188.08,2709.87,2709.87,2709.87,1294.59,1562.16,1562.16,0,956.42,1321.01,1321.01,0
3612305,975,49566,,,,,,,RPR VENTRL HERN BLOCK,2491.24,996.5,0,2491.24,2117.55,SKIPPED,2491.24,2491.24,2117.55,2117.55,2117.55,1014.55,1220.71,1220.71,SKIPPED,SKIPPED,1035.26,1035.26,0
3612306,975,25075,,,,,,,EXC FOREARM LESION <3CM,752.48,300.99,0,752.48,639.61,SKIPPED,752.48,752.48,639.61,639.61,639.61,345.77,368.72,368.72,SKIPPED,SKIPPED,352.83,352.83,0
3612307,975,21930,,,,,,,EXC BACK LESION <3CM,1230,492,0,1230,1045.5,SKIPPED,1230,1230,1045.5,1045.5,1045.5,396.63,602.7,602.7,SKIPPED,SKIPPED,404.72,404.72,0
3612308,272,,,,,,,,REGANES 6' SPINAL NEEDLE,13.28,5.31,0,11.29,11.29,SKIPPED,10.09,10.09,11.29,11.29,11.29,5.6,6.51,6.51,0,3.98,5.71,5.71,11.29
3612309,270,,,,,,,,ULTRA PRO II NEEDLE GUIDE,36.75,14.7,0,31.24,31.24,SKIPPED,27.93,27.93,31.24,31.24,31.24,15.48,18.01,18.01,0,11.02,15.8,15.8,31.24
3612310,272,,,,,,,,"25G 3 1/2"" SPINAL NEEDLE",4.38,1.75,0,3.72,3.72,SKIPPED,3.33,3.33,3.72,3.72,3.72,1.84,2.15,2.15,0,1.31,1.88,1.88,3.72
3612311,270,,,,,,,,CORE BX INSTRUMENT 16G X 16CM,84,33.6,0,71.4,71.4,SKIPPED,63.84,63.84,71.4,71.4,71.4,35.4,41.16,41.16,0,25.2,36.12,36.12,71.4
3612312,270,,,,,,,,5-0-PROLENE,33.83,13.53,0,28.76,28.76,SKIPPED,25.71,25.71,28.76,28.76,28.76,14.26,16.58,16.58,0,10.15,14.55,14.55,28.76
3612313,270,,,,,,,,60 PRONOVA BV-1,41.83,16.73,0,35.56,35.56,SKIPPED,31.79,31.79,35.56,35.56,35.56,17.63,20.5,20.5,0,12.55,17.99,17.99,35.56
3612314,270,,,,,,,,LIGATING TITANIUM WIDE SMALL CLIPS,18.23,7.29,0,15.5,15.5,SKIPPED,13.85,13.85,15.5,15.5,15.5,7.68,8.93,8.93,0,5.47,7.84,7.84,15.5
3612315,270,,,,,,,,LIGATING TITANIUM MED CLIPS,46.14,18.46,0,39.22,39.22,SKIPPED,35.07,35.07,39.22,39.22,39.22,19.44,22.61,22.61,0,13.84,19.84,19.84,39.22
3612316,270,,,,,,,,VESSEL LOOPS BLUE MINI,5,2,0,4.25,4.25,SKIPPED,3.8,3.8,4.25,4.25,4.25,2.11,2.45,2.45,0,1.5,2.15,2.15,4.25
3612317,272,,,,,,,,CATHETER FOGARTY EMBOLECTOMY 4FR,162.24,64.9,0,137.9,137.9,SKIPPED,123.3,123.3,137.9,137.9,137.9,68.36,79.5,79.5,0,48.67,69.76,69.76,137.9
3612318,272,,,,,,,,CATHETER FOGARTY EMBOLECTOMY 3FR,162.24,64.9,0,137.9,137.9,SKIPPED,123.3,123.3,137.9,137.9,137.9,68.36,79.5,79.5,0,48.67,69.76,69.76,137.9
3612319,270,,,,,,,,FOGARTY SOFTJAW 6MM SPRING CLIP,42.46,16.98,0,36.09,36.09,SKIPPED,32.27,32.27,36.09,36.09,36.09,17.89,20.81,20.81,0,12.74,18.26,18.26,36.09
3612323,272,,,,,,,,CATH SPORT PACK 19CM,6277.72,2511.09,0,5336.06,5336.06,SKIPPED,4771.07,4771.07,5336.06,5336.06,5336.06,2645.43,3076.08,3076.08,0,1883.32,2699.42,2699.42,5336.06
3612324,272,,,,,,,,CATH SPORT PACK 23CM,6188.82,2475.53,0,5260.5,5260.5,SKIPPED,4703.5,4703.5,5260.5,5260.5,5260.5,2607.97,3032.52,3032.52,0,1856.65,2661.19,2661.19,5260.5
3612325,272,,,,,,,,CATH SPORT PACK 28CM,6188.82,2475.53,0,5260.5,5260.5,SKIPPED,4703.5,4703.5,5260.5,5260.5,5260.5,2607.97,3032.52,3032.52,0,1856.65,2661.19,2661.19,5260.5
3612326,270,,,,,,,,J WIRE GUIDE,30.77,12.31,0,26.15,26.15,SKIPPED,23.39,23.39,26.15,26.15,26.15,12.97,15.08,15.08,0,9.23,13.23,13.23,26.15
3612327,272,,,,,,,,ENTRY THINWALL NEEDLE,18.74,7.5,0,15.93,15.93,SKIPPED,14.24,14.24,15.93,15.93,15.93,7.9,9.18,9.18,0,5.62,8.06,8.06,15.93
3612328,360,36246,,,,,,,INS CATH ABD/L-EXTRM,3366.32,1346.53,0,2861.37,2861.37,SKIPPED,0,0,2861.37,2861.37,2861.37,1418.57,0,0,0,1009.9,1447.52,1447.52,2861.37
3612329,975,36246,,,,,,,INS CATH ABD/L-EXTRM,617.93,247.17,0,525.24,525.24,SKIPPED,0,0,525.24,525.24,525.24,268.7,302.79,302.79,0,185.38,274.18,274.18,0
3612330,360,75630,,,,,,,AORTOGRAPHY ABDL BI LOW EXTRM CATH RS&I,6030.43,2412.17,0,6030.43,5125.87,SKIPPED,6030.43,6030.43,5125.87,5125.87,5125.87,2541.22,0,0,0,1600.34,2593.08,2593.08,5125.87
3612331,975,75630,,,,,,,AORTOGRAPHY ABDL BI LOW EXTRM CATH RS&I,210.78,84.31,0,210.78,179.16,SKIPPED,210.78,210.78,179.16,179.16,179.16,104.01,210.78,210.78,0,210.78,106.13,106.13,0
3612332,360,10005,,,,,,,FNA W/ IMAGE,1208.77,483.51,0,1027.45,1027.45,SKIPPED,338.91,338.91,1027.45,1027.45,1027.45,509.37,60.06,60.06,0,362.63,519.77,519.77,1027.45
3612333,975,10005,,,,,,,FNA W/ IMAGE,364.5,145.8,0,338.91,309.82,SKIPPED,338.91,338.91,309.82,309.82,309.82,80.93,178.6,178.6,0,109.35,82.58,82.58,0
3612334,360,43327,,,,,,,ESOPG/GSTR FUNDOPLASTY W/ LAPAROTOMY,4154.29,1661.72,0,4057.21,3531.15,SKIPPED,4057.21,4057.21,3531.15,3531.15,3531.15,1750.61,0,0,0,1246.29,1786.34,1786.34,3531.15
3612335,975,43327,,,,,,,ESOPG/GSTR FUNDOPLASTY W/ LAPAROTOMY,2179,871.6,0,2179,1852.15,SKIPPED,2179,2179,1852.15,1852.15,1852.15,885.83,1067.71,1067.71,0,653.7,903.91,903.91,0
3612336,360,12005,,,,,,,RPR S/N/A/GEN/TRK 12.6-20.0 CM,623.13,249.25,129.16,623.13,529.66,SKIPPED,623.13,623.13,529.66,529.66,529.66,262.59,129.16,129.16,SKIPPED,SKIPPED,267.95,267.95,529.66
3612337,975,12005,,,,,,,RPR S/N/A/GEN/TRK 12.6-20.0 CM,228.52,91.41,0,228.52,194.24,SKIPPED,228.52,228.52,194.24,194.24,194.24,102.48,111.97,111.97,SKIPPED,SKIPPED,104.57,104.57,0
3612338,975,35566,,,,,,,BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OT,4517.94,1807.18,0,4517.94,3840.25,SKIPPED,4517.94,4517.94,3840.25,3840.25,3840.25,1759.54,2213.79,2213.79,0,1355.38,1795.45,1795.45,0
3612339,975,37700,,,,,,,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INT,662.12,264.85,0,662.12,562.8,SKIPPED,662.12,662.12,562.8,562.8,562.8,262.62,324.44,324.44,SKIPPED,SKIPPED,267.98,267.98,0
3612340,975,35301,,,,,,,TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV,3053.79,1221.52,0,3053.79,2595.72,SKIPPED,3053.79,3053.79,2595.72,2595.72,2595.72,1195.31,1496.36,1496.36,0,916.14,1219.7,1219.7,0
3612341,975,44144,,,,,,,COLECTOMY PRTL W/COLOST/ILEOST & MUCOFIS,4710.5,1884.2,0,4710.5,4003.92,SKIPPED,4710.5,4710.5,4003.92,4003.92,4003.92,1904.47,2308.14,2308.14,0,1413.15,1943.34,1943.34,0
3612342,975,44005,,,,,,,ENTEROLSS FRING INTSTINAL ADHESION SPX,2627.98,1051.19,0,2627.98,2233.78,SKIPPED,2627.98,2627.98,2233.78,2233.78,2233.78,1180.8,1287.71,1287.71,0,788.39,1204.9,1204.9,0
3612343,975,44320,,,,,,,COLOSTOMY/SKIN LEVEL CECOSTOMY,3196.66,1278.66,0,3196.66,2717.16,SKIPPED,3196.66,3196.66,2717.16,2717.16,2717.16,1299.13,1566.36,1566.36,0,959,1325.64,1325.64,0
3612344,975,44625,,,,,,,CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN,2712.05,1084.82,0,2712.05,2305.24,SKIPPED,2712.05,2712.05,2305.24,2305.24,2305.24,1095.19,1328.9,1328.9,0,813.62,1117.54,1117.54,0
3612345,975,44227,,,,,,,LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANA,4443.48,1777.39,0,4443.48,3776.96,SKIPPED,4443.48,4443.48,3776.96,3776.96,3776.96,1793.28,2177.31,2177.31,0,1333.04,1829.88,1829.88,0
3612346,975,38745,,,,,,,REMOVE ARMPIT LYMPH NODES,2323.14,929.26,0,2323.14,1974.67,SKIPPED,2323.14,2323.14,1974.67,1974.67,1974.67,953.82,1138.34,1138.34,SKIPPED,SKIPPED,973.29,973.29,0
3612347,360,42835,,,,,,,REMOVE ADENOIDS,5826.47,2330.59,748.53,5826.47,4952.5,SKIPPED,5826.47,5826.47,4952.5,4952.5,4952.5,2455.27,748.53,748.53,SKIPPED,SKIPPED,2505.38,2505.38,4952.5
3612348,975,32555,,,,,,,ASPIRATE PLEURA W/ IMAGING,271.81,108.72,0,271.81,231.04,SKIPPED,271.81,271.81,231.04,231.04,231.04,120.65,133.19,133.19,0,81.54,123.11,123.11,0
3612349,975,36590,,,,,,,REMOVE TUNNELED CV CATH,582.14,232.86,0,582.14,494.82,SKIPPED,582.14,582.14,494.82,494.82,494.82,206.44,285.25,285.25,SKIPPED,SKIPPED,210.65,210.65,0
3612350,975,58660,,,,,,,LAPAROSCOPY LYSIS,1774.72,709.89,0,1774.72,1508.51,SKIPPED,1774.72,1774.72,1508.51,1508.51,1508.51,745.48,869.61,869.61,SKIPPED,SKIPPED,760.69,760.69,0
3612352,975,45100,,,,,,,BX RECTUM,790.76,316.3,0,790.76,672.15,SKIPPED,790.76,790.76,672.15,672.15,672.15,330.34,387.47,387.47,SKIPPED,SKIPPED,337.08,337.08,0
3612353,975,36901,,,,,,,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FL,410.75,164.3,0,410.75,349.14,SKIPPED,410.75,410.75,349.14,349.14,349.14,181.54,201.27,201.27,0,123.22,185.24,185.24,0
3612355,975,36247,,,,,,,PLACE CATH IN ARTERY,736.43,294.57,0,625.97,625.97,SKIPPED,0,0,625.97,625.97,625.97,319.52,360.85,360.85,0,220.93,326.04,326.04,0
3612356,975,37226,,,,,,,FEM/POPL REVASC W/STENT,1268.74,507.5,0,1268.74,1078.43,SKIPPED,1268.74,1268.74,1078.43,1078.43,1078.43,549.28,621.68,621.68,SKIPPED,SKIPPED,560.49,560.49,0
3612357,975,13121,,,,,,,CMPLX RPR S/A/L 2.6-7.5 CM,641.41,256.56,0,641.41,545.2,SKIPPED,641.41,641.41,545.2,545.2,545.2,280.29,314.29,314.29,SKIPPED,SKIPPED,286.01,286.01,0
3612358,975,19307,,,,,,,MAST MODF RAD W/AX LYMPH NOD W/WO PECT/A,3152.18,1260.87,0,3152.18,2679.35,SKIPPED,3152.18,3152.18,2679.35,2679.35,2679.35,1281.31,1544.57,1544.57,0,945.65,1307.46,1307.46,0
3612359,975,44950,,,,,,,APPENDECTOMY,1705.07,682.03,0,1705.07,1449.31,SKIPPED,1705.07,1705.07,1449.31,1449.31,1449.31,695.8,835.48,835.48,0,511.52,710,710,0
3612360,360,57135,,,,,,,EXCISION VAGINAL CYST/TUMOR,5199.58,2079.83,867.38,5199.58,4419.64,SKIPPED,5199.58,5199.58,4419.64,4419.64,4419.64,2191.1,867.38,867.38,SKIPPED,SKIPPED,2235.82,2235.82,4419.64
3612361,975,57135,,,,,,,EXCISION VAGINAL CYST/TUMOR,502.19,200.88,0,502.19,426.86,SKIPPED,502.19,502.19,426.86,426.86,426.86,206.87,246.07,246.07,SKIPPED,SKIPPED,211.09,211.09,0
3612362,975,99151,,,,,,,MOD SED SAME PHYS/QHP INITIAL 15 MINS,188.22,75.29,0,159.99,159.99,SKIPPED,119.32,119.32,159.99,159.99,159.99,27.49,92.23,92.23,0,56.47,28.05,28.05,0
3612363,975,49650,,,,,,,LAPAROSCOPY SURG RPR INITIAL INGUINAL HE,1131.61,452.64,0,1131.61,961.87,SKIPPED,1131.61,1131.61,961.87,961.87,961.87,470.78,554.49,554.49,SKIPPED,SKIPPED,480.39,480.39,0
3612364,360,44213,,,,,,,Partial release of large bowel using an,1262.37,504.95,0,1073.01,1073.01,SKIPPED,932.47,932.47,1073.01,1073.01,1073.01,531.96,0,0,0,378.71,542.82,542.82,1073.01
3612365,975,44213,,,,,,,Partial release of large bowel using an,505.41,202.16,0,505.41,429.6,SKIPPED,505.41,505.41,429.6,429.6,429.6,201.33,247.65,247.65,0,151.62,205.44,205.44,0
3612366,360,45334,,,,,,,SIGMOIDOSCOPY FLX CONTROL BLEEDING,2876.76,1150.7,361.12,2876.76,2445.25,SKIPPED,2876.76,2876.76,2445.25,2445.25,2445.25,1212.27,361.12,361.12,SKIPPED,SKIPPED,1237.01,1237.01,2445.25
3612367,975,45334,,,,,,,SIGMOIDOSCOPY FLX CONTROL BLEEDING,288.19,115.28,0,288.19,244.96,SKIPPED,288.19,288.19,244.96,244.96,244.96,128.31,141.21,141.21,SKIPPED,SKIPPED,130.93,130.93,0
3612368,360,46600,,,,,,,DIAGNOSTIC ANOSCOPY,394.22,157.69,0,394.22,335.09,SKIPPED,394.22,394.22,335.09,335.09,335.09,166.12,0,0,0,118.27,169.51,169.51,335.09
3612369,975,46600,,,,,,,DIAGNOSTIC ANOSCOPY,98.65,39.46,0,98.65,83.85,SKIPPED,98.65,98.65,83.85,83.85,83.85,44.35,48.34,48.34,0,29.6,45.26,45.26,0
3612370,975,44960,,,,,,,APPENDECTOMY,2322.26,928.9,0,2322.26,1973.92,SKIPPED,2322.26,2322.26,1973.92,1973.92,1973.92,951.13,1137.91,1137.91,0,696.68,970.54,970.54,0
3612371,975,15936,,,,,,,RMV SACRUM PRESSURE SORE,2345.44,938.18,0,2345.44,1993.62,SKIPPED,2345.44,2345.44,1993.62,1993.62,1993.62,984.05,1149.27,1149.27,SKIPPED,SKIPPED,1004.13,1004.13,0
3612372,360,43333,,,,,,,LAPT RPR PARAESOPH HIATAL HERNIA W/MESH,11410.92,4564.37,0,9699.28,9699.28,SKIPPED,6240.98,6240.98,9699.28,9699.28,9699.28,4808.57,0,0,0,3423.28,4906.7,4906.7,9699.28
3612373,975,43333,,,,,,,LAPT RPR PARAESOPH HIATAL HERNIA W/MESH,3370.34,1348.14,0,3370.34,2864.79,SKIPPED,3370.34,3370.34,2864.79,2864.79,2864.79,1353.82,1651.47,1651.47,0,1011.1,1381.45,1381.45,0
3612374,975,36560,,,,,,,INSERT TUNNELED CV CATH < 5YO,911.73,364.69,0,911.73,774.97,SKIPPED,911.73,911.73,774.97,774.97,774.97,412.84,446.75,446.75,SKIPPED,SKIPPED,421.27,421.27,0
3612375,975,37224,,,,,,,FEM/POPL REVAS W/TLA,1309.64,523.86,0,1309.64,1113.19,SKIPPED,1309.64,1309.64,1113.19,1113.19,1113.19,470.21,641.72,641.72,SKIPPED,SKIPPED,479.81,479.81,0
3612376,975,37191,,,,,,,INS ENDOVAS VENA CAVA FILTR,611.06,244.42,0,611.06,519.4,SKIPPED,611.06,611.06,519.4,519.4,519.4,238.49,299.42,299.42,0,183.32,243.36,243.36,0
3612377,975,36245,,,,,,,INS CATH ABD/L-EXT ART 1ST,654.41,261.76,0,556.25,556.25,SKIPPED,0,0,556.25,556.25,556.25,252.23,320.66,320.66,0,196.32,257.38,257.38,0
3612378,975,37227,,,,,,,FEM/POPL REVASC STNT & ATHER,1976.96,790.78,0,1976.96,1680.42,SKIPPED,1976.96,1976.96,1680.42,1680.42,1680.42,762.1,968.71,968.71,SKIPPED,SKIPPED,777.65,777.65,0
3612379,360,44188,,,,,,,LAP COLOSTOMY,8141.55,3256.62,0,6920.32,6920.32,SKIPPED,6056.87,6056.87,6920.32,6920.32,6920.32,3430.85,0,0,0,2442.46,3500.87,3500.87,6920.32
3612380,975,44188,,,,,,,LAP COLOSTOMY,3256.62,1302.65,0,3256.62,2768.13,SKIPPED,3256.62,3256.62,2768.13,2768.13,2768.13,1319.32,1595.74,1595.74,0,976.99,1346.25,1346.25,0
3612381,360,36558,,,,,,,INSERT TUNNELED CV CATH > 5YO,5503.84,2201.54,867.38,5503.84,4678.26,SKIPPED,5503.84,5503.84,4678.26,4678.26,4678.26,2319.32,867.38,867.38,SKIPPED,SKIPPED,2366.65,2366.65,4678.26
3612382,975,36558,,,,,,,INSERT TUNNELED CV CATH > 5YO,633.9,253.56,0,633.9,538.82,SKIPPED,633.9,633.9,538.82,538.82,538.82,281.93,310.61,310.61,SKIPPED,SKIPPED,287.68,287.68,0
3612383,975,12053,,,,,,,INTMD RPR WND 5.1CM-7.5CM,522.81,209.12,0,522.81,444.39,SKIPPED,522.81,522.81,444.39,444.39,444.39,232.94,256.18,256.18,SKIPPED,SKIPPED,237.69,237.69,0
3612384,975,37248,,,,,,,TRLUML BALO ANGIOP 1ST VEIN,727.63,291.05,0,727.63,618.49,SKIPPED,727.63,727.63,618.49,618.49,618.49,320.27,356.54,356.54,SKIPPED,SKIPPED,326.81,326.81,0
3612385,360,21014,,,,,,,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIA,5147.31,2058.92,582.36,5048.16,4375.21,SKIPPED,5048.16,5048.16,4375.21,4375.21,4375.21,2169.07,582.36,582.36,SKIPPED,SKIPPED,2213.34,2213.34,4375.21
3612386,975,21014,,,,,,,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIA,1373.84,549.54,0,1373.84,1167.76,SKIPPED,1373.84,1373.84,1167.76,1167.76,1167.76,569.09,673.18,673.18,SKIPPED,SKIPPED,580.7,580.7,0
3612387,360,49655,,,,,,,LAPS RPR INCISIONAL HERNIA NCRC8/STRANGU,13400.95,5360.38,1051.35,13400.95,11390.81,SKIPPED,13400.95,13400.95,11390.81,11390.81,11390.81,5647.16,1051.35,1051.35,SKIPPED,SKIPPED,5762.41,5762.41,11390.81
3612388,975,49655,,,,,,,LAPS RPR INCISIONAL HERNIA NCRC8/STRANGU,2737.79,1095.12,0,2737.79,2327.12,SKIPPED,2737.79,2737.79,2327.12,2327.12,2327.12,1120.72,1341.52,1341.52,SKIPPED,SKIPPED,1143.59,1143.59,0
3612389,360,27619,,,,,,,EXC LEG/ANKLE TUM DEEP<5CM,5621.7,2248.68,582.36,5621.7,4778.44,SKIPPED,5621.7,5621.7,4778.44,4778.44,4778.44,2368.98,582.36,582.36,SKIPPED,SKIPPED,2417.33,2417.33,4778.44
3612390,975,27619,,,,,,,EXC LEG/ANKLE TUM DEEP<5CM,1235.59,494.24,0,1235.59,1050.25,SKIPPED,1235.59,1235.59,1050.25,1050.25,1050.25,505.82,605.44,605.44,SKIPPED,SKIPPED,516.14,516.14,0
3612391,975,28286,,,,,,,RPR HAMMERTOE,720.53,288.21,0,720.53,612.45,SKIPPED,720.53,720.53,612.45,612.45,612.45,326.88,353.06,353.06,SKIPPED,SKIPPED,333.55,333.55,0
3612392,360,27704,,,,,,,RMV ANKLE IMPLANT,9305.63,3722.25,867.38,9305.63,7909.79,SKIPPED,9305.63,9305.63,7909.79,7909.79,7909.79,3921.39,867.38,867.38,SKIPPED,SKIPPED,4001.42,4001.42,7909.79
3612393,975,27704,,,,,,,RMV ANKLE IMPLANT,1512.98,605.19,0,1512.98,1286.03,SKIPPED,1512.98,1512.98,1286.03,1286.03,1286.03,625.15,741.36,741.36,SKIPPED,SKIPPED,637.91,637.91,0
3612394,975,12001,,,,,,,RPR S/N/AX/TRUNK<2.5,106.48,42.59,0,106.48,90.51,SKIPPED,106.48,106.48,90.51,90.51,90.51,48.55,52.18,52.18,0,31.94,49.54,49.54,0
3612395,360,13152,,,,,,,CMPLX RPR E/N/E/L 2.6-7.5 CM,1625.54,650.22,200.91,1625.54,1381.71,SKIPPED,1625.54,1625.54,1381.71,1381.71,1381.71,685,200.91,200.91,SKIPPED,SKIPPED,698.98,698.98,1381.71
3612396,975,13152,,,,,,,CMPLX RPR E/N/E/L 2.6-7.5 CM,835.59,334.24,0,835.59,710.25,SKIPPED,835.59,835.59,710.25,710.25,710.25,365.18,409.44,409.44,SKIPPED,SKIPPED,372.63,372.63,0
3612397,360,29834,,,,,,,ELBOW ARTHROSCOPY,6086.72,2434.69,867.38,6086.72,5173.71,SKIPPED,6086.72,6086.72,5173.71,5173.71,5173.71,2564.94,867.38,867.38,SKIPPED,SKIPPED,2617.29,2617.29,5173.71
3612398,975,29834,,,,,,,ELBOW ARTHROSCOPY,1281.13,512.45,0,1281.13,1088.96,SKIPPED,1281.13,1281.13,1088.96,1088.96,1088.96,539.35,627.75,627.75,SKIPPED,SKIPPED,550.36,550.36,0
3612400,975,11000,,,,,,,DEBRIDE INFECT SKIN,69.3,27.72,0,69.3,58.9,SKIPPED,69.3,69.3,58.9,58.9,58.9,30.5,33.96,33.96,0,20.79,31.12,31.12,0
3612401,975,37236,,,,,,,OPEN/PERQ PLACE STENT 1ST,1082.96,433.18,0,1082.96,920.52,SKIPPED,1082.96,1082.96,920.52,920.52,920.52,468.77,530.65,530.65,SKIPPED,SKIPPED,478.34,478.34,0
3612402,975,36860,,,,,,,EXTERNAL CANNULA DECLOTTING,286.23,114.49,0,286.23,243.3,SKIPPED,286.23,286.23,243.3,243.3,243.3,117.94,140.25,140.25,SKIPPED,SKIPPED,120.35,120.35,0
3612403,975,44346,,,,,,,REVISION OF COLOSTOMY,3149.82,1259.93,0,3149.82,2677.35,SKIPPED,3149.82,3149.82,2677.35,2677.35,2677.35,1279.77,1543.41,1543.41,0,944.95,1305.89,1305.89,0
3612404,975,44650,,,,,,,REPAIR BOWEL FISTULA,3857.73,1543.09,0,3857.73,3279.07,SKIPPED,3857.73,3857.73,3279.07,3279.07,3279.07,1558.12,1890.29,1890.29,0,1157.32,1589.92,1589.92,0
3612405,975,49905,,,,,,,OMENTAL FLAP INTRA-ABDOM,945.45,378.18,0,945.45,803.63,SKIPPED,945.45,945.45,803.63,803.63,803.63,378.31,463.27,463.27,0,283.64,386.03,386.03,0
3612406,975,49329,,,,,,,LAPARO PROC ABDM/PER/OMENT,612.41,244.96,0,612.41,520.55,SKIPPED,612.41,612.41,520.55,520.55,520.55,0,300.08,300.08,0,183.72,0,0,0
3612407,360,36578,,,,,,,REPLACE TUNNELED CV CATH,4788.16,1915.26,867.38,4788.16,4069.94,SKIPPED,4788.16,4788.16,4069.94,4069.94,4069.94,2017.73,867.38,867.38,SKIPPED,SKIPPED,2058.91,2058.91,4069.94
3612408,975,36578,,,,,,,REPLACE TUNNELED CV CATH,488.67,195.47,0,488.67,415.37,SKIPPED,488.67,488.67,415.37,415.37,415.37,219.68,239.45,239.45,SKIPPED,SKIPPED,224.16,224.16,0
3612409,360,32551,,,,,,,INSERTION OF CHEST TUBE,1637.6,655.04,0,1637.6,1391.96,SKIPPED,1637.6,1637.6,1391.96,1391.96,1391.96,690.09,0,0,0,491.28,704.17,704.17,1391.96
3612410,975,32551,,,,,,,INSERTION OF CHEST TUBE,422.34,168.94,0,422.34,358.99,SKIPPED,422.34,422.34,358.99,358.99,358.99,169.08,206.95,206.95,0,126.7,172.53,172.53,0
3612411,360,60210,,,,,,,PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSE,12751.01,5100.4,1051.35,12751.01,10838.36,SKIPPED,12751.01,12751.01,10838.36,10838.36,10838.36,5373.27,1051.35,1051.35,SKIPPED,SKIPPED,5482.93,5482.93,10838.36
3612412,975,60210,,,,,,,PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSE,1871.65,748.66,0,1871.65,1590.9,SKIPPED,1871.65,1871.65,1590.9,1590.9,1590.9,770.73,917.11,917.11,SKIPPED,SKIPPED,786.46,786.46,0
3612413,975,49000,,,,,,,EXPLORATORY LAPAROTO,2045.01,818,0,2045.01,1738.26,SKIPPED,2045.01,2045.01,1738.26,1738.26,1738.26,833.29,1002.05,1002.05,0,613.5,850.3,850.3,0
3612414,975,44314,,,,,,,REVISE ILEOSTOMY,2674.04,1069.62,0,2674.04,2272.93,SKIPPED,2674.04,2674.04,2272.93,2272.93,2272.93,1091.45,1310.28,1310.28,0,802.21,1113.72,1113.72,0
3612415,360,21925,,,,,,,BX SOFT TISSUE BACK/FLANK DEEP,4156.32,1662.53,414.14,4156.32,3532.87,SKIPPED,4156.32,4156.32,3532.87,3532.87,3532.87,1751.48,414.14,414.14,SKIPPED,SKIPPED,1787.22,1787.22,3532.87
3612416,975,21925,,,,,,,BX SOFT TISSUE BACK/FLANK DEEP,1168.47,467.39,0,1168.47,993.2,SKIPPED,1168.47,1168.47,993.2,993.2,993.2,411.19,572.55,572.55,SKIPPED,SKIPPED,419.58,419.58,0
3612417,975,37184,,,,,,,PRIM ART MECH THROMECTOMY,1088.47,435.39,0,1088.47,925.2,SKIPPED,1088.47,1088.47,925.2,925.2,925.2,458.85,533.35,533.35,SKIPPED,SKIPPED,468.21,468.21,0
3612418,975,37221,,,,,,,ILIAC REVASC W/STENT,1203.53,481.41,0,1203.53,1023,SKIPPED,1203.53,1203.53,1023,1023,1023,522.37,589.73,589.73,SKIPPED,SKIPPED,533.03,533.03,0
3612419,360,36515,,,,,,,APHERESIS ADSRP/REINFUSE,3784.45,1513.78,0,3216.78,3216.78,SKIPPED,2876.18,2876.18,3216.78,3216.78,3216.78,1594.76,0,0,SKIPPED,SKIPPED,1627.31,1627.31,3216.78
3612420,975,36515,,,,,,,APHERESIS ADSRP/REINFUSE,5283.55,2113.42,0,4491.02,4491.02,SKIPPED,4015.5,4015.5,4491.02,4491.02,4491.02,100.21,2588.94,2588.94,SKIPPED,SKIPPED,102.26,102.26,0
3612421,975,44020,,,,,,,EXPLORE SMALL INTESTINE,2586.53,1034.61,0,2586.53,2198.55,SKIPPED,2586.53,2586.53,2198.55,2198.55,2198.55,1055.32,1267.4,1267.4,0,775.96,1076.86,1076.86,0
3612422,360,28054,,,,,,,ARTHRTOMY W/BX INTERPHALANGEAL JOINT,3567.21,1426.88,867.38,3567.21,3032.13,SKIPPED,3567.21,3567.21,3032.13,3032.13,3032.13,1503.22,867.38,867.38,SKIPPED,SKIPPED,1533.9,1533.9,3032.13
3612423,975,28054,,,,,,,ARTHRTOMY W/BX INTERPHALANGEAL JOINT,566.84,226.74,0,566.84,481.81,SKIPPED,566.84,566.84,481.81,481.81,481.81,257.35,277.75,277.75,SKIPPED,SKIPPED,262.6,262.6,0
3612424,360,64702,,,,,,,NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT,3509.77,1403.91,510.13,3509.77,2983.3,SKIPPED,3509.77,3509.77,2983.3,2983.3,2983.3,1479.02,510.13,510.13,SKIPPED,SKIPPED,1509.2,1509.2,2983.3
3612425,975,64702,,,,,,,NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT,1191.06,476.42,0,1191.06,1012.4,SKIPPED,1191.06,1191.06,1012.4,1012.4,1012.4,559.12,583.62,583.62,SKIPPED,SKIPPED,570.53,570.53,0
3612426,360,36566,,,,,,,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PO,5615.64,2246.26,1051.35,5615.64,4773.29,SKIPPED,5615.64,5615.64,4773.29,4773.29,4773.29,2366.44,1051.35,1051.35,SKIPPED,SKIPPED,2414.73,2414.73,4773.29
3612427,975,36566,,,,,,,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PO,884.49,353.8,0,884.49,751.82,SKIPPED,884.49,884.49,751.82,751.82,751.82,387.75,433.4,433.4,SKIPPED,SKIPPED,395.66,395.66,0
3612428,975,37228,,,,,,,TIB/PER REVASC W/TLA,1321.96,528.78,0,1321.96,1123.67,SKIPPED,1321.96,1321.96,1123.67,1123.67,1123.67,573.2,647.76,647.76,SKIPPED,SKIPPED,584.9,584.9,0
3612429,975,37232,,,,,,,TIB/PER REVASC ADD-ON,490.55,196.22,0,416.97,416.97,SKIPPED,0,0,416.97,416.97,416.97,211.62,240.37,240.37,0,147.16,215.94,215.94,0
3612430,360,28585,,,,,,,OPEN TREATMENT TALOTARSAL JOINT DISLOCAT,6678.78,2671.51,1051.35,6678.78,5676.96,SKIPPED,6678.78,6678.78,5676.96,5676.96,5676.96,2814.44,1051.35,1051.35,SKIPPED,SKIPPED,2871.88,2871.88,5676.96
3612431,975,28585,,,,,,,OPEN TREATMENT TALOTARSAL JOINT DISLOCAT,2178.61,871.44,0,2178.61,1851.82,SKIPPED,2178.61,2178.61,1851.82,1851.82,1851.82,766.38,1067.52,1067.52,SKIPPED,SKIPPED,782.02,782.02,0
3612432,278,,,,,,,,HYPRO CURE,2119,847.6,0,1801.15,1801.15,SKIPPED,1610.44,1610.44,1801.15,1801.15,1801.15,892.95,1038.31,1038.31,0,635.7,911.17,911.17,1801.15
3612433,360,49525,,,,,,,RPR INGUN HERNIA SLIDING,9085.86,3634.34,867.38,9085.86,7722.98,SKIPPED,9085.86,9085.86,7722.98,7722.98,7722.98,3828.78,867.38,867.38,SKIPPED,SKIPPED,3906.92,3906.92,7722.98
3612434,975,49525,,,,,,,RPR INGUN HERNIA SLIDING,1443.48,577.39,0,1443.48,1226.96,SKIPPED,1443.48,1443.48,1226.96,1226.96,1226.96,623.73,707.31,707.31,SKIPPED,SKIPPED,636.46,636.46,0
3612435,975,49561,,,,,,,RPR VENTRAL HERN INIT BLOCK,2350.71,940.28,0,2350.71,1998.1,SKIPPED,2350.71,2350.71,1998.1,1998.1,1998.1,1005.66,1151.85,1151.85,SKIPPED,SKIPPED,1026.18,1026.18,0
3612436,975,34846,,,,,,,VISCER AND INFRARENAL ABDOM AORTA 2 PROS,5168.19,2067.28,0,5168.19,4392.96,SKIPPED,5168.19,5168.19,4392.96,4392.96,4392.96,0,2532.41,2532.41,0,1550.46,0,0,0
3612437,975,35556,,,,,,,ARTERY BYPASS GRAFT,3604.22,1441.69,0,3604.22,3063.59,SKIPPED,3604.22,3604.22,3063.59,3063.59,3063.59,1476.39,1766.07,1766.07,0,1081.27,1506.52,1506.52,0
3612438,975,36620,,,,,,,INSERT CATHETER ARTERY,131.48,52.59,0,111.76,111.76,SKIPPED,0,0,111.76,111.76,111.76,48.49,64.43,64.43,0,39.44,49.48,49.48,0
3612439,975,43279,,,,,,,LAP MYTOMY HELLER,3272.45,1308.98,0,3272.45,2781.58,SKIPPED,3272.45,3272.45,2781.58,2781.58,2781.58,1384.34,1603.5,1603.5,0,981.74,1412.59,1412.59,0
3612440,360,36474,,,,,,,ENDOVENOUS MCHNCHEM ADD-ON,3839.06,1535.62,0,3263.2,3263.2,SKIPPED,0,0,3263.2,3263.2,3263.2,1617.78,0,0,0,1151.72,1650.8,1650.8,3263.2
3612441,975,36474,,,,,,,ENDOVENOUS MCHNCHEM ADD-ON,214.17,85.67,0,182.04,182.04,SKIPPED,0,0,182.04,182.04,182.04,95.36,104.94,104.94,0,64.25,97.31,97.31,0
3612442,360,36479,,,,,,,ENDOVENOUS LASER 1ST VEIN,6891.93,2756.77,0,5858.14,5858.14,SKIPPED,0,0,5858.14,5858.14,5858.14,2904.26,0,0,0,2067.58,2963.53,2963.53,5858.14
3612443,975,36478,,,,,,,ENDOVENOUS LASER 1ST VEIN,673.45,269.38,0,673.45,572.43,SKIPPED,673.45,673.45,572.43,572.43,572.43,296.18,329.99,329.99,SKIPPED,SKIPPED,302.22,302.22,0
3612444,360,36478,,,,,,,ENDOVENOUS LASER ADD-ON,3948.83,1579.53,867.38,3948.83,3356.51,SKIPPED,3948.83,3948.83,3356.51,3356.51,3356.51,1664.04,867.38,867.38,SKIPPED,SKIPPED,1698,1698,3356.51
3612445,975,36479,,,,,,,ENDOVENOUS LASER ADD-ON,330.11,132.04,0,280.59,280.59,SKIPPED,0,0,280.59,280.59,280.59,144.93,161.75,161.75,0,99.03,147.89,147.89,0
3612446,360,37765,,,,,,,STAB PHLEB VEINS XTR 10-20,5955.13,2382.05,198.35,5061.86,5061.86,SKIPPED,1597.14,1597.14,5061.86,5061.86,5061.86,2509.5,198.35,198.35,SKIPPED,SKIPPED,2560.71,2560.71,5061.86
3612447,975,37765,,,,,,,STAB PHLEB VEINS XTR 10-20,1622.16,648.86,0,1597.14,1378.84,SKIPPED,1597.14,1597.14,1378.84,1378.84,1378.84,290.08,794.86,794.86,SKIPPED,SKIPPED,296,296,0
3612448,360,37766,,,,,,,PHLEB VEINS EXTREM 20+,6950.63,2780.25,218.56,5908.04,5908.04,SKIPPED,1800.63,1800.63,5908.04,5908.04,5908.04,2928.99,218.56,218.56,SKIPPED,SKIPPED,2988.77,2988.77,5908.04
3612449,975,37766,,,,,,,PHLEB VEINS EXTREM 20+,1928.46,771.38,0,1800.63,1639.19,SKIPPED,1800.63,1800.63,1639.19,1639.19,1639.19,354.95,944.95,944.95,SKIPPED,SKIPPED,362.19,362.19,0
3612450,360,36473,,,,,,,ENDOVENOUS MCHNCHEM 1ST VEIN,7402.44,2960.98,867.38,6292.07,6292.07,SKIPPED,6167.92,6167.92,6292.07,6292.07,6292.07,3119.39,867.38,867.38,SKIPPED,SKIPPED,3183.05,3183.05,6292.07
3612451,975,36473,,,,,,,ENDOVENOUS MCHNCHEM 1ST VEIN,427.51,171,0,427.51,363.38,SKIPPED,427.51,427.51,363.38,363.38,363.38,191.61,209.48,209.48,SKIPPED,SKIPPED,195.52,195.52,0
3612452,360,33282,,,,,,,IMPLANTATION PT-ACTIVATED CARDIAC EVENT,10293.2,4117.28,0,8749.22,8749.22,SKIPPED,7822.83,7822.83,8749.22,8749.22,8749.22,4337.56,0,0,SKIPPED,SKIPPED,4426.08,4426.08,8749.22
3612453,975,27687,,,,,,,REVISION,1140.48,456.19,0,1140.48,969.41,SKIPPED,1140.48,1140.48,969.41,969.41,969.41,498.46,558.84,558.84,SKIPPED,SKIPPED,508.63,508.63,0
3612454,975,22903,,,,,,,EXC ABD LES SC 3 CM/>,1101.87,440.75,0,1101.87,936.59,SKIPPED,1101.87,1101.87,936.59,936.59,936.59,479,539.92,539.92,SKIPPED,SKIPPED,488.78,488.78,0
3612455,975,27043,,,,,,,EXC HIP PELVIS LES SC>3CM,1181.5,472.6,0,1181.5,1004.28,SKIPPED,1181.5,1181.5,1004.28,1004.28,1004.28,509.71,578.94,578.94,SKIPPED,SKIPPED,520.11,520.11,0
3612456,360,22902,,,,,,,EXC TUMOR SOFT TISSUE ABD. WALL<3 CM,3909.26,1563.7,414.14,3909.26,3322.87,SKIPPED,3909.26,3909.26,3322.87,3322.87,3322.87,1647.36,414.14,414.14,SKIPPED,SKIPPED,1680.98,1680.98,3322.87
3612457,975,22902,,,,,,,EXC TUMOR SOFT TISSUE ABD. WALL<3 CM,1084.09,433.64,0,1084.09,921.48,SKIPPED,1084.09,1084.09,921.48,921.48,921.48,363.32,531.2,531.2,SKIPPED,SKIPPED,370.73,370.73,0
3612458,975,45382,,,,,,,#COLONSCOPY W/CNTR B,954.48,381.79,0,954.48,811.31,SKIPPED,954.48,954.48,811.31,811.31,811.31,283.07,467.7,467.7,SKIPPED,SKIPPED,288.85,288.85,0
3612459,360,44602,,,,,,,SUTURE SMALL INTESTINE,13025.9,5210.36,0,11072.02,11072.02,SKIPPED,6972.29,6972.29,11072.02,11072.02,11072.02,5489.12,0,0,0,3907.77,5601.14,5601.14,11072.02
3612460,975,19020,,,,,,,MASTOTOMY W/EXP ABSC,1159.38,463.75,0,1159.38,985.47,SKIPPED,1159.38,1159.38,985.47,985.47,985.47,340.6,568.1,568.1,SKIPPED,SKIPPED,347.55,347.55,0
3612461,360,28475,,,,,,,TREAT METATARSAL FRACTURE,712.17,284.87,87.17,605.34,605.34,SKIPPED,531.76,531.76,605.34,605.34,605.34,300.11,87.17,87.17,SKIPPED,SKIPPED,306.23,306.23,605.34
3612462,975,28475,,,,,,,TREAT METATARSAL FRACTURE,637.72,255.09,0,542.06,542.06,SKIPPED,531.76,531.76,542.06,542.06,542.06,249.54,312.48,312.48,SKIPPED,SKIPPED,254.63,254.63,0
3612463,360,49566,,,,,,,REPAIR VENTRL HERNIA BLOCK,12590.84,5036.34,1051.35,12590.84,10702.21,SKIPPED,12590.84,12590.84,10702.21,10702.21,10702.21,5305.78,1051.35,1051.35,SKIPPED,SKIPPED,5414.06,5414.06,10702.21
3612464,975,36903,,,,,,,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT,774.29,309.72,0,774.29,658.15,SKIPPED,774.29,774.29,658.15,658.15,658.15,339.55,379.4,379.4,SKIPPED,SKIPPED,346.48,346.48,0
3612465,975,60500,,,,,,,EXPLORE PARATHYROID GLANDS,2300.3,920.12,0,2300.3,1955.26,SKIPPED,2300.3,2300.3,1955.26,1955.26,1955.26,1053.23,1127.15,1127.15,SKIPPED,SKIPPED,1074.72,1074.72,0
3612466,975,34802,,,,,,,ENDOVAS AAA REPR W/2-P PART,3204.21,1281.68,0,2723.58,2723.58,SKIPPED,2435.2,2435.2,2723.58,2723.58,2723.58,1414.69,1570.06,1570.06,0,961.26,1443.56,1443.56,0
3612467,975,35666,,,,,,,ARTERY BYPASS GRAFT,3254.44,1301.78,0,3254.44,2766.27,SKIPPED,3254.44,3254.44,2766.27,2766.27,2766.27,1365.98,1594.68,1594.68,0,976.33,1393.86,1393.86,0
3612468,975,43830,,,,,,,PLACE GASTROSTOMY TUBE,1764,705.6,0,1764,1499.4,SKIPPED,1764,1764,1499.4,1499.4,1499.4,764.42,864.36,864.36,0,529.2,780.02,780.02,0
3612469,360,27339,,,,,,,EXC THIGH/KNEE TUM DEP 5CM/>,7560.69,3024.28,582.36,7560.69,6426.59,SKIPPED,7560.69,7560.69,6426.59,6426.59,6426.59,3186.08,582.36,582.36,SKIPPED,SKIPPED,3251.1,3251.1,6426.59
3612470,975,27339,,,,,,,EXC THIGH/KNEE TUM DEP 5CM/>,1894.01,757.6,0,1894.01,1609.91,SKIPPED,1894.01,1894.01,1609.91,1609.91,1609.91,820.66,928.06,928.06,SKIPPED,SKIPPED,837.41,837.41,0
3612471,360,43241,,,,,,,EGD TUBE/CATH INSERTION,2987.78,1195.11,414.14,2987.78,2539.61,SKIPPED,2987.78,2987.78,2539.61,2539.61,2539.61,1259.06,414.14,414.14,SKIPPED,SKIPPED,1284.75,1284.75,2539.61
3612472,975,43241,,,,,,,EGD TUBE/CATH INSERTION,368.84,147.54,0,368.84,313.51,SKIPPED,368.84,368.84,313.51,313.51,313.51,155.2,180.73,180.73,SKIPPED,SKIPPED,158.37,158.37,0
3612473,975,11401,,,,,,,#EX BN LZ TRK AM LG,246.94,98.78,0,246.94,209.9,SKIPPED,246.94,246.94,209.9,209.9,209.9,115.25,121,121,SKIPPED,SKIPPED,117.6,117.6,0
3612474,975,46020,,,,,,,PLACEMENT OF SETON,687.29,274.92,0,687.29,584.2,SKIPPED,687.29,687.29,584.2,584.2,584.2,125.72,336.77,336.77,SKIPPED,SKIPPED,128.29,128.29,0
3612475,360,40806,,,,,,,INCISION OF LIP FOLD,1694.72,677.89,71.6,1440.51,1440.51,SKIPPED,444.6,444.6,1440.51,1440.51,1440.51,714.16,71.6,71.6,SKIPPED,SKIPPED,728.73,728.73,1440.51
3612476,975,11640,,,,,,,EXC F/E/E/N/L MAL+MRG 0.5CM,457.92,183.17,0,457.92,389.23,SKIPPED,457.92,457.92,389.23,389.23,389.23,137.71,224.38,224.38,SKIPPED,SKIPPED,140.52,140.52,0
3612477,360,15200,,,,,,,SKIN FULL GRAFT TRUNK,5481.7,2192.68,582.36,5481.7,4659.44,SKIPPED,5481.7,5481.7,4659.44,4659.44,4659.44,2309.99,582.36,582.36,SKIPPED,SKIPPED,2357.13,2357.13,4659.44
3612478,975,15200,,,,,,,SKIN FULL GRAFT TRUNK,2057.18,822.87,0,2057.18,1748.6,SKIPPED,2057.18,2057.18,1748.6,1748.6,1748.6,729.2,1008.02,1008.02,SKIPPED,SKIPPED,744.08,744.08,0
3612479,360,49580,,,,,,,RPR UMBIL HERN REDUC <5 YR,7307.33,2922.93,867.38,7307.33,6211.23,SKIPPED,7307.33,7307.33,6211.23,6211.23,6211.23,3079.31,867.38,867.38,SKIPPED,SKIPPED,3142.15,3142.15,6211.23
3612480,975,49580,,,,,,,RPR UMBIL HERN REDUC <5 YR,792.46,316.98,0,792.46,673.59,SKIPPED,792.46,792.46,673.59,673.59,673.59,368.33,388.31,388.31,SKIPPED,SKIPPED,375.85,375.85,0
3612481,360,40804,,,,,,,REMOVAL FOREIGN BODY MOUTH,270.57,108.23,0,270.57,229.98,SKIPPED,270.57,270.57,229.98,229.98,229.98,114.02,0,0,0,81.17,116.35,116.35,229.98
3612482,975,40804,,,,,,,REMOVAL FOREIGN BODY MOUTH,273.06,109.22,0,273.06,232.1,SKIPPED,273.06,273.06,232.1,232.1,232.1,123.17,133.8,133.8,0,81.92,125.68,125.68,0
3612483,360,26951,,,,,,,AMPUTATION OF FINGER/THUMB,4994.69,1997.88,867.38,4994.69,4245.49,SKIPPED,4994.69,4994.69,4245.49,4245.49,4245.49,2104.77,867.38,867.38,SKIPPED,SKIPPED,2147.72,2147.72,4245.49
3612484,975,,,,,,,,AMPUTATION OF FINGER/THUMB,1592.55,637.02,0,1353.67,1353.67,SKIPPED,1210.34,1210.34,1353.67,1353.67,1353.67,0,780.35,780.35,0,477.76,0,0,0
3612485,360,29999,,,,,,,UNLISTED PROCEDURE ARTHROSCOPY,4049.64,1619.86,0,3442.19,3442.19,SKIPPED,1020.78,1020.78,3442.19,3442.19,3442.19,1706.52,0,0,0,1214.89,1741.35,1741.35,3442.19
3612486,975,29999,,,,,,,UNLISTED PROCEDURE ARTHROSCOPY,510.07,204.03,0,510.07,433.56,SKIPPED,510.07,510.07,433.56,433.56,433.56,0,249.93,249.93,0,153.02,0,0,0
3612487,360,0232T,,,,,,,NJX PLATELET PLASMA,2978.85,1191.54,0,2532.02,2532.02,SKIPPED,1567.55,1567.55,2532.02,2532.02,2532.02,1255.29,0,0,0,893.66,1280.91,1280.91,2532.02
3612488,975,0232T,,,,,,,NJX PLATELET PLASMA,112.85,45.14,0,112.85,95.92,SKIPPED,112.85,112.85,95.92,95.92,95.92,0,55.3,55.3,0,33.86,0,0,0
3612489,975,36140,,,,,,,INTRO NDLE/INTRACATH,219.09,87.64,0,186.23,186.23,SKIPPED,0,0,186.23,186.23,186.23,95.24,107.35,107.35,0,65.73,97.18,97.18,0
3612490,270,,,,,,,,STRYKER TOWER,4.73,1.89,0,4.02,4.02,SKIPPED,3.59,3.59,4.02,4.02,4.02,1.99,2.32,2.32,0,1.42,2.03,2.03,4.02
3612491,270,,,,,,,,YELLOW FINS,15.52,6.21,0,13.19,13.19,SKIPPED,11.8,11.8,13.19,13.19,13.19,6.54,7.6,7.6,0,4.66,6.67,6.67,13.19
3612492,360,65420,,,,,,,REMOVE EYE LESION,4238.52,1695.41,582.36,4238.52,3602.74,SKIPPED,4238.52,4238.52,3602.74,3602.74,3602.74,1786.11,582.36,582.36,SKIPPED,SKIPPED,1822.56,1822.56,3602.74
3612493,360,64726,,,,,,,RELEASE FOOT/TOE NERVE,2820.59,1128.24,510.13,2820.59,2397.5,SKIPPED,2820.59,2820.59,2397.5,2397.5,2397.5,1188.59,510.13,510.13,SKIPPED,SKIPPED,1212.85,1212.85,2397.5
3612494,975,64726,,,,,,,RELEASE FOOT/TOE NERVE,690.07,276.03,0,690.07,586.56,SKIPPED,690.07,690.07,586.56,586.56,586.56,297.07,338.13,338.13,SKIPPED,SKIPPED,303.13,303.13,0
3612495,360,28124,,,,,,,PARTIAL REMOVAL OF TOE,3891.38,1556.55,241.37,3307.67,3307.67,SKIPPED,1439.82,1439.82,3307.67,3307.67,3307.67,1639.82,241.37,241.37,SKIPPED,SKIPPED,1673.29,1673.29,3307.67
3612496,975,28124,,,,,,,PARTIAL REMOVAL OF TOE,1202.26,480.9,0,1202.26,1021.92,SKIPPED,1202.26,1202.26,1021.92,1021.92,1021.92,366.3,589.11,589.11,SKIPPED,SKIPPED,373.78,373.78,0
3612497,360,38500,,,,,,,BX/REMOVE LYMPH NODES,5841.54,2336.62,807.26,5841.54,4965.31,SKIPPED,5841.54,5841.54,4965.31,4965.31,4965.31,2461.62,807.26,807.26,SKIPPED,SKIPPED,2511.86,2511.86,4965.31
3612498,360,69421,,,,,,,INCISION OF EARDRUM,3655.27,1462.11,748.53,3655.27,3106.98,SKIPPED,3655.27,3655.27,3106.98,3106.98,3106.98,1540.33,748.53,748.53,SKIPPED,SKIPPED,1571.77,1571.77,3106.98
3612499,360,28002,,,,,,,TRT FOOT INFECTION,3285.16,1314.06,510.13,3285.16,2792.39,SKIPPED,3285.16,3285.16,2792.39,2792.39,2792.39,1384.37,510.13,510.13,SKIPPED,SKIPPED,1412.62,1412.62,2792.39
3612500,975,44025,,,,,,,COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY,2491.29,996.52,0,2491.29,2117.6,SKIPPED,2491.29,2491.29,2117.6,2117.6,2117.6,1064.43,1220.73,1220.73,0,747.39,1086.15,1086.15,0
3612501,360,44340,,,,,,,REVISION OF COLOSTOMY,7815.96,3126.38,1051.35,7815.96,6643.57,SKIPPED,7815.96,7815.96,6643.57,6643.57,6643.57,3293.64,1051.35,1051.35,SKIPPED,SKIPPED,3360.86,3360.86,6643.57
3612502,975,44340,,,,,,,REVISION OF COLOSTOMY,1572.38,628.95,0,1572.38,1336.52,SKIPPED,1572.38,1572.38,1336.52,1336.52,1336.52,681.55,770.47,770.47,SKIPPED,SKIPPED,695.46,695.46,0
3612503,975,11602,,,,,,,EXC TR-EXT MAL+MARG 1.1-2 CM,611.01,244.4,0,611.01,519.36,SKIPPED,611.01,611.01,519.36,519.36,519.36,175.8,299.39,299.39,SKIPPED,SKIPPED,179.39,179.39,0
3612504,975,19302,,,,,,,P-MASTECTOMY W/LN REMOVAL,2292.19,916.88,0,2292.19,1948.36,SKIPPED,2292.19,2292.19,1948.36,1948.36,1948.36,983.94,1123.17,1123.17,SKIPPED,SKIPPED,1004.02,1004.02,0
3612505,975,38542,,,,,,,DISSECTION DEEP JUGULAR NODE,1308.12,523.25,0,1308.12,1111.9,SKIPPED,1308.12,1308.12,1111.9,1111.9,1111.9,571.82,640.98,640.98,SKIPPED,SKIPPED,583.49,583.49,0
3612506,360,60260,,,,,,,THYROIDECTOMY RMVL REMAINING TISS FLWG P,12886.62,5154.65,0,12886.62,10953.63,SKIPPED,12886.62,12886.62,10953.63,10953.63,10953.63,5430.42,0,0,0,3865.99,5541.25,5541.25,10953.63
3612507,975,60260,,,,,,,THYROIDECTOMY RMVL REMAINING TISS FLWG P,2761.88,1104.75,0,2761.88,2347.6,SKIPPED,2761.88,2761.88,2347.6,2347.6,2347.6,1185.69,1353.32,1353.32,0,828.56,1209.89,1209.89,0
3612508,975,64704,,,,,,,REVISE HAND/FOOT NERVE,764.98,305.99,0,764.98,650.23,SKIPPED,764.98,764.98,650.23,650.23,650.23,356.95,374.84,374.84,SKIPPED,SKIPPED,364.23,364.23,0
3612509,975,45379,,,,,,,#COLONOSCOPY FLX W/RMVE F,586.93,234.77,0,586.93,498.89,SKIPPED,586.93,586.93,498.89,498.89,498.89,260.71,287.6,287.6,SKIPPED,SKIPPED,266.03,266.03,0
3612510,360,75716,,,,,,,ANGIOGRAPHY EXTRM BILAT RS&I,5665.42,2266.17,0,5665.42,4815.61,SKIPPED,5665.42,5665.42,4815.61,4815.61,4815.61,2387.41,0,0,0,1600.34,2436.13,2436.13,4815.61
3612511,975,75716,,,,,,,ANGIOGRAPHY EXTRM BILAT RS&I,231.04,92.42,0,231.04,196.38,SKIPPED,231.04,231.04,196.38,196.38,196.38,102.11,231.04,231.04,0,231.04,104.19,104.19,0
3612512,360,35522,,,,,,,BYPASS W/VEIN AXILLARY-BRACHIAL,10488.49,4195.4,0,8915.22,8915.22,SKIPPED,6007.42,6007.42,8915.22,8915.22,8915.22,4419.85,0,0,0,3146.55,4510.05,4510.05,8915.22
3612513,975,35522,,,,,,,BYPASS W/VEIN AXILLARY-BRACHIAL,3080.95,1232.38,0,3080.95,2618.81,SKIPPED,3080.95,3080.95,2618.81,2618.81,2618.81,1233.13,1509.67,1509.67,0,924.28,1258.3,1258.3,0
3612514,360,27899,,,,,,,UNLISTED PROC LEG/ANKLE,3947.54,1579.02,0,3355.41,3355.41,SKIPPED,1020.78,1020.78,3355.41,3355.41,3355.41,1663.49,0,0,0,1184.26,1697.44,1697.44,3355.41
3612515,975,27899,,,,,,,UNLISTED PROC LEG/ANKLE,1212.48,484.99,0,1030.61,1030.61,SKIPPED,1020.78,1020.78,1030.61,1030.61,1030.61,0,594.12,594.12,0,363.74,0,0,0
3612516,360,20551,,,,,,,INJ SINGLE TENDON ORIGIN/INSERTION,507.97,203.19,21.94,431.77,431.77,SKIPPED,153.9,153.9,431.77,431.77,431.77,214.06,21.94,21.94,SKIPPED,SKIPPED,218.43,218.43,431.77
3612517,975,20551,,,,,,,INJ SINGLE TENDON ORIGIN/INSERTION,151.88,60.75,0,151.88,129.1,SKIPPED,151.88,151.88,129.1,129.1,129.1,42.85,74.42,74.42,SKIPPED,SKIPPED,43.72,43.72,0
3612518,975,38740,,,,,,,RMV ARMPIT LYMPH NODES,1748.51,699.4,0,1748.51,1486.23,SKIPPED,1748.51,1748.51,1486.23,1486.23,1486.23,759.69,856.77,856.77,SKIPPED,SKIPPED,775.19,775.19,0
3612519,402,76937,,,,,,,SURG US VASCULAR,592.95,237.18,0,504.01,504.01,SKIPPED,87.53,87.53,504.01,504.01,504.01,249.87,290.55,290.55,0,177.88,254.97,254.97,504.01
3612520,975,76937,,,,,,,SURG US VASCULAR,34.7,13.88,0,34.7,29.5,SKIPPED,34.7,34.7,29.5,29.5,29.5,15.13,17,17,0,10.41,15.44,15.44,0
3612521,360,44186,,,,,,,LAP JEJUNOSTOMY,8599.58,3439.83,0,8599.58,7309.64,SKIPPED,8599.58,8599.58,7309.64,7309.64,7309.64,3623.86,0,0,0,2579.87,3697.82,3697.82,7309.64
3612522,975,44186,,,,,,,LAP JEJUNOSTOMY,1640.03,656.01,0,1640.03,1394.03,SKIPPED,1640.03,1640.03,1394.03,1394.03,1394.03,706.5,803.61,803.61,0,492.01,720.92,720.92,0
3612523,360,21012,,,,,,,EXC FACE LES SBQ 2CM/>,4689.07,1875.63,414.14,3985.71,3985.71,SKIPPED,2578.68,2578.68,3985.71,3985.71,3985.71,1975.97,414.14,414.14,SKIPPED,SKIPPED,2016.3,2016.3,3985.71
3612524,975,21012,,,,,,,EXC FACE LES SBQ 2CM/>,851.29,340.52,0,851.29,723.6,SKIPPED,851.29,851.29,723.6,723.6,723.6,369.86,417.13,417.13,SKIPPED,SKIPPED,377.41,377.41,0
3612525,272,,,,,,,,AMINOFIX PARTICULATE 100MG,750,300,0,637.5,637.5,SKIPPED,570,570,637.5,637.5,637.5,316.05,367.5,367.5,0,225,322.5,322.5,637.5
3612526,272,,,,,,,,PARIETEX,375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3612527,272,,,,,,,,PALINDROME,416,166.4,0,353.6,353.6,SKIPPED,316.16,316.16,353.6,353.6,353.6,175.3,203.84,203.84,0,124.8,178.88,178.88,353.6
3612528,360,15734,,,,,,,MUSCLE/SKIN GRAFT OR TRUNK,6107,2442.8,1051.35,6107,5190.95,SKIPPED,6107,6107,5190.95,5190.95,5190.95,2573.49,1051.35,1051.35,SKIPPED,SKIPPED,2626.01,2626.01,5190.95
3612529,975,15734,,,,,,,MUSCLE/SKIN GRAFT OR TRUNK,3805.87,1522.35,0,3805.87,3234.99,SKIPPED,3805.87,3805.87,3234.99,3234.99,3234.99,1627.29,1864.88,1864.88,SKIPPED,SKIPPED,1660.5,1660.5,0
3612530,320,77001,,,,,,,FLUORO CENTRAL VENOUS ACCESS DEV PLACEME,770.24,308.1,0,654.7,654.7,SKIPPED,337.26,337.26,654.7,654.7,654.7,324.58,377.42,377.42,0,231.07,331.2,331.2,654.7
3612531,975,77001,,,,,,,FLUORO CENTRAL VENOUS ACCESS DEV PLACEME,44.78,17.91,0,44.78,38.06,SKIPPED,44.78,44.78,38.06,38.06,38.06,20.2,21.94,21.94,0,13.43,20.61,20.61,0
3612532,360,28315,,,,,,,RMV SESAMOID BONE,4265.34,1706.14,867.38,4265.34,3625.54,SKIPPED,4265.34,4265.34,3625.54,3625.54,3625.54,1797.42,867.38,867.38,SKIPPED,SKIPPED,1834.1,1834.1,3625.54
3612533,975,28315,,,,,,,RMV SESAMOID BONE,1222.68,489.07,0,1222.68,1039.28,SKIPPED,1222.68,1222.68,1039.28,1039.28,1039.28,359.27,599.11,599.11,SKIPPED,SKIPPED,366.6,366.6,0
3612534,360,21930,,,,,,,EXC BACK LESION<3CM,3384.7,1353.88,414.14,3384.7,2877,SKIPPED,3384.7,3384.7,2877,2877,2877,1426.31,414.14,414.14,SKIPPED,SKIPPED,1455.42,1455.42,2877
3612535,975,36905,,,,,,,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO,1085.34,434.14,0,1085.34,922.54,SKIPPED,1085.34,1085.34,922.54,922.54,922.54,479.65,531.82,531.82,SKIPPED,SKIPPED,489.44,489.44,0
3612536,975,24075,,,,,,,EXC ARM/ELBOW LES SC < 3 CM,1222.68,489.07,0,1222.68,1039.28,SKIPPED,1222.68,1222.68,1039.28,1039.28,1039.28,360.55,599.11,599.11,SKIPPED,SKIPPED,367.91,367.91,0
3612537,975,28309,,,,,,,INCISION OF METATARSALS,2260.3,904.12,0,2260.3,1921.26,SKIPPED,2260.3,2260.3,1921.26,1921.26,1921.26,974.88,1107.55,1107.55,SKIPPED,SKIPPED,994.78,994.78,0
3612538,975,60220,,,,,,,TOTAL THYROID LOBECTOMY,1676.7,670.68,0,1676.7,1425.2,SKIPPED,1676.7,1676.7,1425.2,1425.2,1425.2,771.27,821.58,821.58,SKIPPED,SKIPPED,787.01,787.01,0
3612539,360,43281,,,,,,,LAP PARAESOPHAG HERN REPAIR,17333.18,6933.27,0,17333.18,14733.2,SKIPPED,17333.18,17333.18,14733.2,14733.2,14733.2,7304.2,0,0,0,5199.95,7453.27,7453.27,14733.2
3612540,975,43281,,,,,,,LAP PARAESOPHAG HERN REPAIR,3901.59,1560.64,0,3901.59,3316.35,SKIPPED,3901.59,3901.59,3316.35,3316.35,3316.35,1658.1,1911.78,1911.78,0,1170.48,1691.94,1691.94,0
3612541,975,43247,,,,,,,#GI UPPER W/RMVE FB,435.93,174.37,0,435.93,370.54,SKIPPED,435.93,435.93,370.54,370.54,370.54,192.75,213.61,213.61,SKIPPED,SKIPPED,196.68,196.68,0
3612542,975,44310,,,,,,,ILEOSTOMY/JEJUNOSTOMY,2644.46,1057.78,0,2644.46,2247.79,SKIPPED,2644.46,2644.46,2247.79,2247.79,2247.79,1125.88,1295.79,1295.79,0,793.34,1148.86,1148.86,0
3612543,360,43335,,,,,,,TRANSTHOR DIAPHRAG HERN RPR,11725.2,4690.08,0,9966.42,9966.42,SKIPPED,6619.41,6619.41,9966.42,9966.42,9966.42,4941,0,0,0,3517.56,5041.84,5041.84,9966.42
3612544,975,43335,,,,,,,TRANSTHOR DIAPHRAG HERN RPR,3388.54,1355.42,0,3388.54,2880.26,SKIPPED,3388.54,3388.54,2880.26,2880.26,2880.26,1422.77,1660.38,1660.38,0,1016.56,1451.81,1451.81,0
3612545,360,75625,,,,,,,CONTRAST EXAM ABD AORTA,5508.44,2203.38,0,5508.44,4682.17,SKIPPED,5508.44,5508.44,4682.17,4682.17,4682.17,2321.26,0,0,0,1600.34,2368.63,2368.63,4682.17
3612546,975,75625,,,,,,,CONTRAST EXAM ABD AORTA,133.74,53.5,0,133.74,113.68,SKIPPED,133.74,133.74,113.68,113.68,113.68,74.13,133.74,133.74,0,133.74,75.64,75.64,0
3612547,975,38120,,,,,,,LAPAROSCOPY SPLEBECTOMY,2669.98,1067.99,0,2669.98,2269.48,SKIPPED,2669.98,2669.98,2269.48,2269.48,2269.48,1142.52,1308.29,1308.29,0,800.99,1165.84,1165.84,0
3612548,975,49320,,,,,,,DIAG LAPARO SPEARATE PROC,828.31,331.32,0,828.31,704.06,SKIPPED,828.31,828.31,704.06,704.06,704.06,356.58,405.87,405.87,SKIPPED,SKIPPED,363.86,363.86,0
3612549,975,60200,,,,,,,RMV THYROID LESION,1659.17,663.67,0,1659.17,1410.29,SKIPPED,1659.17,1659.17,1410.29,1410.29,1410.29,729.08,812.99,812.99,SKIPPED,SKIPPED,743.96,743.96,0
3612550,975,34845,,,,,,,VISC & INFRAREN ABD 1 PROSTH,4644.75,1857.9,0,4644.75,3948.04,SKIPPED,4644.75,4644.75,3948.04,3948.04,3948.04,0,2275.93,2275.93,0,1393.42,0,0,0
3612551,975,34812,,,,,,,OPEN FEM EXPOS,529.66,211.86,0,529.66,450.21,SKIPPED,529.66,529.66,450.21,450.21,450.21,217.37,259.53,259.53,0,158.9,221.81,221.81,0
3612552,975,45171,,,,,,,EXC REST TUM TRANSANAL PART,1526.44,610.58,0,1526.44,1297.47,SKIPPED,1526.44,1526.44,1297.47,1297.47,1297.47,679.84,747.96,747.96,SKIPPED,SKIPPED,693.71,693.71,0
3612553,975,37225,,,,,,,FEM/POPL REVAS W/ ATHER,1559.62,623.85,0,1559.62,1325.68,SKIPPED,1559.62,1559.62,1325.68,1325.68,1325.68,636.14,764.21,764.21,SKIPPED,SKIPPED,649.12,649.12,0
3612554,975,37223,,,,,,,ILIAC REVASC W/STENT ADD-ON,552.63,221.05,0,469.74,469.74,SKIPPED,0,0,469.74,469.74,469.74,224.58,270.79,270.79,0,165.79,229.16,229.16,0
3612555,360,49204,,,,,,,EXC ABD TUM>5CM,13847.66,5539.06,0,11770.51,11770.51,SKIPPED,7565.52,7565.52,11770.51,11770.51,11770.51,5835.4,0,0,0,4154.3,5954.49,5954.49,11770.51
3612556,975,49204,,,,,,,EXC ABD TUM>5CM,3901.59,1560.64,0,3901.59,3316.35,SKIPPED,3901.59,3901.59,3316.35,3316.35,3316.35,1646.04,1911.78,1911.78,0,1170.48,1679.63,1679.63,0
3612557,360,33228,,,,,,,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2,17458.27,6983.31,1051.35,17458.27,14839.53,SKIPPED,17458.27,17458.27,14839.53,14839.53,14839.53,7356.92,1051.35,1051.35,SKIPPED,SKIPPED,7507.06,7507.06,14839.53
3612558,360,49082,,,,,,,ABD PARACENTHESIS,1582.59,633.04,269.69,1582.59,1345.2,SKIPPED,1582.59,1582.59,1345.2,1345.2,1345.2,666.9,269.69,269.69,SKIPPED,SKIPPED,680.51,680.51,1345.2
3612559,975,49082,,,,,,,ABD PARACENTHESIS,190.16,76.06,0,190.16,161.64,SKIPPED,190.16,190.16,161.64,161.64,161.64,79.88,93.18,93.18,SKIPPED,SKIPPED,81.51,81.51,0
3612560,360,35190,,,,,,,RPR/TRAUMATIC AV FISTULA EXTREMITIES,9231.35,3692.54,0,9231.35,7846.65,SKIPPED,9231.35,9231.35,7846.65,7846.65,7846.65,3890.09,0,0,0,2769.4,3969.48,3969.48,7846.65
3612561,975,35190,,,,,,,RPR/TRAUMATIC AV FISTULA EXTREMITIES,1948.89,779.56,0,1948.89,1656.56,SKIPPED,1948.89,1948.89,1656.56,1656.56,1656.56,815.57,954.96,954.96,0,584.67,832.21,832.21,0
3612562,975,37249,,,,,,,TRLUML BALO ANGIOP ADD VEIN,376.51,150.6,0,320.03,320.03,SKIPPED,0,0,320.03,320.03,320.03,155.53,184.49,184.49,0,112.95,158.7,158.7,0
3612563,975,49324,,,,,,,LAP INSERT TUNNEL IP CATH,987.85,395.14,0,987.85,839.67,SKIPPED,987.85,987.85,839.67,839.67,839.67,419.61,484.05,484.05,SKIPPED,SKIPPED,428.17,428.17,0
3612564,975,44300,,,,,,,OPEN BOWEL TO SKIN,2140.32,856.13,0,2140.32,1819.27,SKIPPED,2140.32,2140.32,1819.27,1819.27,1819.27,910.91,1048.76,1048.76,0,642.1,929.5,929.5,0
3612565,975,11422,,,,,,,EXC H-F-NK-SP B9+MARG 1.1-2,343.32,137.33,0,343.32,291.82,SKIPPED,343.32,343.32,291.82,291.82,291.82,147.77,168.23,168.23,SKIPPED,SKIPPED,150.79,150.79,0
3612566,975,36902,,,,,,,INTRO CATH DLYS CIRCUT,621.56,248.62,0,621.56,528.33,SKIPPED,621.56,621.56,528.33,528.33,528.33,258.61,304.56,304.56,SKIPPED,SKIPPED,263.89,263.89,0
3612567,975,49659,,,,,,,LAPARO PROC. HERNIA REPAIR,638.14,255.26,0,638.14,542.42,SKIPPED,638.14,638.14,542.42,542.42,542.42,0,312.69,312.69,0,191.44,0,0,0
3612568,975,11444,,,,,,,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M,540.56,216.22,0,540.56,459.48,SKIPPED,540.56,540.56,459.48,459.48,459.48,246.31,264.87,264.87,SKIPPED,SKIPPED,251.34,251.34,0
3612569,360,37799,,,,,,,UNLISTED VASCULAR PROC,6381.42,2552.57,0,5424.21,5424.21,SKIPPED,2909.71,2909.71,5424.21,5424.21,5424.21,2689.13,0,0,0,1914.43,2744.01,2744.01,5424.21
3612570,975,37799,,,,,,,UNLISTED VASCULAR PROC,2552.56,1021.02,0,2552.56,2169.68,SKIPPED,2552.56,2552.56,2169.68,2169.68,2169.68,0,1250.75,1250.75,0,765.77,0,0,0
3612571,975,45110,,,,,,,PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST,4708.2,1883.28,0,4708.2,4001.97,SKIPPED,4708.2,4708.2,4001.97,4001.97,4001.97,1978.88,2307.02,2307.02,0,1412.46,2019.27,2019.27,0
3612572,360,36482,,,,,,,ENDOVEN THERAPY CHEM ADHES 1ST,7468.8,2987.52,0,7468.8,6348.48,SKIPPED,7468.8,7468.8,6348.48,6348.48,6348.48,3147.35,0,0,0,2240.64,3211.58,3211.58,6348.48
3612573,975,36482,,,,,,,ENDOVEN THERAPY CHEM ADHES 1ST,453.09,181.24,0,453.09,385.13,SKIPPED,453.09,453.09,385.13,385.13,385.13,191.64,222.01,222.01,0,135.93,195.55,195.55,0
3612574,360,28230,,,,,,,INCISION FOOT TENDON(S),3565.94,1426.38,224.91,3031.05,3031.05,SKIPPED,1342.35,1342.35,3031.05,3031.05,3031.05,1502.68,224.91,224.91,SKIPPED,SKIPPED,1533.35,1533.35,3031.05
3612575,975,28230,,,,,,,INCISION FOOT TENDON(S),722.38,288.95,0,722.38,614.02,SKIPPED,722.38,722.38,614.02,614.02,614.02,311.97,353.97,353.97,SKIPPED,SKIPPED,318.34,318.34,0
3612576,360,75860,,,,,,,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&,3073.42,1229.37,0,3073.42,2612.41,SKIPPED,3073.42,3073.42,2612.41,2612.41,2612.41,1295.14,0,0,0,1600.34,1321.57,1321.57,2612.41
3612577,975,75860,,,,,,,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&,134.22,53.69,0,134.22,114.09,SKIPPED,134.22,134.22,114.09,114.09,114.09,59.55,134.22,134.22,0,134.22,60.77,60.77,0
3612578,360,36005,,,,,,,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,1273.74,509.5,0,1082.68,1082.68,SKIPPED,0,0,1082.68,1082.68,1082.68,536.76,0,0,0,382.12,547.71,547.71,1082.68
3612579,975,36005,,,,,,,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,124.13,49.65,0,105.51,105.51,SKIPPED,0,0,105.51,105.51,105.51,51.41,60.82,60.82,0,37.24,52.46,52.46,0
3612580,278,,,,,,,,SUPERION 8MM-16MM(VERTIFLEX),26250,10500,0,22312.5,22312.5,SKIPPED,19950,19950,22312.5,22312.5,22312.5,11061.75,12862.5,12862.5,0,7875,11287.5,11287.5,22312.5
3612581,272,,,,,,,,ENDO GASTROC DISP KIT,2640,1056,0,2244,2244,SKIPPED,2006.4,2006.4,2244,2244,2244,1112.5,1293.6,1293.6,0,792,1135.2,1135.2,2244
3612582,360,36471,,,,,,,INJECT SCLEROSANT MULT INCMPTNT VEINS,682.82,273.13,0,620.73,580.4,SKIPPED,620.73,620.73,580.4,580.4,580.4,287.74,110,110,0,204.85,293.61,293.61,580.4
3612583,975,36471,,,,,,,INJECT SCLEROSANT MULT INCMPTNT VEINS,195.27,78.11,0,195.27,165.98,SKIPPED,195.27,195.27,165.98,165.98,165.98,80.9,95.68,95.68,0,58.58,82.55,82.55,0
3612584,360,19306,,,,,,,MAST RAD URBAN TYPE,10720.76,4288.3,0,9112.65,9112.65,SKIPPED,5893.18,5893.18,9112.65,9112.65,9112.65,4517.73,0,0,0,3216.23,4609.93,4609.93,9112.65
3612585,975,19306,,,,,,,MAST RAD URBAN TYPE,3027.34,1210.94,0,3027.34,2573.24,SKIPPED,3027.34,3027.34,2573.24,2573.24,2573.24,1327.72,1483.4,1483.4,0,908.2,1354.82,1354.82,0
3612586,360,11400,,,,,,,"EXC BENIGN,TRUNK,ARMS",641.97,256.79,73.91,545.67,545.67,SKIPPED,436.05,436.05,545.67,545.67,545.67,270.53,73.91,73.91,SKIPPED,SKIPPED,276.05,276.05,545.67
3612587,975,11400,,,,,,,"EXC BENIGN,TRUNK,ARMS",285.51,114.2,0,285.51,242.68,SKIPPED,285.51,285.51,242.68,242.68,242.68,91.24,139.9,139.9,SKIPPED,SKIPPED,93.1,93.1,0
3612588,360,49255,,,,,,,RMV OMENTUM,4935.39,1974.16,0,4195.08,4195.08,SKIPPED,3903.79,3903.79,4195.08,4195.08,4195.08,2079.78,0,0,0,1480.62,2122.22,2122.22,4195.08
3612589,975,49255,,,,,,,RMV OMENTUM,2010.14,804.06,0,2010.14,1708.62,SKIPPED,2010.14,2010.14,1708.62,1708.62,1708.62,859.67,984.97,984.97,0,603.04,877.21,877.21,0
3612590,360,45333,,,,,,,SIGMOIDOSCOPY/POLYPECTOMY,2514.29,1005.72,269.69,2514.29,2137.15,SKIPPED,2514.29,2514.29,2137.15,2137.15,2137.15,1059.52,269.69,269.69,SKIPPED,SKIPPED,1081.14,1081.14,2137.15
3612591,975,45333,,,,,,,SIGMOIDOSCOPY/POLYPECTOMY,242.5,97,0,242.5,206.12,SKIPPED,242.5,242.5,206.12,206.12,206.12,101.96,118.82,118.82,SKIPPED,SKIPPED,104.04,104.04,0
3612592,360,40510,,,,,,,PARTIAL EXCISION OF LIP,6163.16,2465.26,748.53,6163.16,5238.69,SKIPPED,6163.16,6163.16,5238.69,5238.69,5238.69,2597.16,748.53,748.53,SKIPPED,SKIPPED,2650.16,2650.16,5238.69
3612593,975,40510,,,,,,,PARTIAL EXCISION OF LIP,897.23,358.89,0,897.23,762.65,SKIPPED,897.23,897.23,762.65,762.65,762.65,383.43,439.64,439.64,SKIPPED,SKIPPED,391.26,391.26,0
3612594,260,Q4145,,,,,,,"EPIFIX,INJECTABLE 1MG",879.52,351.81,0,747.59,747.59,SKIPPED,19.8,19.8,747.59,747.59,747.59,370.63,430.96,430.96,0,263.86,378.19,378.19,747.59
3612595,975,35302,,,,,,,RECHANNEL ARTERY,2876.64,1150.66,0,2876.64,2445.14,SKIPPED,2876.64,2876.64,2445.14,2445.14,2445.14,1185.73,1409.55,1409.55,0,862.99,1209.93,1209.93,0
3612596,975,27337,,,,,,,EXC THIGH/KNEE LESION 3CM>,1056.81,422.72,0,1056.81,898.29,SKIPPED,1056.81,1056.81,898.29,898.29,898.29,456.88,517.84,517.84,SKIPPED,SKIPPED,466.2,466.2,0
3612597,975,49540,,,,,,,RPR LUMBAR HERNIA,1702.71,681.08,0,1702.71,1447.3,SKIPPED,1702.71,1702.71,1447.3,1447.3,1447.3,735.53,834.33,834.33,SKIPPED,SKIPPED,750.54,750.54,0
3612598,975,17999,,,,,,,SKIN TISSUE PROC.,701.97,280.79,0,701.97,596.67,SKIPPED,701.97,701.97,596.67,596.67,596.67,0,343.97,343.97,0,210.59,0,0,0
3612599,975,44145,,,,,,,PART RMV COLON,4224.78,1689.91,0,4224.78,3591.06,SKIPPED,4224.78,4224.78,3591.06,3591.06,3591.06,1783.44,2070.14,2070.14,0,1267.43,1819.84,1819.84,0
3612600,975,21011,,,,,,,EXC FACE LESION <2CM,613.83,245.53,0,613.83,521.76,SKIPPED,613.83,613.83,521.76,521.76,521.76,282.74,300.78,300.78,0,184.15,288.51,288.51,0
3612601,360,35371,,,,,,,RECHANNEL ARTERY,9403.64,3761.46,0,7993.09,7993.09,SKIPPED,4060.63,4060.63,7993.09,7993.09,7993.09,3962.7,0,0,0,2821.09,4043.57,4043.57,7993.09
3612602,975,35371,,,,,,,RECHANNEL ARTERY,2095.1,838.04,0,2095.1,1780.84,SKIPPED,2095.1,2095.1,1780.84,1780.84,1780.84,862.96,1026.6,1026.6,0,628.53,880.57,880.57,0
3612603,360,35656,,,,,,,ART BYP FEMORAL POPLITCAL,4794.9,1917.96,0,4794.9,4075.66,SKIPPED,4794.9,4794.9,4075.66,4075.66,4075.66,2020.57,0,0,0,1438.47,2061.81,2061.81,4075.66
3612604,975,35656,,,,,,,ART BYP FEMORAL POPLITCAL,2775.38,1110.15,0,2775.38,2359.07,SKIPPED,2775.38,2775.38,2359.07,2359.07,2359.07,1137.83,1359.94,1359.94,0,832.61,1161.05,1161.05,0
3612605,360,60650,,,,,,,LAP ADRENALECTOMY,17563.75,7025.5,0,14929.19,14929.19,SKIPPED,5879.55,5879.55,14929.19,14929.19,14929.19,7401.36,0,0,0,5269.12,7552.41,7552.41,14929.19
3612606,975,60650,,,,,,,LAP ADRENALECTOMY,3038.23,1215.29,0,3038.23,2582.5,SKIPPED,3038.23,3038.23,2582.5,2582.5,2582.5,1285.98,1488.73,1488.73,0,911.47,1312.22,1312.22,0
3612607,360,49650,,,,,,,LAP ING HERNIA RPR INIT,12688.47,5075.39,1051.35,12688.47,10785.2,SKIPPED,12688.47,12688.47,10785.2,10785.2,10785.2,5346.92,1051.35,1051.35,SKIPPED,SKIPPED,5456.04,5456.04,10785.2
3612608,975,49650,,,,,,,LAP ING HERNIA RPR INIT,1084.73,433.89,0,1084.73,922.02,SKIPPED,1084.73,1084.73,922.02,922.02,922.02,470.78,531.52,531.52,SKIPPED,SKIPPED,480.39,480.39,0
3612609,360,11621,,,,,,,EXC S/N/H/F/G MAL+MRG 0.6-1,2105.26,842.1,121.55,1789.47,1789.47,SKIPPED,713.07,713.07,1789.47,1789.47,1789.47,887.15,121.55,121.55,SKIPPED,SKIPPED,905.26,905.26,1789.47
3612610,975,11621,,,,,,,EXC S/N/H/F/G MAL+MRG 0.6-1,357.99,143.2,0,357.99,304.29,SKIPPED,357.99,357.99,304.29,304.29,304.29,162.43,175.42,175.42,SKIPPED,SKIPPED,165.74,165.74,0
3612611,360,27625,,,,,,,RMV ANKLE JOINT LINING,4759.92,1903.97,867.38,4759.92,4045.93,SKIPPED,4759.92,4759.92,4045.93,4045.93,4045.93,2005.83,867.38,867.38,SKIPPED,SKIPPED,2046.77,2046.77,4045.93
3612612,975,27625,,,,,,,RMV ANKLE JOINT LINING,1387.54,555.02,0,1387.54,1179.41,SKIPPED,1387.54,1387.54,1179.41,1179.41,1179.41,630.47,679.89,679.89,SKIPPED,SKIPPED,643.34,643.34,0
3612613,278,,,,,,,,HEALICOIL RG SA (multi size),1094.38,437.75,0,930.22,930.22,SKIPPED,831.73,831.73,930.22,930.22,930.22,461.17,536.25,536.25,0,328.31,470.58,470.58,930.22
3612614,278,,,,,,,,DISP FIRSTPASS STR,772.5,309,0,656.62,656.62,SKIPPED,587.1,587.1,656.62,656.62,656.62,325.54,378.52,378.52,0,231.75,332.18,332.18,656.62
3612615,975,10121,,,,,,,RMV FOREIGN BODY,441.88,176.75,0,441.88,375.6,SKIPPED,441.88,441.88,375.6,375.6,375.6,200.66,216.52,216.52,SKIPPED,SKIPPED,204.76,204.76,0
3612616,360,11422,,,,,,,"EXC H,F,NK,SP B9+MARG 1.2-2CM",2412.77,965.11,92.39,2050.85,2050.85,SKIPPED,530.1,530.1,2050.85,2050.85,2050.85,1016.74,92.39,92.39,SKIPPED,SKIPPED,1037.49,1037.49,2050.85
3612617,360,13131,,,,,,,RPR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5CM,1214.29,485.72,129.16,1214.29,1032.15,SKIPPED,1214.29,1214.29,1032.15,1032.15,1032.15,511.7,129.16,129.16,SKIPPED,SKIPPED,522.14,522.14,1032.15
3612618,975,13131,,,,,,,RPR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5CM,600.46,240.18,0,600.46,510.39,SKIPPED,600.46,600.46,510.39,510.39,510.39,263.42,294.23,294.23,SKIPPED,SKIPPED,268.8,268.8,0
3612619,360,35540,,,,,,,ART BYP GRFT AORTBIFEMORAL,12845.47,5138.19,0,12094.92,10918.65,SKIPPED,12094.92,12094.92,10918.65,10918.65,10918.65,5413.08,0,0,0,3853.64,5523.55,5523.55,10918.65
3612620,975,35540,,,,,,,ART BYP GRFT AORTBIFEMORAL,5898.27,2359.31,0,5898.27,5013.53,SKIPPED,5898.27,5898.27,5013.53,5013.53,5013.53,2571.41,2890.15,2890.15,0,1769.48,2623.89,2623.89,0
3612621,360,43800,,,,,,,RECONSTRUNCTION OF PYLORUS,6393.57,2557.43,0,5434.53,5434.53,SKIPPED,4583.99,4583.99,5434.53,5434.53,5434.53,2694.26,0,0,0,1918.07,2749.24,2749.24,5434.53
3612622,975,43800,,,,,,,RECONSTRUNCTION OF PYLORUS,2226.37,890.55,0,2226.37,1892.41,SKIPPED,2226.37,2226.37,1892.41,1892.41,1892.41,1007.24,1090.92,1090.92,0,667.91,1027.8,1027.8,0
3612623,360,58940,,,,,,,REMOVAL OF OVARY(S),5226.68,2090.67,0,4442.68,4442.68,SKIPPED,2562.2,2562.2,4442.68,4442.68,4442.68,2202.52,0,0,0,1568,2247.47,2247.47,4442.68
3612624,975,58940,,,,,,,REMOVAL OF OVARY(S),1248.95,499.58,0,1248.95,1061.61,SKIPPED,1248.95,1248.95,1061.61,1061.61,1061.61,610.95,611.99,611.99,0,374.68,623.42,623.42,0
3612625,360,11005,,,,,,,DEBRIDE ABD WALL,3798.46,1519.38,0,3798.46,3228.69,SKIPPED,3798.46,3798.46,3228.69,3228.69,3228.69,1600.67,0,0,0,1139.54,1633.34,1633.34,3228.69
3612626,975,11005,,,,,,,DEBRIDE ABD WALL,1878.94,751.58,0,1878.94,1597.1,SKIPPED,1878.94,1878.94,1597.1,1597.1,1597.1,831.23,920.68,920.68,0,563.68,848.19,848.19,0
3612627,975,44143,,,,,,,PARTIAL REMOVAL COLON,3997.34,1598.94,0,3997.34,3397.74,SKIPPED,3997.34,3997.34,3397.74,3397.74,3397.74,1789.68,1958.7,1958.7,0,1199.2,1826.2,1826.2,0
3612628,975,27632,,,,,,,EXC LEG/ANKLE LESION SC 3CM/>,988.12,395.25,0,988.12,839.9,SKIPPED,988.12,988.12,839.9,839.9,839.9,449.08,484.18,484.18,SKIPPED,SKIPPED,458.25,458.25,0
3612630,975,11770,,,,,,,RMV PILONIDAL CYST-SIMPLE,439.35,175.74,0,439.35,373.45,SKIPPED,439.35,439.35,373.45,373.45,373.45,201.96,215.28,215.28,SKIPPED,SKIPPED,206.08,206.08,0
3612631,360,43762,,,,,,,CHG GASTROSTOMY TUBE,288.66,115.46,0,288.66,245.36,SKIPPED,288.66,288.66,245.36,245.36,245.36,121.64,94.95,94.95,0,86.6,124.12,124.12,245.36
3612632,975,43762,,,,,,,CHG GASTROSTOMY TUBE,564.71,225.88,0,564.71,480,SKIPPED,564.71,564.71,480,480,480,40.18,276.71,276.71,0,169.41,41,41,0
3612633,975,17250,,,,,,,CHEMICAL CAUTERY OF TISSUE,88.88,35.55,0,88.88,75.55,SKIPPED,88.88,88.88,75.55,75.55,75.55,40.55,43.55,43.55,0,26.66,41.38,41.38,0
3612634,975,44312,,,,,,,REVISION OF ILEOSTOMY,1421.85,568.74,0,1421.85,1208.57,SKIPPED,1421.85,1421.85,1208.57,1208.57,1208.57,650.72,696.71,696.71,SKIPPED,SKIPPED,664,664,0
3612635,975,49651,,,,,,,LAP INGUINAL HERNIA RPR,1327.57,531.03,0,1327.57,1128.43,SKIPPED,1327.57,1327.57,1128.43,1128.43,1128.43,614.44,650.51,650.51,SKIPPED,SKIPPED,626.98,626.98,0
3612636,360,44160,,,,,,,REMOVAL OF COLON,11984.89,4793.96,0,10187.16,10187.16,SKIPPED,6133.58,6133.58,10187.16,10187.16,10187.16,5050.43,0,0,0,3595.47,5153.5,5153.5,10187.16
3612637,975,44160,,,,,,,REMOVAL OF COLON,2982,1192.8,0,2982,2534.7,SKIPPED,2982,2982,2534.7,2534.7,2534.7,1342.4,1461.18,1461.18,0,894.6,1369.8,1369.8,0
3612638,360,29895,,,,,,,ANKLE ARTHROSCOPY,5528.12,2211.25,867.38,5528.12,4698.9,SKIPPED,5528.12,5528.12,4698.9,4698.9,4698.9,2329.55,867.38,867.38,SKIPPED,SKIPPED,2377.09,2377.09,4698.9
3612639,975,29895,,,,,,,ANKLE ARTHROSCOPY,1126.56,450.62,0,1126.56,957.58,SKIPPED,1126.56,1126.56,957.58,957.58,957.58,514.36,552.01,552.01,SKIPPED,SKIPPED,524.86,524.86,0
3612640,975,11623,,,,,,,EXC S/N/H/F/G MAL+MRG 2.1-3CM,508.52,203.41,0,508.52,432.24,SKIPPED,508.52,508.52,432.24,432.24,432.24,227.38,249.17,249.17,SKIPPED,SKIPPED,232.02,232.02,0
3612641,360,15851,,,,,,,REMOVE SUTURES DIFF SURGEON,2726.39,1090.56,57.17,2317.43,2317.43,SKIPPED,321.48,321.48,2317.43,2317.43,2317.43,1148.9,57.17,57.17,SKIPPED,SKIPPED,1172.35,1172.35,2317.43
3612642,975,15851,,,,,,,REMOVE SUTURES DIFF SURGEON,110.89,44.36,0,110.89,94.26,SKIPPED,110.89,110.89,94.26,94.26,94.26,49.37,54.34,54.34,SKIPPED,SKIPPED,50.38,50.38,0
3612643,975,49020,,,,,,,DRAIN ABD ABCESS,3814.59,1525.84,0,3814.59,3242.4,SKIPPED,3814.59,3814.59,3242.4,3242.4,3242.4,1724.71,1869.15,1869.15,0,1144.38,1759.91,1759.91,0
3612644,975,27603,,,,,,,DRAIN LOWER LEG LESION,922.81,369.12,0,922.81,784.39,SKIPPED,922.81,922.81,784.39,784.39,784.39,429.46,452.18,452.18,SKIPPED,SKIPPED,438.22,438.22,0
3612645,272,,,,,,,,MAHURKAR DIALYSIS CATH,220,88,0,187,187,SKIPPED,167.2,167.2,187,187,187,92.71,107.8,107.8,0,66,94.6,94.6,187
3612646,272,,,,,,,,BIO PATCH,30,12,0,25.5,25.5,SKIPPED,22.8,22.8,25.5,25.5,25.5,12.64,14.7,14.7,0,9,12.9,12.9,25.5
3612647,360,28153,,,,,,,PARTIAL REMOVAL OF TOE,4051.28,1620.51,867.38,4051.28,3443.59,SKIPPED,4051.28,4051.28,3443.59,3443.59,3443.59,1707.21,867.38,867.38,SKIPPED,SKIPPED,1742.05,1742.05,3443.59
3612648,975,28153,,,,,,,PARTIAL REMOVAL OF TOE,636.23,254.49,0,636.23,540.8,SKIPPED,636.23,636.23,540.8,540.8,540.8,290.72,311.75,311.75,SKIPPED,SKIPPED,296.65,296.65,0
3612649,360,49422,,,,,,,RMV TUNNELED IP CATH,5836.87,2334.75,867.38,5836.87,4961.34,SKIPPED,5836.87,5836.87,4961.34,4961.34,4961.34,2459.65,867.38,867.38,SKIPPED,SKIPPED,2509.85,2509.85,4961.34
3612650,975,49422,,,,,,,RMV TUNNELED IP CATH,910.56,364.22,0,910.56,773.98,SKIPPED,910.56,910.56,773.98,773.98,773.98,238.12,446.17,446.17,SKIPPED,SKIPPED,242.98,242.98,0
3612651,360,15101,,,,,,,SKIN SPLT GRFT T/A/L ADD-ON,2431.01,972.4,0,2066.36,2066.36,SKIPPED,0,0,2066.36,2066.36,2066.36,1024.42,0,0,0,729.3,1045.33,1045.33,2066.36
3612652,975,15101,,,,,,,SKIN SPLT GRFT T/A/L ADD-ON,264.42,105.77,0,224.76,224.76,SKIPPED,0,0,224.76,224.76,224.76,121.25,129.57,129.57,0,79.33,123.72,123.72,0
3612653,360,49550,,,,,,,REPAIR INT FEMORAL HERNIA; REDUCIBLE,6934.46,2773.78,867.38,6934.46,5894.29,SKIPPED,6934.46,6934.46,5894.29,5894.29,5894.29,2922.18,867.38,867.38,SKIPPED,SKIPPED,2981.82,2981.82,5894.29
3612654,975,49550,,,,,,,REPAIR INT FEMORAL HERNIA; REDUCIBLE,1375.92,550.37,0,1375.92,1169.53,SKIPPED,1375.92,1375.92,1169.53,1169.53,1169.53,626.82,674.2,674.2,SKIPPED,SKIPPED,639.61,639.61,0
3612655,278,,,,,,,,MEDTRONIC,33745,13498,0,28683.25,28683.25,SKIPPED,25646.2,25646.2,28683.25,28683.25,28683.25,14220.14,16535.05,16535.05,0,10123.5,14510.35,14510.35,28683.25
3612656,278,,,,,,,,INTEGRA MSHED BILAYER WOUND MATRIX,47602.5,19041,0,40462.12,40462.12,SKIPPED,36177.9,36177.9,40462.12,40462.12,40462.12,20059.7,23325.22,23325.22,0,14280.75,20469.08,20469.08,40462.12
3612657,360,49324,,,,,,,LAP INSERT TUNNEL IP CATH,9351.26,3740.5,1051.35,9351.26,7948.57,SKIPPED,9351.26,9351.26,7948.57,7948.57,7948.57,3940.62,1051.35,1051.35,SKIPPED,SKIPPED,4021.04,4021.04,7948.57
3612658,360,28232,,,,,,,"TENOTOMY, TOE SINGLE TENDON",2609.75,1043.9,209.9,2218.29,2218.29,SKIPPED,1263.69,1263.69,2218.29,2218.29,2218.29,1099.75,209.9,209.9,SKIPPED,SKIPPED,1122.19,1122.19,2218.29
3612659,975,28232,,,,,,,"TENOTOMY, TOE SINGLE TENDON",583.09,233.24,0,583.09,495.63,SKIPPED,583.09,583.09,495.63,495.63,495.63,264.48,285.71,285.71,SKIPPED,SKIPPED,269.88,269.88,0
3612660,975,49999,,,,,,,"UNLISTED PROCEDURE, ABD PERTONEUM & OMEN",668.54,267.42,0,668.54,568.26,SKIPPED,668.54,668.54,568.26,568.26,568.26,0,327.58,327.58,0,200.56,0,0,0
3612661,360,43280,,,,,,,LAP ESOPHAGOGASTRIC FUNDOPLASTY,15863.99,6345.6,0,15863.99,13484.39,SKIPPED,15863.99,15863.99,13484.39,13484.39,13484.39,6685.09,0,0,0,4759.2,6821.52,6821.52,13484.39
3612662,975,43280,,,,,,,LAP ESOPHAGOGASTRIC FUNDOPLASTY,2592.26,1036.9,0,2592.26,2203.42,SKIPPED,2592.26,2592.26,2203.42,2203.42,2203.42,1164.7,1270.21,1270.21,0,777.68,1188.47,1188.47,0
3612663,360,28140,,,,,,,METATARSECTOMY,4623.02,1849.21,867.38,4623.02,3929.57,SKIPPED,4623.02,4623.02,3929.57,3929.57,3929.57,1948.14,867.38,867.38,SKIPPED,SKIPPED,1987.9,1987.9,3929.57
3612664,975,28140,,,,,,,METATARSECTOMY,1057.52,423.01,0,1057.52,898.89,SKIPPED,1057.52,1057.52,898.89,898.89,898.89,471.07,518.18,518.18,SKIPPED,SKIPPED,480.68,480.68,0
3612665,975,43659,,,,,,,UNLISTED LAP STOMACH,668.54,267.42,0,668.54,568.26,SKIPPED,668.54,668.54,568.26,568.26,568.26,0,327.58,327.58,0,200.56,0,0,0
3612666,360,27632,,,,,,,EXC LEG/ANKLE LESS 3CM,5180.49,2072.2,582.36,5180.49,4403.42,SKIPPED,5180.49,5180.49,4403.42,4403.42,4403.42,2183.06,582.36,582.36,SKIPPED,SKIPPED,2227.61,2227.61,4403.42
3612667,360,49561,,,,,,,RPR VENTRAL HERN INIT BLOCK FAC,6824.25,2729.7,867.38,6824.25,5800.61,SKIPPED,6824.25,6824.25,5800.61,5800.61,5800.61,2875.74,867.38,867.38,SKIPPED,SKIPPED,2934.43,2934.43,5800.61
3612668,360,23075,,,,,,,EXC SHOULDER LESS 3CM,4064.66,1625.86,414.14,4064.66,3454.96,SKIPPED,4064.66,4064.66,3454.96,3454.96,3454.96,1712.84,414.14,414.14,SKIPPED,SKIPPED,1747.8,1747.8,3454.96
3612669,975,23075,,,,,,,EXC SHOULDER LESS 3CM,778.63,311.45,0,778.63,661.84,SKIPPED,778.63,778.63,661.84,661.84,661.84,359.75,381.53,381.53,SKIPPED,SKIPPED,367.09,367.09,0
3612670,360,45110,,,,,,,PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST,4254.27,1701.71,0,4254.27,3616.13,SKIPPED,4254.27,4254.27,3616.13,3616.13,3616.13,1792.75,0,0,0,1276.28,1829.34,1829.34,3616.13
3612671,360,36593,,,,,,,DECLOT VASCULAR DEVICE,661.24,264.5,0,562.05,562.05,SKIPPED,150.48,150.48,562.05,562.05,562.05,278.64,25.12,25.12,0,198.37,284.33,284.33,562.05
3612672,360,36597,,,,,,,REPOSITION VENOUS CATHETER,2049.35,819.74,414.14,2049.35,1741.95,SKIPPED,2049.35,2049.35,1741.95,1741.95,1741.95,863.6,414.14,414.14,SKIPPED,SKIPPED,881.22,881.22,1741.95
3612673,260,96369,,,,,,,SUBCU THER INFUSION UP TO 1 HR,468.56,187.42,0,468.56,398.28,SKIPPED,468.56,468.56,398.28,398.28,398.28,197.45,229.59,229.59,0,140.57,201.48,201.48,398.28
3612674,260,96370,,,,,,,Subc ther infusion addl hr,148.35,59.34,0,126.1,126.1,SKIPPED,75,75,126.1,126.1,126.1,62.51,72.69,72.69,0,44.5,63.79,63.79,126.1
3612675,260,96377,,,,,,,APPLICATON ON-BODY INJECTOR,167.06,66.82,0,167.06,142,SKIPPED,167.06,167.06,142,142,142,70.4,81.86,81.86,0,50.12,71.84,71.84,142
3612676,260,96523,,,,,,,PORT FLUSH,178.31,71.32,0,178.31,151.56,SKIPPED,178.31,178.31,151.56,151.56,151.56,75.14,87.37,87.37,0,53.49,76.67,76.67,151.56
3612677,272,,,,,,,,CONTOUR STAPLER RELOADS,664.4,265.76,0,564.74,564.74,SKIPPED,504.94,504.94,564.74,564.74,564.74,279.98,325.56,325.56,0,199.32,285.69,285.69,564.74
3612678,272,,,,,,,,CONTOUR STAPLER,3579.35,1431.74,0,3042.45,3042.45,SKIPPED,2720.31,2720.31,3042.45,3042.45,3042.45,1508.34,1753.88,1753.88,0,1073.8,1539.12,1539.12,3042.45
3612679,278,,,,,,,,COVIDIEN MESH SYM 1510,1665.67,666.27,0,1415.82,1415.82,SKIPPED,1265.91,1265.91,1415.82,1415.82,1415.82,701.92,816.18,816.18,0,499.7,716.24,716.24,1415.82
3612680,278,,,,,,,,COVIDIEN MESH SYM 2015,2672.02,1068.81,0,2271.22,2271.22,SKIPPED,2030.74,2030.74,2271.22,2271.22,2271.22,1125.99,1309.29,1309.29,0,801.61,1148.97,1148.97,2271.22
3612681,278,,,,,,,,BARD 3D MAX MESH RT,524,209.6,0,445.4,445.4,SKIPPED,398.24,398.24,445.4,445.4,445.4,220.81,256.76,256.76,0,157.2,225.32,225.32,445.4
3612682,278,,,,,,,,BARD 3D MAX MESH LT,524,209.6,0,445.4,445.4,SKIPPED,398.24,398.24,445.4,445.4,445.4,220.81,256.76,256.76,0,157.2,225.32,225.32,445.4
3612683,278,,,,,,,,BARD ALLOMAX GRAFT,35500,14200,0,30175,30175,SKIPPED,26980,26980,30175,30175,30175,14959.7,17395,17395,0,10650,15265,15265,30175
3612684,278,,,,,,,,COVIDIEN MESH SYM 2520,4264.22,1705.69,0,3624.59,3624.59,SKIPPED,3240.81,3240.81,3624.59,3624.59,3624.59,1796.94,2089.47,2089.47,0,1279.27,1833.61,1833.61,3624.59
3612685,278,,,,,,,,COVIDIEN MESH SYM 9,1335.97,534.39,0,1135.57,1135.57,SKIPPED,1015.34,1015.34,1135.57,1135.57,1135.57,562.98,654.63,654.63,0,400.79,574.47,574.47,1135.57
3612686,278,,,,,,,,COVIDIEN MESH SYM 12,1832.22,732.89,0,1557.39,1557.39,SKIPPED,1392.49,1392.49,1557.39,1557.39,1557.39,772.09,897.79,897.79,0,549.67,787.85,787.85,1557.39
3612687,278,,,,,,,,COVIDIEN MESH SYM 15,2398.22,959.29,0,2038.49,2038.49,SKIPPED,1822.65,1822.65,2038.49,2038.49,2038.49,1010.61,1175.13,1175.13,0,719.47,1031.23,1031.23,2038.49
3612688,278,,,,,,,,COVIDIEN MESH SYM 2520,5993,2397.2,0,5094.05,5094.05,SKIPPED,4554.68,4554.68,5094.05,5094.05,5094.05,2525.45,2936.57,2936.57,0,1797.9,2576.99,2576.99,5094.05
3612689,360,58661,,,,,,,LAP REMOVAL OVARY/ADNEXA,11100.14,4440.06,1051.35,11100.14,9435.12,SKIPPED,11100.14,11100.14,9435.12,9435.12,9435.12,4677.6,1051.35,1051.35,SKIPPED,SKIPPED,4773.06,4773.06,9435.12
3612690,975,58661,,,,,,,LAP REMOVAL OVARY/ADNEXA,1541.89,616.76,0,1541.89,1310.61,SKIPPED,1541.89,1541.89,1310.61,1310.61,1310.61,714.83,755.53,755.53,SKIPPED,SKIPPED,729.42,729.42,0
3612691,360,37700,,,,,,,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INT,7056.01,2822.4,867.38,7056.01,5997.61,SKIPPED,7056.01,7056.01,5997.61,5997.61,5997.61,2973.4,867.38,867.38,SKIPPED,SKIPPED,3034.08,3034.08,5997.61
3612692,975,37700,,,,,,,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INT,592.24,236.9,0,592.24,503.4,SKIPPED,592.24,592.24,503.4,503.4,503.4,262.62,290.2,290.2,SKIPPED,SKIPPED,267.98,267.98,0
3612693,360,47000,,,,,,,BX LIVER NEEDLE PERCUTANEOUS,2300.75,920.3,414.14,2300.75,1955.64,SKIPPED,2300.75,2300.75,1955.64,1955.64,1955.64,969.53,414.14,414.14,SKIPPED,SKIPPED,989.32,989.32,1955.64
3612694,975,47000,,,,,,,BX LIVER NEEDLE PERCUTANEOUS,217.7,87.08,0,217.7,185.04,SKIPPED,217.7,217.7,185.04,185.04,185.04,95.85,106.67,106.67,SKIPPED,SKIPPED,97.81,97.81,0
3612695,360,49521,,,,,,,RPR RECRT ING HERNIA ANY AGE,9302.27,3720.91,867.38,9302.27,7906.93,SKIPPED,9302.27,9302.27,7906.93,7906.93,7906.93,3919.98,867.38,867.38,SKIPPED,SKIPPED,3999.98,3999.98,7906.93
3612696,975,49521,,,,,,,RPR RECRT ING HERNIA ANY AGE,1713.51,685.4,0,1713.51,1456.48,SKIPPED,1713.51,1713.51,1456.48,1456.48,1456.48,777.24,839.62,839.62,SKIPPED,SKIPPED,793.1,793.1,0
3612697,360,44146,,,,,,,COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOS,14421.98,5768.79,0,12258.68,12258.68,SKIPPED,10473.75,10473.75,12258.68,12258.68,12258.68,6077.42,0,0,0,4326.59,6201.45,6201.45,12258.68
3612698,975,44146,,,,,,,COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOS,5096.24,2038.5,0,5096.24,4331.8,SKIPPED,5096.24,5096.24,4331.8,4331.8,4331.8,2272.24,2497.16,2497.16,0,1528.87,2318.61,2318.61,0
3612699,360,33285,,,,,,,INSERT SUBCUTANEOUS CARDIAC RHYTHM MONIT,15302.73,6121.09,0,15302.73,13007.32,SKIPPED,15302.73,15302.73,13007.32,13007.32,13007.32,6448.57,1051.35,1051.35,0,4590.82,6580.17,6580.17,13007.32
3612700,975,33285,,,,,,,INSERT SUBCUTANEOUS CARDIAC RHYTHM MONIT,216.68,86.67,0,216.68,184.18,SKIPPED,216.68,216.68,184.18,184.18,184.18,93.85,106.17,106.17,0,65,95.77,95.77,0
3612701,975,75710,,,,,,,ANGIOGRAPHY EXTREMITY-UNILATERAL,206.1,82.44,0,206.1,175.18,SKIPPED,206.1,206.1,175.18,175.18,175.18,90.77,206.1,206.1,0,206.1,92.62,92.62,0
3612702,975,36217,,,,,,,SLCTV CATH 3RD+ORD SLCTV THRC/BRCH/CPHLC,791.27,316.51,0,672.58,672.58,SKIPPED,0,0,672.58,672.58,672.58,348.14,387.72,387.72,0,237.38,355.24,355.24,0
3612703,975,75600,,,,,,,AORTOGRAPHY THORACIC,58.15,23.26,0,58.15,49.43,SKIPPED,58.15,58.15,49.43,49.43,49.43,26.15,58.15,58.15,0,58.15,26.68,26.68,0
3612704,360,49651,,,,,,,LAP SURG RPR RECURRENT INGUINAL HERNIA,11607.6,4643.04,1051.35,11607.6,9866.46,SKIPPED,11607.6,11607.6,9866.46,9866.46,9866.46,4891.44,1051.35,1051.35,SKIPPED,SKIPPED,4991.27,4991.27,9866.46
3612705,360,49203,,,,,,,EXC/DEST. OPEN ABD TUMOR 5CM/<,4675.69,1870.28,0,4675.69,3974.34,SKIPPED,4675.69,4675.69,3974.34,3974.34,3974.34,1970.34,0,0,0,1402.71,2010.55,2010.55,3974.34
3612706,975,44650,,,,,,,SURGICAL ASSIST-CLSR ENTEROENTERC/ENTERO,617.23,246.89,0,1589.92,524.65,SKIPPED,617.23,617.23,524.65,524.65,524.65,1558.12,302.44,302.44,0,185.17,1589.92,1589.92,0
3612707,975,43235,,,,,,,SURGICAL ASSIST-ESOPHAGOGASTRODUODENOSCO,64.53,25.81,0,136.49,54.85,SKIPPED,64.53,64.53,54.85,54.85,54.85,133.76,31.62,31.62,SKIPPED,SKIPPED,136.49,136.49,0
3612708,975,44146,,,,,,,SURGICAL ASSIST-COLECTOMY PARTL.,815.4,326.16,0,2318.61,693.09,SKIPPED,815.4,815.4,693.09,693.09,693.09,2272.24,399.55,399.55,0,244.62,2318.61,2318.61,0
3612709,975,47000,,,,,,,SRGICAL ASSIST-BX LIVER NEEDLE PERCUTANE,34.83,13.93,0,97.81,29.61,SKIPPED,34.83,34.83,29.61,29.61,29.61,95.85,17.07,17.07,SKIPPED,SKIPPED,97.81,97.81,0
3612710,975,49651,,,,,,,SURGICAL ASSIST-LAP INGUINAL HERNIA,212.4,84.96,0,626.98,180.54,SKIPPED,212.4,212.4,180.54,180.54,180.54,614.44,104.08,104.08,SKIPPED,SKIPPED,626.98,626.98,0
3612711,975,44180,,,,,,,SURGICAL ASSIST-LAPAROSCPY ENTRERO,391.03,156.41,0,1015.52,332.38,SKIPPED,391.03,391.03,332.38,332.38,332.38,995.21,191.6,191.6,0,117.31,1015.52,1015.52,0
3612712,975,49565,,,,,,,SURGICAL ASSIS- RPR HERNIA INCISION,294.02,117.61,0,850.1,249.92,SKIPPED,294.02,294.02,249.92,249.92,249.92,833.1,144.07,144.07,SKIPPED,SKIPPED,850.1,850.1,0
3612713,360,64620,,,,,,,DSTRJ NEURLYTIC AGENT INTERCOSTAL NERVE,4426.88,1770.75,269.69,3762.85,3762.85,SKIPPED,3192.86,3192.86,3762.85,3762.85,3762.85,1865.49,269.69,269.69,SKIPPED,SKIPPED,1903.56,1903.56,3762.85
3612714,975,64620,,,,,,,DSTRJ NEURLYTIC AGENT INTERCOSTAL NERVE,414.46,165.78,0,414.46,352.29,SKIPPED,414.46,414.46,352.29,352.29,352.29,193.98,203.09,203.09,SKIPPED,SKIPPED,197.94,197.94,0
3612715,975,11004,,,,,,,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT,1391.6,556.64,0,1391.6,1182.86,SKIPPED,1391.6,1391.6,1182.86,1182.86,1182.86,614.8,681.88,681.88,0,417.48,627.35,627.35,0
3612716,360,64415,,,,,,,"Injection, anesthetic agent, brachial pl",2022.6,809.04,269.69,2022.6,1719.21,SKIPPED,2022.6,2022.6,1719.21,1719.21,1719.21,852.33,269.69,269.69,SKIPPED,SKIPPED,869.72,869.72,1719.21
3612717,975,64415,,,,,,,"Injection, anesthetic agent, brachial pl",158.6,63.44,0,158.6,134.81,SKIPPED,158.6,158.6,134.81,134.81,134.81,69.32,77.71,77.71,SKIPPED,SKIPPED,70.73,70.73,0
3612718,360,38745,,,,,,,AXILLARY YMPHADENECTOMY COMPLETE,10423.57,4169.43,1051.35,10423.57,8860.03,SKIPPED,10423.57,10423.57,8860.03,8860.03,8860.03,4392.5,1051.35,1051.35,SKIPPED,SKIPPED,4482.14,4482.14,8860.03
3612719,360,44625,,,,,,,CLOSURE ENTEROSTOMY LG/SM ANAST & RESC,5591.33,2236.53,0,5022.08,4752.63,SKIPPED,5022.08,5022.08,4752.63,4752.63,4752.63,2356.18,0,0,0,1677.4,2404.27,2404.27,4752.63
3612720,360,49999,,,,,,,UNLISTED PROC. ABD PERTONEUM & OMENTUM,4358.81,1743.52,0,3704.99,3704.99,SKIPPED,3531.58,3531.58,3704.99,3704.99,3704.99,1836.8,0,0,0,1307.64,1874.29,1874.29,3704.99
3612721,360,64486,,,,,,,TAP BLOCK UNILAT,2341.97,936.79,0,1990.67,1990.67,SKIPPED,0,0,1990.67,1990.67,1990.67,986.91,56.38,56.38,0,702.59,1007.05,1007.05,1990.67
3612722,975,64486,,,,,,,TAP BLOCK UNILAT,145.27,58.11,0,123.48,123.48,SKIPPED,0,0,123.48,123.48,123.48,61.36,71.18,71.18,0,43.58,62.61,62.61,0
3612723,360,36248,,,,,,,SLCTV CATH 2ND+ ORD ABDL PEL/LXTR ART BR,1666.47,666.59,0,1416.5,1416.5,SKIPPED,0,0,1416.5,1416.5,1416.5,702.25,0,0,0,499.94,716.58,716.58,1416.5
3612724,975,36248,,,,,,,SLCTV CATH 2ND+ ORD ABDL PEL/LXTR ART BR,119.57,47.83,0,101.63,101.63,SKIPPED,0,0,101.63,101.63,101.63,52.32,58.59,58.59,0,35.87,53.39,53.39,0
3612725,360,27700,,,,,,,ARTHROPLASTY ANKLE,7886.47,3154.59,1051.35,7886.47,6703.5,SKIPPED,7886.47,7886.47,6703.5,6703.5,6703.5,3323.36,1051.35,1051.35,SKIPPED,SKIPPED,3391.18,3391.18,6703.5
3612726,975,27700,,,,,,,ARTHROPLASTY ANKLE,1506.68,602.67,0,1506.68,1280.68,SKIPPED,1506.68,1506.68,1280.68,1280.68,1280.68,674.88,738.27,738.27,SKIPPED,SKIPPED,688.65,688.65,0
3612727,975,21933,,,,,,,EXC TUMOR SOFT TISS BACK/FLANK 5 CM>,1760.31,704.12,0,1760.31,1496.26,SKIPPED,1760.31,1760.31,1496.26,1496.26,1496.26,802.44,862.55,862.55,SKIPPED,SKIPPED,818.82,818.82,0
3612728,360,17110,,,,,,,DESTRUCT BENIGN LESION P TO 14,2406.71,962.68,0,2045.7,2045.7,SKIPPED,802.51,802.51,2045.7,2045.7,2045.7,1014.19,0,0,0,722.01,1034.89,1034.89,2045.7
3612729,360,75726,,,,,,,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS,6320.63,2528.25,0,6320.63,5372.54,SKIPPED,6320.63,6320.63,5372.54,5372.54,5372.54,2663.51,0,0,0,2738.1,2717.87,2717.87,5372.54
3612730,975,75726,,,,,,,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS,132.86,53.14,0,132.86,112.93,SKIPPED,132.86,132.86,112.93,112.93,112.93,104.29,132.86,132.86,0,132.86,106.42,106.42,0
3612731,360,35011,,,,,,,REPAIR ANEURYSM AXIL-BRACHIAL FISTULA OP,10618.66,4247.46,0,10618.66,9025.86,SKIPPED,10618.66,10618.66,9025.86,9025.86,9025.86,4474.7,0,0,0,3185.6,4566.02,4566.02,9025.86
3612732,975,35011,,,,,,,REPAIR ANEURYSM AXIL-BRACHIAL FISTULA OP,2425.86,970.34,0,2425.86,2061.98,SKIPPED,2425.86,2425.86,2061.98,2061.98,2061.98,1070.48,1188.67,1188.67,0,727.76,1092.33,1092.33,0
3612733,360,42825,,,,,,,TONSILLECTOMY ,208.34,83.34,0,208.34,177.09,SKIPPED,208.34,208.34,177.09,177.09,177.09,91.72,102.09,102.09,0,62.5,93.59,93.59,0
3612744,975,37230,,,,,,,REVSC OPN/PERO W/STNT/ANGIOP SM VSL,1697.63,679.05,0,1697.63,1442.99,SKIPPED,1697.63,1697.63,1442.99,1442.99,1442.99,737.59,831.84,831.84,SKIPPED,SKIPPED,752.64,752.64,0
3612745,975,44015,,,,,,,TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD,342.39,136.96,0,342.39,291.03,SKIPPED,342.39,342.39,291.03,291.03,291.03,151.77,167.77,167.77,0,102.72,154.87,154.87,0
3612746,278,,,,,,,,GRAFIX PL(ALL SIZES),7500,3000,0,6375,6375,SKIPPED,5700,5700,6375,6375,6375,3160.5,3675,3675,0,2250,3225,3225,6375
3612747,278,,,,,,,,10MM STERILE HTR KIT,2487.5,995,0,2114.38,2114.38,SKIPPED,1890.5,1890.5,2114.38,2114.38,2114.38,1048.24,1218.88,1218.88,0,746.25,1069.63,1069.63,2114.38
3612748,278,,,,,,,,ART BMC PROCESSING KIT,3750,1500,0,3187.5,3187.5,SKIPPED,2850,2850,3187.5,3187.5,3187.5,1580.25,1837.5,1837.5,0,1125,1612.5,1612.5,3187.5
3612749,360,58671,,,,,,,LAPAROSCOPY TUBAL BLOCK,6734.76,2693.9,1051.35,6734.76,5724.55,SKIPPED,6734.76,6734.76,5724.55,5724.55,5724.55,2838.03,1051.35,1051.35,SKIPPED,SKIPPED,2895.95,2895.95,5724.55
3612750,975,58671,,,,,,,LAPAROSCOPY TUBAL BLOCK,857.88,343.15,0,857.88,729.2,SKIPPED,857.88,857.88,729.2,729.2,729.2,408.8,420.36,420.36,SKIPPED,SKIPPED,417.14,417.14,0
3612751,975,38220,,,,,,,BONE MARROW ASPIRATION,166.92,66.77,0,166.92,141.88,SKIPPED,166.92,166.92,141.88,141.88,141.88,74.92,81.79,81.79,SKIPPED,SKIPPED,76.45,76.45,0
3612752,975,28005,,,,,,,TREAT FOOT BONE LESION,1385.49,554.2,0,1385.49,1177.67,SKIPPED,1385.49,1385.49,1177.67,1177.67,1177.67,631.88,678.89,678.89,SKIPPED,SKIPPED,644.78,644.78,0
3612753,360,27659,,,,,,,RPR FLEXOR TENDON LEG WITH OR W/O GRAFT,6141.02,2456.41,1051.35,6141.02,5219.87,SKIPPED,6141.02,6141.02,5219.87,5219.87,5219.87,2587.83,1051.35,1051.35,SKIPPED,SKIPPED,2640.64,2640.64,5219.87
3612754,975,27659,,,,,,,RPR FLEXOR TENDON LEG WITH OR W/O GRAFT,1136.66,454.66,0,1136.66,966.16,SKIPPED,1136.66,1136.66,966.16,966.16,966.16,517.41,556.96,556.96,SKIPPED,SKIPPED,527.97,527.97,0
3612755,360,60252,,,,,,,THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK D,15133.06,6053.22,0,15133.06,12863.1,SKIPPED,15133.06,15133.06,12863.1,12863.1,12863.1,6377.08,0,0,0,4539.92,6507.22,6507.22,12863.1
3612756,975,60252,,,,,,,THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK D,3145.17,1258.07,0,3145.17,2673.39,SKIPPED,3145.17,3145.17,2673.39,2673.39,2673.39,1436.79,1541.13,1541.13,0,943.55,1466.11,1466.11,0
3612757,360,28092,,,,,,,EXC TOE LESIONS,4148.93,1659.57,510.13,4148.93,3526.59,SKIPPED,4148.93,4148.93,3526.59,3526.59,3526.59,1748.36,510.13,510.13,SKIPPED,SKIPPED,1784.04,1784.04,3526.59
3612758,975,28092,,,,,,,EXC TOE LESIONS,645.62,258.25,0,645.62,548.78,SKIPPED,645.62,645.62,548.78,548.78,548.78,295.62,316.35,316.35,SKIPPED,SKIPPED,301.65,301.65,0
3612759,360,11008,,,,,,,EXC PROSTHETIC MATRL ABD WALL FOR INFECT,4090.47,1636.19,0,3476.9,3476.9,SKIPPED,1356.93,1356.93,3476.9,3476.9,3476.9,1723.72,0,0,0,1227.14,1758.9,1758.9,3476.9
3612761,360,15920,,,,,,,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PR,5046.8,2018.72,582.36,5046.8,4289.78,SKIPPED,5046.8,5046.8,4289.78,4289.78,4289.78,2126.72,582.36,582.36,SKIPPED,SKIPPED,2170.12,2170.12,4289.78
3612762,975,15920,,,,,,,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PR,1438.41,575.36,0,1438.41,1222.65,SKIPPED,1438.41,1438.41,1222.65,1222.65,1222.65,697.54,704.82,704.82,SKIPPED,SKIPPED,711.78,711.78,0
3612763,360,44206,,,,,,,LAPS COLECTOMY PRTL W/END CLST & CLSR DS,10331.1,4132.44,0,8781.44,8781.44,SKIPPED,8653.12,8653.12,8781.44,8781.44,8781.44,4353.52,0,0,0,3099.33,4442.37,4442.37,8781.44
3612764,975,44206,,,,,,,LAPS COLECTOMY PRTL W/END CLST & CLSR DS,4211.31,1684.52,0,4211.31,3579.61,SKIPPED,4211.31,4211.31,3579.61,3579.61,3579.61,1883,2063.54,2063.54,0,1263.39,1921.43,1921.43,0
3612780,975,11008,,,,,,,EXC PROSTHETIC MATRL ABD WALL FOR INFECT,660.46,264.18,0,660.46,561.39,SKIPPED,660.46,660.46,561.39,561.39,561.39,292.74,323.63,323.63,0,198.14,298.71,298.71,0
3612781,975,37246,,,,,,,TRLUML BALO ANGIOP 1ST ART-out side surg,849.3,339.72,0,849.3,721.9,SKIPPED,849.3,849.3,721.9,721.9,721.9,371.66,416.16,416.16,SKIPPED,SKIPPED,379.24,379.24,0
3612782,975,11106,,,,,,,INCAL BX SKN SINGLE LES-outside surg,336.99,134.8,0,336.99,286.44,SKIPPED,336.99,336.99,286.44,286.44,286.44,62,165.13,165.13,0,101.1,63.27,63.27,0
3612783,975,11107,,,,,,,INCAL BX SKN EA SEP/ADDL-outside surg,161.63,64.65,0,137.39,137.39,SKIPPED,0,0,137.39,137.39,137.39,33.83,79.2,79.2,0,48.49,34.52,34.52,0
3612784,975,44140,,,,,,,SurgicalAssist:PARTIAL REMOVAL OF COLON,515.31,206.12,0,1480.08,438.01,SKIPPED,515.31,515.31,438.01,438.01,438.01,1450.48,252.5,252.5,0,154.59,1480.08,1480.08,0
3612785,975,44144,,,,,,,SurgicalAssist:PARTIAL REMOVAL OF COLON,679.88,271.95,0,1943.34,577.9,SKIPPED,679.88,679.88,577.9,577.9,577.9,1904.47,333.14,333.14,0,203.96,1943.34,1943.34,0
3612786,975,47001,,,,,,,SurgicalAssist:NEEDLE BIOPSY LIVER ADD-O,40.18,16.07,0,113.06,34.15,SKIPPED,0,0,34.15,34.15,34.15,110.8,19.69,19.69,0,12.05,113.06,113.06,0
3612787,975,27132,,,,,,,SurgicalAssist:TOTAL HIP ARTHROPLASTY,641.72,256.69,0,1846.7,545.46,SKIPPED,641.72,641.72,545.46,545.46,545.46,1809.77,314.44,314.44,0,192.52,1846.7,1846.7,0
3612788,360,14041,,,,,,,TIS TRNFR F/C/C/M/N/A/G/H/F,5599.06,2239.62,582.36,5599.06,4759.2,SKIPPED,5599.06,5599.06,4759.2,4759.2,4759.2,2359.45,582.36,582.36,SKIPPED,SKIPPED,2407.6,2407.6,4759.2
3612789,975,14041,,,,,,,TIS TRNFR F/C/C/M/N/A/G/H/F,1859.5,743.8,0,1859.5,1580.58,SKIPPED,1859.5,1859.5,1580.58,1580.58,1580.58,827.73,911.16,911.16,SKIPPED,SKIPPED,844.62,844.62,0
3612790,360,28113,,,,,,,PART REMOVAL OF METATARSAL,4000.84,1600.34,867.38,4000.84,3400.71,SKIPPED,4000.84,4000.84,3400.71,3400.71,3400.71,1685.95,867.38,867.38,SKIPPED,SKIPPED,1720.36,1720.36,3400.71
3612791,975,28113,,,,,,,PART REMOVAL OF METATARSAL,1018.35,407.34,0,1018.35,865.6,SKIPPED,1018.35,1018.35,865.6,865.6,865.6,466.72,498.99,498.99,SKIPPED,SKIPPED,476.25,476.25,0
3612792,360,49402,,,,,,,REMOVAL PERITONEAL FOREIGN BODY,7216.69,2886.68,867.38,7216.69,6134.19,SKIPPED,7216.69,7216.69,6134.19,6134.19,6134.19,3041.12,867.38,867.38,SKIPPED,SKIPPED,3103.18,3103.18,6134.19
3612793,975,49402,,,,,,,REMOVAL PERITONEAL FOREIGN BODY,1977.73,791.09,0,1977.73,1681.07,SKIPPED,1977.73,1977.73,1681.07,1681.07,1681.07,923.93,969.09,969.09,SKIPPED,SKIPPED,942.79,942.79,0
3612794,272,,,,,,,,ENT wand EVAC 70 Xtra,667.5,267,0,567.38,567.38,SKIPPED,507.3,507.3,567.38,567.38,567.38,281.29,327.08,327.08,0,200.25,287.03,287.03,567.38
3612795,272,,,,,,,,Ventralex small hernia patch 4.3cm,1120.9,448.36,0,952.76,952.76,SKIPPED,851.88,851.88,952.76,952.76,952.76,472.35,549.24,549.24,0,336.27,481.99,481.99,952.76
3612796,360,44310,,,,,,,ILEOSTOMY/JEJUNOSTOMY NON-TUBE,7926.26,3170.5,0,6737.32,6737.32,SKIPPED,5158.45,5158.45,6737.32,6737.32,6737.32,3340.12,0,0,0,2377.88,3408.29,3408.29,6737.32
3612797,975,60545,,,,,,,ADRENALECTOMY EXPLW/EXC RETROPERTIN,1768.85,707.54,0,1768.85,1503.52,SKIPPED,1768.85,1768.85,1503.52,1503.52,1503.52,1346.39,866.74,866.74,0,530.66,1373.87,1373.87,0
3612798,360,49905,,,,,,,OMENTAL FLAP INTRA-ABD,4270.48,1708.19,0,3629.91,3629.91,SKIPPED,1747.34,1747.34,3629.91,3629.91,3629.91,1799.58,0,0,0,1281.14,1836.31,1836.31,3629.91
3612799,360,49322,,,,,,,LAPAROSCOPIC ASPIRATION ABDOMINAL CAVITY,6797.57,2719.03,1051.35,6797.57,5777.93,SKIPPED,6797.57,6797.57,5777.93,5777.93,5777.93,2864.5,1051.35,1051.35,SKIPPED,SKIPPED,2922.96,2922.96,5777.93
3612800,975,49322,,,,,,,LAPAROSCOPIC ASPIRATION ABDOMINAL CAVITY,854.33,341.73,0,854.33,726.18,SKIPPED,854.33,854.33,726.18,726.18,726.18,407.14,418.62,418.62,SKIPPED,SKIPPED,415.45,415.45,0
3612801,360,15830,,,,,,,EXCISION SKIN ABD INFRAUMBILICAL PANNICU,12432.95,4973.18,1051.35,12432.95,10568.01,SKIPPED,12432.95,12432.95,10568.01,10568.01,10568.01,5239.25,1051.35,1051.35,SKIPPED,SKIPPED,5346.17,5346.17,10568.01
3612802,975,15830,,,,,,,EXCISION SKIN ABD INFRAUMBILICAL PANNICU,2693.03,1077.21,0,2693.03,2289.08,SKIPPED,2693.03,2693.03,2289.08,2289.08,2289.08,1272.08,1319.58,1319.58,SKIPPED,SKIPPED,1298.04,1298.04,0
3612803,360,28725,,,,,,,ARTHRODESIS SUBTALAR,8750.49,3500.2,1051.35,8750.49,7437.92,SKIPPED,8750.49,8750.49,7437.92,7437.92,7437.92,3687.46,1051.35,1051.35,SKIPPED,SKIPPED,3762.71,3762.71,7437.92
3612804,975,28725,,,,,,,ARTHRODESIS SUBTALAR,1794.58,717.83,0,1794.58,1525.39,SKIPPED,1794.58,1794.58,1525.39,1525.39,1525.39,850.1,879.34,879.34,SKIPPED,SKIPPED,867.45,867.45,0
3612805,360,49418,,,,,,,INSJ INTRAPERITONEAL CATHETHER W/IMG GUI,6385.46,2554.18,867.38,6385.46,5427.64,SKIPPED,6385.46,6385.46,5427.64,5427.64,5427.64,2690.84,867.38,867.38,SKIPPED,SKIPPED,2745.75,2745.75,5427.64
3612806,975,49418,,,,,,,INSJ INTRAPERITONEAL CATHETHER W/IMG GUI,476.86,190.74,0,476.86,405.33,SKIPPED,476.86,476.86,405.33,405.33,405.33,219.06,233.66,233.66,SKIPPED,SKIPPED,223.53,223.53,0
3612807,360,36470,,,,,,,INSJ INTRAPERITONEAL CATHETHER W/IMG GUI,622.47,248.99,0,529.1,529.1,SKIPPED,360.81,360.81,529.1,529.1,529.1,262.31,64.1,64.1,0,186.74,267.66,267.66,529.1
3612808,360,49590,,,,,,,RPR SPIGELIAN HERNIA,7142.55,2857.02,867.38,7142.55,6071.17,SKIPPED,7142.55,7142.55,6071.17,6071.17,6071.17,3009.87,867.38,867.38,SKIPPED,SKIPPED,3071.3,3071.3,6071.17
3612809,975,49590,,,,,,,RPR SPIGELIAN HERNIA,1318.81,527.52,0,1318.81,1120.99,SKIPPED,1318.81,1318.81,1120.99,1120.99,1120.99,623.59,646.22,646.22,SKIPPED,SKIPPED,636.32,636.32,0
3612810,278,,,,,,,,PROLENE MESH 3X6,399.42,159.77,0,339.51,339.51,SKIPPED,303.56,303.56,339.51,339.51,339.51,168.32,195.72,195.72,0,119.83,171.75,171.75,339.51
3612811,278,,,,,,,,VENTRALEX ST HERNIA PATCH,1120.9,448.36,0,952.76,952.76,SKIPPED,851.88,851.88,952.76,952.76,952.76,472.35,549.24,549.24,0,336.27,481.99,481.99,952.76
3612812,278,,,,,,,,VENTRALEX ST HERNIA PATCH MD 6.4CM/2.5,1351.2,540.48,0,1148.52,1148.52,SKIPPED,1026.91,1026.91,1148.52,1148.52,1148.52,569.4,662.09,662.09,0,405.36,581.02,581.02,1148.52
3612813,278,,,,,,,,ASNIS SCREW(ANY SIZE),1071,428.4,0,910.35,910.35,SKIPPED,813.96,813.96,910.35,910.35,910.35,451.32,524.79,524.79,0,321.3,460.53,460.53,910.35
3612814,272,,,,,,,,ASNIS DRILL(ANY SIZE),1470,588,0,1249.5,1249.5,SKIPPED,1117.2,1117.2,1249.5,1249.5,1249.5,619.46,720.3,720.3,0,441,632.1,632.1,1249.5
3612815,272,,,,,,,,ASNIS K-WIRE(ANY SIZE),192,76.8,0,163.2,163.2,SKIPPED,145.92,145.92,163.2,163.2,163.2,80.91,94.08,94.08,0,57.6,82.56,82.56,163.2
3612816,360,41800,,,,,,,I&D DENTOALVEOLAR STRUCTURE,544.29,217.72,0,498.94,462.65,SKIPPED,498.94,498.94,462.65,462.65,462.65,229.36,0,0,0,163.29,234.04,234.04,462.65
3612817,975,41800,,,,,,,I&D DENTOALVEOLAR STRUCTURE,345.02,138.01,0,345.02,293.27,SKIPPED,345.02,345.02,293.27,293.27,293.27,168.43,169.06,169.06,0,103.51,171.87,171.87,0
3612818,360,36468,,,,,,,INJECTIONS SCLEROSANT SPIDER VEINS LIM/T,348.16,139.26,0,348.16,295.94,SKIPPED,348.16,348.16,295.94,295.94,295.94,146.72,0,0,0,104.45,149.71,149.71,295.94
3612819,975,36468,,,,,,,INJECTIONS SCLEROSANT SPIDER VEINS LIM/T,206.06,82.42,0,206.06,175.15,SKIPPED,206.06,206.06,175.15,175.15,175.15,0,100.97,100.97,0,61.82,0,0,0
3612820,975,35661,,,,,,,SurgicalAssist:BYPASS FEMORAL/FEMORAL,2510.21,1004.08,0,2510.21,2133.68,SKIPPED,2510.21,2510.21,2133.68,2133.68,2133.68,1146.99,1230,1230,0,753.06,1170.4,1170.4,0
3612821,975,48999,,,,,,,SurgicalAssist:UNLISTED PROC. PANCREAS,4507.8,1803.12,0,3831.63,3831.63,SKIPPED,2721.04,2721.04,3831.63,3831.63,3831.63,0,2208.82,2208.82,0,1352.34,0,0,0
3612822,360,40800,,,,,,,"I&D ABSC, CYST, VESTIBULE MOUTH SIMPLE",522.09,208.84,0,522.09,443.78,SKIPPED,522.09,522.09,443.78,443.78,443.78,220.01,133.1,133.1,0,156.63,224.5,224.5,443.78
3612823,975,40800,,,,,,,"I&D ABSC, CYST, VESTIBULE MOUTH SIMPLE",295.16,118.06,0,295.16,250.89,SKIPPED,295.16,295.16,250.89,250.89,250.89,130.79,144.63,144.63,0,88.55,133.46,133.46,0
3612824,360,43840,,,,,,,RPR STOMACH LESION,8682.19,3472.88,0,7379.86,7379.86,SKIPPED,6711.46,6711.46,7379.86,7379.86,7379.86,3658.67,0,0,0,2604.66,3733.34,3733.34,7379.86
3612825,360,36575,,,,,,,RPR TUN/NON TUN CTR CATH W/O PORT/PUMP,1492.18,596.87,254.87,1492.18,1268.35,SKIPPED,1492.18,1492.18,1268.35,1268.35,1268.35,628.81,254.87,254.87,SKIPPED,SKIPPED,641.64,641.64,1268.35
3612826,975,36575,,,,,,,RPR TUN/NON TUN CTR CATH W/O PORT/PUMP,81.45,32.58,0,81.45,69.23,SKIPPED,81.45,81.45,69.23,69.23,69.23,36.89,39.91,39.91,SKIPPED,SKIPPED,37.64,37.64,0
3612827,360,28615,,,,,,,OPEN TRT TARSOMETARSAL JOINT,6554.01,2621.6,1051.35,6554.01,5570.91,SKIPPED,6554.01,6554.01,5570.91,5570.91,5570.91,2761.86,1051.35,1051.35,SKIPPED,SKIPPED,2818.22,2818.22,5570.91
3612828,975,28615,,,,,,,OPEN TRT TARSOMETARSAL JOINT,1857.44,742.98,0,1857.44,1578.82,SKIPPED,1857.44,1857.44,1578.82,1578.82,1578.82,907.41,910.15,910.15,SKIPPED,SKIPPED,925.93,925.93,0
3612829,278,,,,,,,,STEM EXTENSION,20000,8000,0,17000,17000,SKIPPED,15200,15200,17000,17000,17000,8428,9800,9800,0,6000,8600,8600,17000
3612830,278,,,,,,,,BIOSURE REGENOSORB SCREW(ALL SIZES),1622.5,649,0,1379.12,1379.12,SKIPPED,1233.1,1233.1,1379.12,1379.12,1379.12,683.73,795.02,795.02,0,486.75,697.68,697.68,1379.12
3612831,278,,,,,,,,LOCK DISTAL FIBULA,1625,650,0,1381.25,1381.25,SKIPPED,1235,1235,1381.25,1381.25,1381.25,684.78,796.25,796.25,0,487.5,698.75,698.75,1381.25
3612832,278,,,,,,,,4.0 LOCKING SCREWS(ALL SIZES),775,310,0,658.75,658.75,SKIPPED,589,589,658.75,658.75,658.75,326.58,379.75,379.75,0,232.5,333.25,333.25,658.75
3612833,278,,,,,,,,4.0 PT SCREWS,175,70,0,148.75,148.75,SKIPPED,133,133,148.75,148.75,148.75,73.74,85.75,85.75,0,52.5,75.25,75.25,148.75
3612834,278,,,,,,,,2.5-3.5 DRILL(STRYKER),1457.5,583,0,1238.88,1238.88,SKIPPED,1107.7,1107.7,1238.88,1238.88,1238.88,614.2,714.18,714.18,0,437.25,626.73,626.73,1238.88
3612835,278,,,,,,,,Z PLATE 1.7MM,2045,818,0,1738.25,1738.25,SKIPPED,1554.2,1554.2,1738.25,1738.25,1738.25,861.76,1002.05,1002.05,0,613.5,879.35,879.35,1738.25
3612836,360,44144,,,,,,,COLECTOMY PRTL W/COLST/ILEOST & MUSCOFIS,7756.09,3102.44,0,7756.09,6592.68,SKIPPED,7756.09,7756.09,6592.68,6592.68,6592.68,3268.42,0,0,0,2326.83,3335.12,3335.12,6592.68
3612837,360,28193,,,,,,,RMV FB FOOT COMPLICATED,3316.59,1326.64,414.14,3316.59,2819.1,SKIPPED,3316.59,3316.59,2819.1,2819.1,2819.1,1397.61,414.14,414.14,SKIPPED,SKIPPED,1426.13,1426.13,2819.1
3612838,975,28193,,,,,,,RMV FB FOOT COMPLICATED,853.68,341.47,0,853.68,725.63,SKIPPED,853.68,853.68,725.63,725.63,725.63,403.23,418.3,418.3,SKIPPED,SKIPPED,411.46,411.46,0
3612839,360,44005,,,,,,,FREEING OF BOWEL ADHESION,8682.19,3472.88,0,7379.86,7379.86,SKIPPED,5409.06,5409.06,7379.86,7379.86,7379.86,3658.67,0,0,0,2604.66,3733.34,3733.34,7379.86
3612840,360,44207,,,,,,,LAP COLECTOMY W/ COLOPXTSTMY,10016.93,4006.77,0,8994.08,8514.39,SKIPPED,8994.08,8994.08,8514.39,8514.39,8514.39,4221.13,0,0,0,3005.08,4307.28,4307.28,8514.39
3612841,975,44207,,,,,,,LAP COLECTOMY W/ COLOPXTSTMY,3903.51,1561.4,0,3903.51,3317.98,SKIPPED,3903.51,3903.51,3317.98,3317.98,3317.98,1958.81,1912.72,1912.72,0,1171.05,1998.79,1998.79,0
3612842,360,38531,,,,,,,OPEN BX/EXC INGUINOFEMORAL,2085.89,834.36,0,2085.89,1773.01,SKIPPED,2085.89,2085.89,1773.01,1773.01,1773.01,878.99,0,0,0,625.77,896.93,896.93,1773.01
3612843,975,38531,,,,,,,OPEN BX/EXC INGUINOFEMORAL,996.69,398.68,0,996.69,847.19,SKIPPED,996.69,996.69,847.19,847.19,847.19,484.4,488.38,488.38,0,299.01,494.29,494.29,0
3612844,360,30000,,,,,,,I&D ABSCESS NASAL INTERNAL,1011.77,404.71,0,860,860,SKIPPED,441.66,441.66,860,860,860,426.36,82.31,82.31,0,303.53,435.06,435.06,860
3612845,975,30000,,,,,,,I&D ABSCESS NASAL INTERNAL,269.28,107.71,0,269.28,228.89,SKIPPED,269.28,269.28,228.89,228.89,228.89,132.15,131.95,131.95,0,80.78,134.85,134.85,0
3612846,360,36010,,,,,,,INTRO CATH SUP/INF VENA CAVA,2323.36,929.34,0,1974.86,1974.86,SKIPPED,0,0,1974.86,1974.86,1974.86,979.06,0,0,0,697.01,999.04,999.04,1974.86
3612847,975,36010,,,,,,,INTRO CATH SUP/INF VENA CAVA,253.92,101.57,0,215.83,215.83,SKIPPED,0,0,215.83,215.83,215.83,116.62,124.42,124.42,0,76.18,119,119,0
3612848,360,75822,,,,,,,VENOGRAPHY EXTREMITY BIL RS&I,2600.52,1040.21,0,2600.52,2210.44,SKIPPED,2600.52,2600.52,2210.44,2210.44,2210.44,1095.86,0,0,0,631.07,1118.22,1118.22,2210.44
3612849,975,75822,,,,,,,VENOGRAPHY EXTREMITY BIL RS&I,284.25,113.7,0,284.25,241.61,SKIPPED,284.25,284.25,241.61,241.61,241.61,76.24,284.25,284.25,0,284.25,77.8,77.8,0
3612850,360,75825,,,,,,,VENOGRAPHY CAVAL INF RS&I,4623.56,1849.42,0,4623.56,3930.03,SKIPPED,4623.56,4623.56,3930.03,3930.03,3930.03,1948.37,0,0,0,1600.34,1988.13,1988.13,3930.03
3612851,975,75825,,,,,,,VENOGRAPHY CAVAL INF RS&I,283.15,113.26,0,283.15,240.68,SKIPPED,283.15,283.15,240.68,240.68,240.68,58,283.15,283.15,0,283.15,59.18,59.18,0
3612852,360,75827,,,,,,,VENOGRAPHY CAVAL SUP RS&I,3319.58,1327.83,0,3111.86,2821.64,SKIPPED,3111.86,3111.86,2821.64,2821.64,2821.64,1398.87,0,0,0,393.27,1427.42,1427.42,2821.64
3612853,975,75827,,,,,,,VENOGRAPHY CAVAL SUP RS&I,30.07,12.03,0,59.94,25.56,SKIPPED,30.07,30.07,25.56,25.56,25.56,58.74,30.07,30.07,0,30.07,59.94,59.94,0
3612854,360,44187,,,,,,,LAP ILEO/JEJUNO-STOMY,6705.89,2682.36,0,5700.01,5700.01,SKIPPED,5453.38,5453.38,5700.01,5700.01,5700.01,2825.86,0,0,0,2011.77,2883.53,2883.53,5700.01
3612855,975,44187,,,,,,,LAP ILEO/JEJUNO-STOMY,2524.32,1009.73,0,2524.32,2145.67,SKIPPED,2524.32,2524.32,2145.67,2145.67,2145.67,1188.78,1236.92,1236.92,0,757.3,1213.04,1213.04,0
3612856,360,30000,,,,,,,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPR,1011.77,404.71,0,860,860,SKIPPED,441.66,441.66,860,860,860,426.36,82.31,82.31,0,303.53,435.06,435.06,860
3612857,975,30000,,,,,,,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPR,269.28,107.71,0,269.28,228.89,SKIPPED,269.28,269.28,228.89,228.89,228.89,132.15,131.95,131.95,0,80.78,134.85,134.85,0
3612858,360,64488,,,,,,,TAP BLOCK BILATERAL BY INJECTION(S),4126.93,1650.77,0,3507.89,3507.89,SKIPPED,0,0,3507.89,3507.89,3507.89,1739.09,69.97,69.97,0,1238.08,1774.58,1774.58,3507.89
3612859,975,64488,,,,,,,TAP BLOCK BILATERAL BY INJECTION(S),162.76,65.1,0,138.35,138.35,SKIPPED,0,0,138.35,138.35,138.35,75.94,79.75,79.75,0,48.83,77.49,77.49,0
3612860,360,19305,,,,,,,MAST RAD W/AXILLARY LYMPH,7978.19,3191.28,0,6781.46,6781.46,SKIPPED,5545.44,5545.44,6781.46,6781.46,6781.46,3362.01,0,0,0,2393.46,3430.62,3430.62,6781.46
3612861,975,19305,,,,,,,MAST RAD W/AXILLARY LYMPH,2602.74,1041.1,0,2602.74,2212.33,SKIPPED,2602.74,2602.74,2212.33,2212.33,2212.33,1245.54,1275.34,1275.34,0,780.82,1270.96,1270.96,0
3612862,975,28111,,,,,,,PART REMOVAL METATARSAL,749.05,299.62,0,749.05,636.69,SKIPPED,749.05,749.05,636.69,636.69,636.69,353.28,367.03,367.03,SKIPPED,SKIPPED,360.49,360.49,0
3612863,272,,,,,,,,RAP-PAC LATEX FREE,713.8,285.52,0,606.73,606.73,SKIPPED,542.49,542.49,606.73,606.73,606.73,300.79,349.76,349.76,0,214.14,306.93,306.93,606.73
3612864,975,43249,,,,,,,EGD W/ ESO DILATE <30MM,354.91,141.96,0,354.91,301.67,SKIPPED,354.91,354.91,301.67,301.67,301.67,167.3,173.91,173.91,SKIPPED,SKIPPED,170.71,170.71,0
3612865,360,32555,,,,,,,THORACENTIESIS W/ IMAGE,2189.07,875.63,0,2189.07,1860.71,SKIPPED,2189.07,2189.07,1860.71,1860.71,1860.71,922.47,254.87,254.87,0,656.72,941.3,941.3,1860.71
3612866,360,11462,,,,,,,EXC HIDRAENITIS,6343.79,2537.52,582.36,6343.79,5392.22,SKIPPED,6343.79,6343.79,5392.22,5392.22,5392.22,2673.27,582.36,582.36,SKIPPED,SKIPPED,2727.83,2727.83,5392.22
3612867,975,11462,,,,,,,EXC HIDRAENITIS,1919.35,767.74,0,1919.35,1631.45,SKIPPED,1919.35,1919.35,1631.45,1631.45,1631.45,270.96,940.48,940.48,SKIPPED,SKIPPED,276.49,276.49,0
3612868,360,36573,,,,,,,INSERT PICC,3549.42,1419.77,0,3549.42,3017.01,SKIPPED,3549.42,3549.42,3017.01,3017.01,3017.01,1495.72,414.14,414.14,0,1064.83,1526.25,1526.25,3017.01
3612869,360,49325,,,,,,,LAP W/ REVISION,11408.1,4563.24,1051.35,11408.1,9696.88,SKIPPED,11408.1,11408.1,9696.88,9696.88,9696.88,4807.37,1051.35,1051.35,SKIPPED,SKIPPED,4905.48,4905.48,9696.88
3612870,975,49325,,,,,,,LAP W/ REVISION,952.65,381.06,0,952.65,809.75,SKIPPED,952.65,952.65,809.75,809.75,809.75,447.88,466.8,466.8,SKIPPED,SKIPPED,457.02,457.02,0
3612871,360,60540,,,,,,,ADRENALECTOMY,10207.52,4083.01,0,8676.39,8676.39,SKIPPED,5231.74,5231.74,8676.39,8676.39,8676.39,4301.45,0,0,0,3062.26,4389.23,4389.23,8676.39
3612872,975,60540,,,,,,,ADRENALECTOMY,2458.98,983.59,0,2458.98,2090.13,SKIPPED,2458.98,2458.98,2090.13,2090.13,2090.13,1164.36,1204.9,1204.9,0,737.69,1188.12,1188.12,0
3612873,360,44208,,,,,,,LAP CHOLE W/ COLOPXTSTMY,11700.9,4680.36,0,9945.76,9945.76,SKIPPED,9812.31,9812.31,9945.76,9945.76,9945.76,4930.76,0,0,0,3510.27,5031.39,5031.39,9945.76
3612874,975,44208,,,,,,,LAP CHOLE W/ COLOPXTSTMY,4552.8,1821.12,0,4552.8,3869.88,SKIPPED,4552.8,4552.8,3869.88,3869.88,3869.88,2134.14,2230.87,2230.87,0,1365.84,2177.69,2177.69,0
3612875,360,52332,,,,,,,CYSTO W/ INSERT,6385.83,2554.33,867.38,6385.83,5427.96,SKIPPED,6385.83,6385.83,5427.96,5427.96,5427.96,2690.99,867.38,867.38,SKIPPED,SKIPPED,2745.91,2745.91,5427.96
3612876,975,52332,,,,,,,CYSTO W/ INSERT,358.52,143.41,0,358.52,304.74,SKIPPED,358.52,358.52,304.74,304.74,304.74,168.01,175.67,175.67,SKIPPED,SKIPPED,171.44,171.44,0
3612877,360,85670,,,,,,,LAPARASCOPY TUBAL CAUTERY,6362.31,2544.92,0,5407.96,5407.96,SKIPPED,27.06,27.06,5407.96,5407.96,5407.96,2681.07,0,0,0,5.38,2735.79,2735.79,5407.96
3612878,975,58670,,,,,,,LAPARASCOPY TUBAL CAUTERY,852.08,340.83,0,852.08,724.27,SKIPPED,852.08,852.08,724.27,724.27,724.27,409.54,417.52,417.52,SKIPPED,SKIPPED,417.9,417.9,0
3612879,360,23655,,,,,,,SHOULDER DISCL W/MANIPUL REG ANES.,2362.71,945.08,510.13,2362.71,2008.3,SKIPPED,2362.71,2362.71,2008.3,2008.3,2008.3,995.65,510.13,510.13,SKIPPED,SKIPPED,1015.97,1015.97,2008.3
3612880,975,23655,,,,,,,SHOULDER DISCL W/MANIPUL REG ANES,922.58,369.03,0,922.58,784.19,SKIPPED,922.58,922.58,784.19,784.19,784.19,451.62,452.06,452.06,SKIPPED,SKIPPED,460.84,460.84,0
3612881,975,35583,,,,,,,IN-SITU VEIN BYPASS FEM-POP,3303.68,1321.47,0,3303.68,2808.13,SKIPPED,3303.68,3303.68,2808.13,2808.13,2808.13,1520.27,1618.8,1618.8,0,991.1,1551.3,1551.3,0
3612882,360,69100,,,,,,,BX EXTERNAL EAR,704.99,282,0,599.24,599.24,SKIPPED,333.45,333.45,599.24,599.24,599.24,297.09,54.57,54.57,0,211.5,303.15,303.15,599.24
3612883,975,69100,,,,,,,BX EXTERNAL EAR,110.06,44.02,0,110.06,93.55,SKIPPED,110.06,110.06,93.55,93.55,93.55,50.77,53.93,53.93,0,33.02,51.81,51.81,0
3612884,360,45381,,,,,,,COLONOSCOPY SUBMUCOUS NJX,2305.99,922.4,361.12,2305.99,1960.09,SKIPPED,2305.99,2305.99,1960.09,1960.09,1960.09,971.75,361.12,361.12,SKIPPED,SKIPPED,991.58,991.58,1960.09
3612885,975,,,,,,,,COLONOSCOPY SUBMUCOUS NJX,465.11,186.04,0,395.34,395.34,SKIPPED,353.48,353.48,395.34,395.34,395.34,0,227.9,227.9,0,139.53,0,0,0
3612886,272,,,,,,,,Vascular Guard Patch VG0108N 0.8cm x 0.8,509.97,203.99,0,433.47,433.47,SKIPPED,387.58,387.58,433.47,433.47,433.47,214.9,249.89,249.89,0,152.99,219.29,219.29,433.47
3612887,360,45381,,,,,,,COLONOSCOPY SUBMUCOUS NJX,2305.99,922.4,361.12,2305.99,1960.09,SKIPPED,2305.99,2305.99,1960.09,1960.09,1960.09,971.75,361.12,361.12,SKIPPED,SKIPPED,991.58,991.58,1960.09
3612888,975,45381,,,,,,,COLONOSCOPY SUBMUCOUS NJX,465.11,186.04,0,465.11,395.34,SKIPPED,465.11,465.11,395.34,395.34,395.34,218.58,227.9,227.9,SKIPPED,SKIPPED,223.04,223.04,0
3612889,360,69110,,,,,,,REMOVAL EXTERNAL EAR/PARTIAL,5891.45,2356.58,582.36,5891.45,5007.73,SKIPPED,5891.45,5891.45,5007.73,5007.73,5007.73,2482.65,582.36,582.36,SKIPPED,SKIPPED,2533.32,2533.32,5007.73
3612890,975,69110,,,,,,,REMOVAL EXTERNAL EAR/PARTIAL,738.98,295.59,0,738.98,628.13,SKIPPED,738.98,738.98,628.13,628.13,628.13,363.09,362.1,362.1,SKIPPED,SKIPPED,370.5,370.5,0
3612891,360,55041,,,,,,,EXC HYDROCELE BILATERAL,8392.79,3357.12,867.38,8392.79,7133.87,SKIPPED,8392.79,8392.79,7133.87,7133.87,7133.87,3536.72,867.38,867.38,SKIPPED,SKIPPED,3608.9,3608.9,7133.87
3612892,975,55041,,,,,,,EXC HYDROCELE BILATERAL,1183.05,473.22,0,1183.05,1005.59,SKIPPED,1183.05,1183.05,1005.59,1005.59,1005.59,559.75,579.69,579.69,SKIPPED,SKIPPED,571.17,571.17,0
3612893,360,25028,,,,,,,I&D FOREARM WRIST DEEP ABSCESS,5223.2,2089.28,867.38,5223.2,4439.72,SKIPPED,5223.2,5223.2,4439.72,4439.72,4439.72,2201.06,867.38,867.38,SKIPPED,SKIPPED,2245.98,2245.98,4439.72
3612894,975,25028,,,,,,,I&D FOREARM WRIST DEEP ABSCESS,1352.25,540.9,0,1352.25,1149.41,SKIPPED,1352.25,1352.25,1149.41,1149.41,1149.41,781.74,662.6,662.6,SKIPPED,SKIPPED,797.69,797.69,0
3612895,360,28070,,,,,,,SYNOVECTOMY TAROMETATARSAL JT,7743.35,3097.34,1051.35,7743.35,6581.85,SKIPPED,7743.35,7743.35,6581.85,6581.85,6581.85,3263.05,1051.35,1051.35,SKIPPED,SKIPPED,3329.64,3329.64,6581.85
3612896,975,28070,,,,,,,SYNOVECTOMY TAROMETATARSAL JT,816.64,326.66,0,816.64,694.14,SKIPPED,816.64,816.64,694.14,694.14,694.14,381.54,400.15,400.15,SKIPPED,SKIPPED,389.33,389.33,0
3612897,975,28108,,,,,,,REMOVAL TOE LESION,666.41,266.56,0,666.41,566.45,SKIPPED,666.41,666.41,566.45,566.45,566.45,316.48,326.54,326.54,SKIPPED,SKIPPED,322.94,322.94,0
3612898,360,20205,,,,,,,DEEP MUSCLE BX,1919.21,767.68,582.36,1919.21,1631.33,SKIPPED,1919.21,1919.21,1631.33,1631.33,1631.33,808.75,582.36,582.36,SKIPPED,SKIPPED,825.26,825.26,1631.33
3612899,975,20205,,,,,,,DEEP MUSCLE BX,448.61,179.44,0,448.61,381.32,SKIPPED,448.61,448.61,381.32,381.32,381.32,164.62,219.82,219.82,SKIPPED,SKIPPED,167.98,167.98,0
3612900,360,27680,,,,,,,"TENOLYSIS, FLEX/EXT TENDON; SINGLE",4353.77,1741.51,867.38,4353.77,3700.7,SKIPPED,4353.77,4353.77,3700.7,3700.7,3700.7,1834.68,867.38,867.38,SKIPPED,SKIPPED,1872.12,1872.12,3700.7
3612901,975,27680,,,,,,,"TENOLYSIS, FLEX/EXT TENDON; SINGLE",973.65,389.46,0,973.65,827.6,SKIPPED,973.65,973.65,827.6,827.6,827.6,459.3,477.09,477.09,SKIPPED,SKIPPED,468.67,468.67,0
3612902,360,28022,,,,,,,"Arthrotomy, metatarsophalangeal joint",5711.32,2284.53,867.38,5711.32,4854.62,SKIPPED,5711.32,5711.32,4854.62,4854.62,4854.62,2406.75,867.38,867.38,SKIPPED,SKIPPED,2455.87,2455.87,4854.62
3612903,975,28022,,,,,,,"Arthrotomy, metatarsophalangeal joint",750.77,300.31,0,750.77,638.15,SKIPPED,750.77,750.77,638.15,638.15,638.15,358.42,367.88,367.88,SKIPPED,SKIPPED,365.73,365.73,0
3612904,360,66761,,,,,,,REVISION OF IRIS,1790.01,716,151.86,1521.51,1521.51,SKIPPED,899.46,899.46,1521.51,1521.51,1521.51,754.31,151.86,151.86,SKIPPED,SKIPPED,769.7,769.7,1521.51
3612905,360,36596,,,,,,,MECHANICAL REMOVAL OF TISSUE/OBSTRUCTIVE,2126.55,850.62,414.14,2126.55,1807.57,SKIPPED,2126.55,2126.55,1807.57,1807.57,1807.57,896.13,414.14,414.14,SKIPPED,SKIPPED,914.42,914.42,1807.57
3612906,975,36596,,,,,,,MECHANICAL REMOVAL OF TISSUE/OBSTRUCTIVE,101.08,40.43,0,101.08,85.92,SKIPPED,101.08,101.08,85.92,85.92,85.92,47.92,49.53,49.53,SKIPPED,SKIPPED,48.9,48.9,0
3612907,360,27596,,,,,,,REAMPUTATION OF THIGH,7855.59,3142.24,0,6677.25,6677.25,SKIPPED,3544.12,3544.12,6677.25,6677.25,6677.25,3310.34,0,0,0,2356.68,3377.9,3377.9,6677.25
3612908,975,27596,,,,,,,REAMPUTATION OF THIGH,1632.39,652.96,0,1632.39,1387.53,SKIPPED,1632.39,1632.39,1387.53,1387.53,1387.53,772.06,799.87,799.87,0,489.72,787.82,787.82,0
3612909,272,,,,,,,,BVI BEAVER ARTHRO LOC BANANA 4MM BLADE,87.5,35,0,74.38,74.38,SKIPPED,66.5,66.5,74.38,74.38,74.38,36.88,42.88,42.88,0,26.25,37.63,37.63,74.38
3612910,272,,,,,,,,FREE NEEDLE,0.75,0.3,0,0.64,0.64,SKIPPED,0.57,0.57,0.64,0.64,0.64,0.31,0.37,0.37,0,0.22,0.32,0.32,0.64
3612911,272,,,,,,,,5X30 PLASTER SPLINT,1.1,0.44,0,0.94,0.94,SKIPPED,0.84,0.84,0.94,0.94,0.94,0.46,0.54,0.54,0,0.33,0.47,0.47,0.94
3612912,272,,,,,,,,4-0 MERSILENE FS-2,4.45,1.78,0,3.78,3.78,SKIPPED,3.38,3.38,3.78,3.78,3.78,1.87,2.18,2.18,0,1.34,1.91,1.91,3.78
3612913,272,,,,,,,,3-0 PDS SH,6.8,2.72,0,5.78,5.78,SKIPPED,5.17,5.17,5.78,5.78,5.78,2.86,3.33,3.33,0,2.04,2.92,2.92,5.78
3612914,272,,,,,,,,4.0 EGG BURR,198,79.2,0,168.3,168.3,SKIPPED,150.48,150.48,168.3,168.3,168.3,83.44,97.02,97.02,0,59.4,85.14,85.14,168.3
3612915,272,,,,,,,,PRECISION THIN BLADE 7X.38X39.5MM,114.5,45.8,0,97.32,97.32,SKIPPED,87.02,87.02,97.32,97.32,97.32,48.26,56.1,56.1,0,34.35,49.24,49.24,97.32
3612916,272,,,,,,,,MICRO SAGITTAL BLADE,126.4,50.56,0,107.44,107.44,SKIPPED,96.06,96.06,107.44,107.44,107.44,53.26,61.94,61.94,0,37.92,54.35,54.35,107.44
3612917,272,,,,,,,,#2 FIBERWIRE,55,22,0,46.75,46.75,SKIPPED,41.8,41.8,46.75,46.75,46.75,23.18,26.95,26.95,0,16.5,23.65,23.65,46.75
3612918,272,,,,,,,,2-0 FIBERWIRE,55,22,0,46.75,46.75,SKIPPED,41.8,41.8,46.75,46.75,46.75,23.18,26.95,26.95,0,16.5,23.65,23.65,46.75
3612919,272,,,,,,,,SHORT BEVEL BURNER,625,250,0,531.25,531.25,SKIPPED,475,475,531.25,531.25,531.25,263.38,306.25,306.25,0,187.5,268.75,268.75,531.25
3612920,272,,,,,,,,POWER MINI 2.9 INCISOR PLUS ELITE BLADE,155,62,0,131.75,131.75,SKIPPED,117.8,117.8,131.75,131.75,131.75,65.32,75.95,75.95,0,46.5,66.65,66.65,131.75
3612921,272,,,,,,,,TOPAZ MICRO DEBRIDER,1125,450,0,956.25,956.25,SKIPPED,855,855,956.25,956.25,956.25,474.08,551.25,551.25,0,337.5,483.75,483.75,956.25
3612922,272,,,,,,,,ANKLE DISTRACTOR FOOT STRAP,127.5,51,0,108.38,108.38,SKIPPED,96.9,96.9,108.38,108.38,108.38,53.73,62.48,62.48,0,38.25,54.83,54.83,108.38
3612923,272,,,,,,,,LOOPED SUTURE(BATTLE ACL),195,78,0,165.75,165.75,SKIPPED,148.2,148.2,165.75,165.75,165.75,82.17,95.55,95.55,0,58.5,83.85,83.85,165.75
3612924,360,44360,,,,,,,SMALL INTESTINAL ENDOSCOPY/ENTEROSCOPY,3326.24,1330.5,414.14,3326.24,2827.3,SKIPPED,3326.24,3326.24,2827.3,2827.3,2827.3,1401.67,414.14,414.14,SKIPPED,SKIPPED,1430.28,1430.28,2827.3
3612926,975,44360,,,,,,,SMALL INTESTINAL ENDOSCOPY/ENTEROSCOPY,316.97,126.79,0,316.97,269.42,SKIPPED,316.97,316.97,269.42,269.42,269.42,156.53,155.32,155.32,SKIPPED,SKIPPED,159.72,159.72,0
3612927,360,36861,,,,,,,XTRNL CANNILA DECLOSTTING SPX W/BALOON,4860.57,1944.23,1051.35,4860.57,4131.48,SKIPPED,4860.57,4860.57,4131.48,4131.48,4131.48,2048.25,1051.35,1051.35,SKIPPED,SKIPPED,2090.05,2090.05,4131.48
3612928,975,36861,,,,,,,XTRNL CANNILA DECLOSTTING SPX W/BALOON,303.17,121.27,0,303.17,257.69,SKIPPED,303.17,303.17,257.69,257.69,257.69,147.87,148.55,148.55,SKIPPED,SKIPPED,150.89,150.89,0
3612929,360,58100,,,,,,,ENDOMETRIAL BX,375.95,150.38,40.42,319.56,319.56,SKIPPED,232.56,232.56,319.56,319.56,319.56,158.43,40.42,40.42,SKIPPED,SKIPPED,161.66,161.66,319.56
3612930,975,58100,,,,,,,ENDOMETRIAL BX,141.38,56.55,0,141.38,120.17,SKIPPED,141.38,141.38,120.17,120.17,120.17,69.26,69.28,69.28,SKIPPED,SKIPPED,70.67,70.67,0
3612931,360,43233,,,,,,,EGD W/ESO DILATE 30MM OR LARGER,3027.47,1210.99,414.14,3027.47,2573.35,SKIPPED,3027.47,3027.47,2573.35,2573.35,2573.35,1275.77,414.14,414.14,SKIPPED,SKIPPED,1301.81,1301.81,2573.35
3612932,975,43233,,,,,,,EGD W/ESO DILATE 30MM OR LARGER,504.4,201.76,0,504.4,428.74,SKIPPED,504.4,504.4,428.74,428.74,428.74,249.13,247.16,247.16,SKIPPED,SKIPPED,254.21,254.21,0
3612933,360,33206,,,,,,,INSERT HEART PACEMAKER ATRIAL,17057.88,6823.15,1051.35,17057.88,14499.2,SKIPPED,17057.88,17057.88,14499.2,14499.2,14499.2,7188.19,1051.35,1051.35,SKIPPED,SKIPPED,7334.89,7334.89,14499.2
3612934,360,49329,,,,,,,ULISTED LAPAROSCOPIC PROC. ABD/PERITO/OM,9853.6,3941.44,0,9853.6,8375.56,SKIPPED,9853.6,9853.6,8375.56,8375.56,8375.56,4152.31,0,0,0,2956.08,4237.05,4237.05,8375.56
3612935,360,44020,,,,,,,ENTEROTOMY SMALL INTESTINE,12776.87,5110.75,0,10860.34,10860.34,SKIPPED,4802.16,4802.16,10860.34,10860.34,10860.34,5384.17,0,0,0,3833.06,5494.05,5494.05,10860.34
3612936,975,47379,,,,,,,LAPAROSCOPE LIVER PROCEDURE,308.7,123.48,0,308.7,262.4,SKIPPED,308.7,308.7,262.4,262.4,262.4,0,151.26,151.26,0,92.61,0,0,0
3612937,975,11463,,,,,,,REMOVE SWEAT GLAND LESION,715.04,286.02,0,715.04,607.78,SKIPPED,715.04,715.04,607.78,607.78,607.78,362.39,350.37,350.37,SKIPPED,SKIPPED,369.79,369.79,0
3612938,272,,,,,,,,SLT LIGHT MED LASER,687.5,275,0,584.38,584.38,SKIPPED,522.5,522.5,584.38,584.38,584.38,289.72,336.88,336.88,0,206.25,295.63,295.63,584.38
3612939,272,,,,,,,,YAG LIGHT MED LASER,437.5,175,0,371.88,371.88,SKIPPED,332.5,332.5,371.88,371.88,371.88,184.37,214.38,214.38,0,131.25,188.13,188.13,371.88
3612940,272,,,,,,,,FEMTO LAR,1221.5,488.6,0,1038.28,1038.28,SKIPPED,928.34,928.34,1038.28,1038.28,1038.28,514.74,598.54,598.54,0,366.45,525.25,525.25,1038.28
3612941,272,,,,,,,,LAPAROSCOPIC ARGON APPLICATOR,475,190,0,403.75,403.75,SKIPPED,361,361,403.75,403.75,403.75,200.16,232.75,232.75,0,142.5,204.25,204.25,403.75
3612942,360,27638,,,,,,,EXC/CURETTAGE BONE CYST,6327.54,2531.02,1051.35,6327.54,5378.41,SKIPPED,6327.54,6327.54,5378.41,5378.41,5378.41,2666.42,1051.35,1051.35,SKIPPED,SKIPPED,2720.84,2720.84,5378.41
3612943,975,27638,,,,,,,EXC/CURETTAGE BONE CYST,1671.31,668.52,0,1671.31,1420.61,SKIPPED,1671.31,1671.31,1420.61,1420.61,1420.61,821.44,818.94,818.94,SKIPPED,SKIPPED,838.2,838.2,0
3612944,360,64445,,,,,,,"NERVE BLOCK, SCIATIC NERVE",1842.28,736.91,0,1565.94,1565.94,SKIPPED,389.88,389.88,1565.94,1565.94,1565.94,776.34,71.6,71.6,0,552.68,792.18,792.18,1565.94
3612945,975,64445,,,,,,,"NERVE BLOCK, SCIATIC NERVE",119.19,47.68,0,119.19,101.31,SKIPPED,119.19,119.19,101.31,101.31,101.31,58.78,58.4,58.4,0,35.76,59.98,59.98,0
3612946,360,28107,,,,,,,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGR,3843.59,1537.44,1051.35,3843.59,3267.05,SKIPPED,3843.59,3843.59,3267.05,3267.05,3267.05,1619.69,1051.35,1051.35,SKIPPED,SKIPPED,1652.74,1652.74,3267.05
3612947,975,28107,,,,,,,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGR,769.52,307.81,0,769.52,654.09,SKIPPED,769.52,769.52,654.09,654.09,654.09,381.37,377.06,377.06,SKIPPED,SKIPPED,389.15,389.15,0
3612948,360,36247,,,,,,,"SELECTIVE CATH PLACEMENT, INITIAL 3RD",3904.09,1561.64,0,3318.48,3318.48,SKIPPED,0,0,3318.48,3318.48,3318.48,1645.18,0,0,0,1171.23,1678.76,1678.76,3318.48
3612949,975,36247,,,,,,,"SELECTIVE CATH PLACEMENT, INITIAL 3RD",664.01,265.6,0,564.41,564.41,SKIPPED,0,0,564.41,564.41,564.41,319.52,325.36,325.36,0,199.2,326.04,326.04,0
3612950,360,58110,,,,,,,ENDOMETRIAL BX CONJUNCT W/ COLONOSCOPY,520.65,208.26,0,442.55,442.55,SKIPPED,0,0,442.55,442.55,442.55,219.4,0,0,0,156.2,223.88,223.88,442.55
3612951,975,58110,,,,,,,ENDOMETRIAL BX CONJUNCT W/ COLONOSCOPY,90.47,36.19,0,76.9,76.9,SKIPPED,0,0,76.9,76.9,76.9,43.94,44.33,44.33,0,27.14,44.84,44.84,0
3612952,360,65855,,,,,,,TRABECULOPLASTY LASER SURGERY,1815.82,726.33,108.56,1543.45,1543.45,SKIPPED,646.38,646.38,1543.45,1543.45,1543.45,765.18,108.56,108.56,SKIPPED,SKIPPED,780.8,780.8,1543.45
3612953,975,65855,,,,,,,TRABECULOPLASTY LASER SURGERY,450.3,180.12,0,450.3,382.76,SKIPPED,450.3,450.3,382.76,382.76,382.76,223.18,220.65,220.65,SKIPPED,SKIPPED,227.73,227.73,0
3612954,360,28208,,,,,,,"RPR TEND EXTENSOR FOOT, EACH",6413.76,2565.5,867.38,6413.76,5451.7,SKIPPED,6413.76,6413.76,5451.7,5451.7,5451.7,2702.76,867.38,867.38,SKIPPED,SKIPPED,2757.92,2757.92,5451.7
3612955,975,28208,,,,,,,"RPR TEND EXTENSOR FOOT, EACH",694.91,277.96,0,694.91,590.67,SKIPPED,694.91,694.91,590.67,590.67,590.67,350.29,340.51,340.51,SKIPPED,SKIPPED,357.44,357.44,0
3612956,360,28250,,,,,,,DIVISION PLANTAR FASCIA & MUSC,5360.96,2144.38,867.38,5360.96,4556.82,SKIPPED,5360.96,5360.96,4556.82,4556.82,4556.82,2259.11,867.38,867.38,SKIPPED,SKIPPED,2305.21,2305.21,4556.82
3612957,975,28250,,,,,,,DIVISION PLANTAR FASCIA & MUSC,888.51,355.4,0,888.51,755.23,SKIPPED,888.51,888.51,755.23,755.23,755.23,444.59,435.37,435.37,SKIPPED,SKIPPED,453.66,453.66,0
3612958,360,37221,,,,,,,ILIAC REVASC W/ STENT,22186.65,8874.66,1051.35,22186.65,18858.65,SKIPPED,22186.65,22186.65,18858.65,18858.65,18858.65,9349.45,1051.35,1051.35,SKIPPED,SKIPPED,9540.26,9540.26,18858.65
3612959,360,G9661,,,,,,,COLONOSCOPY PT>=86 W/ HIGH RISK,8215.83,3286.33,0,6983.46,6983.46,SKIPPED,0,0,6983.46,6983.46,6983.46,3462.15,0,0,0,2464.75,3532.81,3532.81,6983.46
3612960,975,G9661,,,,,,,COLONOSCOPY PT>=86 W/ HIGH RISK,4244.63,1697.85,0,3607.94,3607.94,SKIPPED,0,0,3607.94,3607.94,3607.94,0,2079.87,2079.87,0,1273.39,0,0,0
3612961,360,37191,,,,,,,INSERT IVC FILTER,10545.41,4218.16,0,10545.41,8963.6,SKIPPED,10545.41,10545.41,8963.6,8963.6,8963.6,4443.84,0,0,0,3163.62,4534.53,4534.53,8963.6
3612962,360,67031,,,,,,,LASER SURGERY EYE STRAND,1643.83,657.53,204.91,1643.83,1397.26,SKIPPED,1643.83,1643.83,1397.26,1397.26,1397.26,692.71,204.91,204.91,SKIPPED,SKIPPED,706.85,706.85,1397.26
3612963,360,36907,,,,,,,TRLUML BALLOON ANGIOP CTR DIALYSIS,12469.83,4987.93,0,10599.36,10599.36,SKIPPED,0,0,10599.36,10599.36,10599.36,5254.79,0,0,0,3740.95,5362.03,5362.03,10599.36
3612964,975,36907,,,,,,,TRLUML BALLOON ANGIOP CTR DIALYSIS,311.13,124.45,0,264.46,264.46,SKIPPED,0,0,264.46,264.46,264.46,157.49,152.45,152.45,0,93.34,160.7,160.7,0
3612965,278,,,,,,,,CLARIX CORD 1K #CR-10-2525,4687.5,1875,0,3984.38,3984.38,SKIPPED,3562.5,3562.5,3984.38,3984.38,3984.38,1975.32,2296.88,2296.88,0,1406.25,2015.63,2015.63,3984.38
3612966,278,,,,,,,,CLARIX FLO #CR-FL-50MG,4000,1600,0,3400,3400,SKIPPED,3040,3040,3400,3400,3400,1685.6,1960,1960,0,1200,1720,1720,3400
3612967,975,60240,,,,,,,THYROIDECTOMY TOTAL/COMPLETE PROF,1946.55,778.62,0,1946.55,1654.57,SKIPPED,1946.55,1946.55,1654.57,1654.57,1654.57,998.69,953.81,953.81,SKIPPED,SKIPPED,1019.07,1019.07,0
3612968,360,21556,,,,,,,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFAS,6915.98,2766.39,582.36,6915.98,5878.58,SKIPPED,6915.98,6915.98,5878.58,5878.58,5878.58,2914.39,582.36,582.36,SKIPPED,SKIPPED,2973.87,2973.87,5878.58
3612969,975,21556,,,,,,,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFAS,1130.64,452.26,0,1130.64,961.04,SKIPPED,1130.64,1130.64,961.04,961.04,961.04,580.52,554.01,554.01,SKIPPED,SKIPPED,592.37,592.37,0
3612970,360,44141,,,,,,,"COLECTOMY,PARTIAL;W/ANASTOMOSIS SKIN LEV",10969.88,4387.95,0,9324.4,9324.4,SKIPPED,9023.05,9023.05,9324.4,9324.4,9324.4,4622.71,0,0,0,3290.96,4717.05,4717.05,9324.4
3612971,975,44141,,,,,,,"COLECTOMY,PARTIAL;W/ANASTOMOSIS SKIN LEV",3859.25,1543.7,0,3859.25,3280.36,SKIPPED,3859.25,3859.25,3280.36,3280.36,3280.36,1964.14,1891.03,1891.03,0,1157.78,2004.22,2004.22,0
3612972,360,44121,,,,,,,RESECTION OF SMALL INTESTINE; EACH ADD.,1418.92,567.57,0,1206.08,1206.08,SKIPPED,1198.42,1198.42,1206.08,1206.08,1206.08,597.94,0,0,0,425.68,610.14,610.14,1206.08
3612973,975,44121,,,,,,,RESECTION OF SMALL INTESTINE; EACH ADD.,508.52,203.41,0,508.52,432.24,SKIPPED,508.52,508.52,432.24,432.24,432.24,258.23,249.17,249.17,0,152.56,263.5,263.5,0
3612976,360,27606,,,,,,,TENOTOMY ACHILLES,5292,2116.8,867.38,5292,4498.2,SKIPPED,5292,5292,4498.2,4498.2,4498.2,2230.05,867.38,867.38,SKIPPED,SKIPPED,2275.56,2275.56,4498.2
3612977,975,27606,,,,,,,TENOTOMY ACHILLES,589.16,235.66,0,589.16,500.79,SKIPPED,589.16,589.16,500.79,500.79,500.79,298.88,288.69,288.69,SKIPPED,SKIPPED,304.98,304.98,0
3612978,272,,,,,,,,PINK PAD KIT,275,110,0,233.75,233.75,SKIPPED,209,209,233.75,233.75,233.75,115.88,134.75,134.75,0,82.5,118.25,118.25,233.75
3612979,272,,,,,,,,ARM CRADLES,51.25,20.5,0,43.56,43.56,SKIPPED,38.95,38.95,43.56,43.56,43.56,21.6,25.11,25.11,0,15.38,22.04,22.04,43.56
3612980,272,,,,,,,,STRATAFIX,66.45,26.58,0,56.48,56.48,SKIPPED,50.5,50.5,56.48,56.48,56.48,28,32.56,32.56,0,19.94,28.57,28.57,56.48
3612981,272,,,,,,,,GASTRIC LAVAGE,34.62,13.85,0,29.43,29.43,SKIPPED,26.31,26.31,29.43,29.43,29.43,14.59,16.96,16.96,0,10.39,14.89,14.89,29.43
3612982,272,,,,,,,,Edlich 3 Fr lavage tray,34.65,13.86,0,29.45,29.45,SKIPPED,26.33,26.33,29.45,29.45,29.45,14.6,16.98,16.98,0,10.4,14.9,14.9,29.45
3612983,360,47379,,,,,,,UNLISTED LAPAROSOPIC LIVER PROCEDURE,8689.05,3475.62,0,8689.05,7385.69,SKIPPED,8689.05,8689.05,7385.69,7385.69,7385.69,3661.56,0,0,0,2606.72,3736.29,3736.29,7385.69
3612984,278,,,,,,,,LAPIPLASTY SYSTEM 2,14987.5,5995,0,12739.38,12739.38,SKIPPED,11390.5,11390.5,12739.38,12739.38,12739.38,6315.74,7343.88,7343.88,0,4496.25,6444.63,6444.63,12739.38
3612985,272,,,,,,,,SAWBLADE(SM4011),375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3612986,272,,,,,,,,WECK-HEMO LOCK CLIP M-L# 544230,73.93,29.57,0,62.84,62.84,SKIPPED,56.19,56.19,62.84,62.84,62.84,31.15,36.23,36.23,0,22.18,31.79,31.79,62.84
3612987,272,,,,,,,,SEE SHARP #30977,87.5,35,0,74.38,74.38,SKIPPED,66.5,66.5,74.38,74.38,74.38,36.88,42.88,42.88,0,26.25,37.63,37.63,74.38
3612988,272,,,,,,,,LAPIPLASTY SET #SK14,14987.5,5995,0,12739.38,12739.38,SKIPPED,11390.5,11390.5,12739.38,12739.38,12739.38,6315.74,7343.88,7343.88,0,4496.25,6444.63,6444.63,12739.38
3612989,272,,,,,,,,Lapiplasty Saw Blade #sk4011,375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3612990,360,28740,,,,,,,ARTHRODESIS MIDTARSOMETATARSAL SINGLE,7127.28,2850.91,1051.35,7127.28,6058.19,SKIPPED,7127.28,7127.28,6058.19,6058.19,6058.19,3003.44,1051.35,1051.35,SKIPPED,SKIPPED,3064.73,3064.73,6058.19
3612991,975,28740,,,,,,,ARTHRODESIS MIDTARSOMETATARSAL SINGLE,1327.89,531.16,0,1327.89,1128.71,SKIPPED,1327.89,1327.89,1128.71,1128.71,1128.71,676.87,650.67,650.67,SKIPPED,SKIPPED,690.68,690.68,0
3612992,360,28737,,,,,,,ARTHRD W/ TDN LNGTH&ADVMNT TARSL NVCLR-C,8731.42,3492.57,1051.35,8731.42,7421.71,SKIPPED,8731.42,8731.42,7421.71,7421.71,7421.71,3679.42,1051.35,1051.35,SKIPPED,SKIPPED,3754.51,3754.51,7421.71
3612993,975,28737,,,,,,,ARTHRD W/ TDN LNGTH&ADVMNT TARSL NVCLR-C,1471.68,588.67,0,1471.68,1250.93,SKIPPED,1471.68,1471.68,1250.93,1250.93,1250.93,754.32,721.12,721.12,SKIPPED,SKIPPED,769.71,769.71,0
3612994,360,15822,,,,,,,Blepharoplasty upper eyelid,6408.83,2563.53,582.36,6408.83,5447.51,SKIPPED,6408.83,6408.83,5447.51,5447.51,5447.51,2700.68,582.36,582.36,SKIPPED,SKIPPED,2755.8,2755.8,5447.51
3612995,975,15822,,,,,,,Blepharoplasty upper eyelid,1406.43,562.57,0,1406.43,1195.47,SKIPPED,1406.43,1406.43,1195.47,1195.47,1195.47,438.31,689.15,689.15,SKIPPED,SKIPPED,447.26,447.26,0
3612996,360,62270,,,,,,,"Spinal puncture, lumbar diagnostic",1386.74,554.7,252.66,1386.74,1178.73,SKIPPED,1386.74,1386.74,1178.73,1178.73,1178.73,584.37,252.66,252.66,SKIPPED,SKIPPED,596.3,596.3,1178.73
3612997,975,62270,,,,,,,"Spinal puncture, lumbar diagnostic",469.26,187.7,0,469.26,398.87,SKIPPED,469.26,469.26,398.87,398.87,398.87,67.03,229.94,229.94,SKIPPED,SKIPPED,68.4,68.4,0
3612998,270,,,,,,,,SWISS EYE MASK,60,24,0,51,51,SKIPPED,45.6,45.6,51,51,51,25.28,29.4,29.4,0,18,25.8,25.8,51
3612999,272,,,,,,,,PNEUMOCLEAR INSUFFLATION,56.88,22.75,0,48.35,48.35,SKIPPED,43.23,43.23,48.35,48.35,48.35,23.97,27.87,27.87,0,17.06,24.46,24.46,48.35
3613001,278,,,,,,,,HAMMER TOE IMPLANT SYSTEM,2487.5,995,0,2114.38,2114.38,SKIPPED,1890.5,1890.5,2114.38,2114.38,2114.38,1048.24,1218.88,1218.88,0,746.25,1069.63,1069.63,2114.38
3613002,278,,,,,,,,LISRANCE SCREW 3.7X26MM,3957.5,1583,0,3363.88,3363.88,SKIPPED,3007.7,3007.7,3363.88,3363.88,3363.88,1667.7,1939.18,1939.18,0,1187.25,1701.73,1701.73,3363.88
3613003,360,47564,,,,,,,LAP CHOLE W/ EXPLORE COMMON BILE DUCT,14422.85,5769.14,1051.35,14422.85,12259.42,SKIPPED,14422.85,14422.85,12259.42,12259.42,12259.42,6077.79,1051.35,1051.35,SKIPPED,SKIPPED,6201.83,6201.83,12259.42
3613004,975,47564,,,,,,,LAP CHOLE W/ EXPLORE COMMON BILE DUCT,2557.65,1023.06,0,2557.65,2174,SKIPPED,2557.65,2557.65,2174,2174,2174,1209.73,1253.25,1253.25,SKIPPED,SKIPPED,1234.42,1234.42,0
3613005,360,15847,,,,,,,EXC EXCESSIVE SKIN & SUBQ,6680.26,2672.1,0,5678.22,5678.22,SKIPPED,0,0,5678.22,5678.22,5678.22,2815.06,0,0,0,2004.08,2872.51,2872.51,5678.22
3613006,975,15847,,,,,,,EXC EXCESSIVE SKIN & SUBQ,607.38,242.95,0,516.27,516.27,SKIPPED,0,0,516.27,516.27,516.27,0,297.62,297.62,0,182.21,0,0,0
3613007,360,15777,,,,,,,BIO IMPLANT SOFT TISSUE-ADD ON,5219.66,2087.86,0,4436.71,4436.71,SKIPPED,0,0,4436.71,4436.71,4436.71,2199.56,0,0,0,1565.9,2244.45,2244.45,4436.71
3613008,975,15777,,,,,,,BIO IMPLANT SOFT TISSUE-ADD ON,496.98,198.79,0,422.43,422.43,SKIPPED,0,0,422.43,422.43,422.43,232.13,243.52,243.52,0,149.09,236.87,236.87,0
3613009,360,34710,,,,,,,DLYD PLMT XTN PROSTH 1ST VSL,4153.54,1661.42,0,3963.45,3530.51,SKIPPED,3963.45,3963.45,3530.51,3530.51,3530.51,1750.3,0,0,0,1246.06,1786.02,1786.02,3530.51
3613010,975,34710,,,,,,,DLYD PLMT XTN PROSTH 1ST VSL,1837.89,735.16,0,1837.89,1562.21,SKIPPED,1837.89,1837.89,1562.21,1562.21,1562.21,842.07,900.57,900.57,0,551.37,859.26,859.26,0
3613011,360,60500,,,,,,,PARATHYROIDECTOMY/EXPLORATION PARATHYROI,14590.71,5836.28,1051.35,14590.71,12402.1,SKIPPED,14590.71,14590.71,12402.1,12402.1,12402.1,6148.53,1051.35,1051.35,SKIPPED,SKIPPED,6274.01,6274.01,12402.1
3613012,975,60500,,,,,,,PARATHYROIDECTOMY/EXPLORATION PARATHYROI,2906.01,1162.4,0,2906.01,2470.11,SKIPPED,2906.01,2906.01,2470.11,2470.11,2470.11,1053.23,1423.94,1423.94,SKIPPED,SKIPPED,1074.72,1074.72,0
3613013,360,21011,,,,,,,EXC FACE LESION,4381.61,1752.64,0,3724.37,3724.37,SKIPPED,1090.98,1090.98,3724.37,3724.37,3724.37,1846.41,197.77,197.77,0,1314.48,1884.09,1884.09,3724.37
3613014,360,49421,,,,,,,INSERTION TUNNEL INTRAPERITONEAL CATH DI,8575.69,3430.28,867.38,8575.69,7289.34,SKIPPED,8575.69,8575.69,7289.34,7289.34,7289.34,3613.8,867.38,867.38,SKIPPED,SKIPPED,3687.55,3687.55,7289.34
3613015,975,49421,,,,,,,INSERTION TUNNEL INTRAPERITONEAL CATH DI,524.44,209.78,0,524.44,445.77,SKIPPED,524.44,524.44,445.77,445.77,445.77,243.35,256.98,256.98,SKIPPED,SKIPPED,248.32,248.32,0
3613016,360,23076,,,,,,,EXC TUMOR SHOULDER SOFT TISS SUBFASCI<5,5616.69,2246.68,582.36,5616.69,4774.19,SKIPPED,5616.69,5616.69,4774.19,4774.19,4774.19,2366.88,582.36,582.36,SKIPPED,SKIPPED,2415.18,2415.18,4774.19
3613017,975,23076,,,,,,,EXC TUMOR SHOULDER SOFT TISS SUBFASCI<5,1177.23,470.89,0,1177.23,1000.65,SKIPPED,1177.23,1177.23,1000.65,1000.65,1000.65,592.66,576.84,576.84,SKIPPED,SKIPPED,604.76,604.76,0
3613018,360,36475,,,,,,,ENDOVEOUS ABLTJ INCOMPLETE VEIN XTR RF,7512.44,3004.98,867.38,7512.44,6385.57,SKIPPED,7512.44,7512.44,6385.57,6385.57,6385.57,3165.74,867.38,867.38,SKIPPED,SKIPPED,3230.35,3230.35,6385.57
3613019,975,36475,,,,,,,ENDOVEOUS ABLTJ INCOMPLETE VEIN XTR RF,610.12,244.05,0,610.12,518.6,SKIPPED,610.12,610.12,518.6,518.6,518.6,296.05,298.96,298.96,SKIPPED,SKIPPED,302.09,302.09,0
3613020,272,,,,,,,,ARISTA TIP APPLICATOR,288.5,115.4,0,245.22,245.22,SKIPPED,219.26,219.26,245.22,245.22,245.22,121.58,141.36,141.36,0,86.55,124.06,124.06,245.22
3613021,360,62328,,,,,,,SPINAL PUNCTURE,1025.44,410.18,0,1025.44,871.62,SKIPPED,1025.44,1025.44,871.62,871.62,871.62,432.12,252.66,252.66,0,307.63,440.94,440.94,871.62
3613022,975,62328,,,,,,,SPINAL PUNCTURE,188.99,75.6,0,188.99,160.64,SKIPPED,188.99,188.99,160.64,160.64,160.64,95.58,92.61,92.61,0,56.7,97.53,97.53,0
3613023,360,44227,,,,,,,LAPAROSCOPY SURGICAL CLOSED ENTEROSTOMY,3261.2,1304.48,0,3261.2,2772.02,SKIPPED,3261.2,3261.2,2772.02,2772.02,2772.02,1374.27,0,0,0,978.36,1402.32,1402.32,2772.02
3613024,272,,,,,,,,ELECTROLUB,193.13,77.25,0,164.16,164.16,SKIPPED,146.78,146.78,164.16,164.16,164.16,81.39,94.63,94.63,0,57.94,83.05,83.05,164.16
3613025,272,,,,,,,,MEGA SUTURE CUT,1562.5,625,0,1328.12,1328.12,SKIPPED,1187.5,1187.5,1328.12,1328.12,1328.12,658.44,765.62,765.62,0,468.75,671.88,671.88,1328.12
3613026,272,,,,,,,,VESSEL SEALER,1562.5,625,0,1328.12,1328.12,SKIPPED,1187.5,1187.5,1328.12,1328.12,1328.12,658.44,765.62,765.62,0,468.75,671.88,671.88,1328.12
3613027,272,,,,,,,,General Surg. DaVinci Robert,2000,800,0,1700,1700,SKIPPED,1520,1520,1700,1700,1700,842.8,980,980,0,600,860,860,1700
3613028,272,,,,,,,,V.A.C Via,2237.5,895,0,1901.88,1901.88,SKIPPED,1700.5,1700.5,1901.88,1901.88,1901.88,942.89,1096.38,1096.38,0,671.25,962.13,962.13,1901.88
3613029,278,,,,,,,,PERITONEAL DIALYSIS IMPLANT SYSTEM,485,194,0,412.25,412.25,SKIPPED,368.6,368.6,412.25,412.25,412.25,204.38,237.65,237.65,0,145.5,208.55,208.55,412.25
3613030,272,,,,,,,,2PC CATHETER CONNECTOR,378,151.2,0,321.3,321.3,SKIPPED,287.28,287.28,321.3,321.3,321.3,159.29,185.22,185.22,0,113.4,162.54,162.54,321.3
3613031,278,,,,,,,,FLEX NECK ARC PERITONEAL DIALYSIS CATH,400,160,0,340,340,SKIPPED,304,304,340,340,340,168.56,196,196,0,120,172,172,340
3613032,272,,,,,,,,PRINEO DERMABOND,203,81.2,0,172.55,172.55,SKIPPED,154.28,154.28,172.55,172.55,172.55,85.54,99.47,99.47,0,60.9,87.29,87.29,172.55
3613033,272,,,,,,,,BRAVO REFLUX CALIBRATION DEVICE,777,310.8,0,660.45,660.45,SKIPPED,590.52,590.52,660.45,660.45,660.45,327.43,380.73,380.73,0,233.1,334.11,334.11,660.45
3613034,360,91035,,,,,,,GASTROESOHAGEAL REFLUX TEST W/ ELECTRODE,1880.17,752.07,0,1880.17,1598.14,SKIPPED,1880.17,1880.17,1598.14,1598.14,1598.14,792.3,0,0,0,564.05,808.47,808.47,1598.14
3613035,975,91035,,,,,,,GASTROESOHAGEAL REFLUX TEST W/ ELECTRODE,1038.37,415.35,0,1038.37,882.61,SKIPPED,1038.37,1038.37,882.61,882.61,882.61,89.85,508.8,508.8,0,311.51,91.68,91.68,0
3613036,360,44604,,,,,,,"SUTURE LARGE INTESTINE FOR WOUND, INJURY",9091.95,3636.78,0,7728.16,7728.16,SKIPPED,5228.37,5228.37,7728.16,7728.16,7728.16,3831.35,0,0,0,2727.58,3909.54,3909.54,7728.16
3613037,975,44604,,,,,,,"SUTURE LARGE INTESTINE FOR WOUND, INJURY",2507.61,1003.04,0,2507.61,2131.47,SKIPPED,2507.61,2507.61,2131.47,2131.47,2131.47,1138.95,1228.73,1228.73,0,752.28,1162.19,1162.19,0
3613038,360,64999,,,,,,,UNLISTED PROCEDURE OF NERVOUS SYSTEM,2558.85,1023.54,0,2175.02,2175.02,SKIPPED,1162.32,1162.32,2175.02,2175.02,2175.02,1078.3,0,0,0,767.66,1100.31,1100.31,2175.02
3613039,975,64999,,,,,,,UNLISTED PROCEDURE OF NERVOUS SYSTEM,637.61,255.04,0,637.61,541.97,SKIPPED,637.61,637.61,541.97,541.97,541.97,0,312.43,312.43,0,191.28,0,0,0
3613040,360,35236,,,,,,,RPR BLOOD VESSEL W/ VEIN GRAFT/ UPPER EX,6167.7,2467.08,0,6167.7,5242.54,SKIPPED,6167.7,6167.7,5242.54,5242.54,5242.54,2599.07,0,0,0,1850.31,2652.11,2652.11,5242.54
3613041,975,35236,,,,,,,RPR BLOOD VESSEL W/ VEIN GRAFT/ UPPER EX,2001.55,800.62,0,2001.55,1701.32,SKIPPED,2001.55,2001.55,1701.32,1701.32,1701.32,1065.83,980.76,980.76,0,600.46,1087.58,1087.58,0
3613042,360,35266,,,,,,,RPR BLOOD VESSEL W/GRAFT OTHER THAN VEIN,6511.05,2604.42,0,6511.05,5534.39,SKIPPED,6511.05,6511.05,5534.39,5534.39,5534.39,2743.76,0,0,0,1953.32,2799.75,2799.75,5534.39
3613043,975,35266,,,,,,,RPR BLOOD VESSEL W/ VEIN GRAFT/ UPPER EX,1719.84,687.94,0,1719.84,1461.86,SKIPPED,1719.84,1719.84,1461.86,1461.86,1461.86,917.15,842.72,842.72,0,515.95,935.87,935.87,0
3613044,360,34101,,,,,,,EMBOLECTOMY/THROMBECTOMY W/ OR W/O CATH,8249.85,3299.94,0,8249.85,7012.37,SKIPPED,8249.85,8249.85,7012.37,7012.37,7012.37,3476.49,0,0,0,2474.96,3547.44,3547.44,7012.37
3613045,975,34101,,,,,,,EMBOLECTOMY/THROMBECTOMY W/ OR W/O CATH,1182.97,473.19,0,1182.97,1005.52,SKIPPED,1182.97,1182.97,1005.52,1005.52,1005.52,633.4,579.66,579.66,0,354.89,646.33,646.33,0
3613046,360,34111,,,,,,,EMBOLECTOMY/THROMBECTOMY W/ OR W/O CATH,5192.25,2076.9,0,5192.25,4413.41,SKIPPED,5192.25,5192.25,4413.41,4413.41,4413.41,2188.02,0,0,0,1557.68,2232.67,2232.67,4413.41
3613047,975,34111,,,,,,,EMBOLECTOMY/THROMBECTOMY W/ OR W/O CATH,1189.55,475.82,0,1189.55,1011.12,SKIPPED,1189.55,1189.55,1011.12,1011.12,1011.12,636.91,582.88,582.88,0,356.86,649.91,649.91,0
3613048,360,58670,,,,,,,LAPAROSCOPY TUBAL CAUTHERY,7887.6,3155.04,1051.35,7887.6,6704.46,SKIPPED,7887.6,7887.6,6704.46,6704.46,6704.46,3323.84,1051.35,1051.35,SKIPPED,SKIPPED,3391.67,3391.67,6704.46
3613049,975,44205,,,,,,,LAP COLECTOMY PRTL W/ RMVL TERM ILEUM,2693.38,1077.35,0,2693.38,2289.37,SKIPPED,2693.38,2693.38,2289.37,2289.37,2289.37,1444.06,1319.76,1319.76,0,808.01,1473.53,1473.53,0
3613050,975,35903,,,,,,,EXCISION INFECTED GRAFT EXT,1127.57,451.03,0,1127.57,958.43,SKIPPED,1127.57,1127.57,958.43,958.43,958.43,603.85,552.51,552.51,0,338.27,616.17,616.17,0
3613051,975,33286,,,,,,,REMOVAL SUBQ CARDICA RHYTHM MONITOR,174.15,69.66,0,174.15,148.03,SKIPPED,174.15,174.15,148.03,148.03,148.03,92.7,85.33,85.33,0,52.24,94.59,94.59,0
3613052,360,28312,,,,,,,REVISION OF TOE ANY,3094.35,1237.74,867.38,3094.35,2630.2,SKIPPED,3094.35,3094.35,2630.2,2630.2,2630.2,1303.96,867.38,867.38,SKIPPED,SKIPPED,1330.57,1330.57,2630.2
3613053,975,28312,,,,,,,REVISION OF TOE ANY,659.23,263.69,0,659.23,560.35,SKIPPED,659.23,659.23,560.35,560.35,560.35,360.31,323.02,323.02,SKIPPED,SKIPPED,367.66,367.66,0
3613054,360,28310,,,,,,,REVISION OF BIG TOE,3735.9,1494.36,1051.35,3735.9,3175.52,SKIPPED,3735.9,3735.9,3175.52,3175.52,3175.52,1574.31,1051.35,1051.35,SKIPPED,SKIPPED,1606.44,1606.44,3175.52
3613055,975,28310,,,,,,,REVISION OF BIG TOE,740.48,296.19,0,740.48,629.41,SKIPPED,740.48,740.48,629.41,629.41,629.41,396.72,362.84,362.84,SKIPPED,SKIPPED,404.82,404.82,0
3613056,975,19301,,,,,,,MASTECTOMY PARTIAL PUMPECTOMY,1331.48,532.59,0,1331.48,1131.76,SKIPPED,1331.48,1331.48,1131.76,1131.76,1131.76,716.84,652.43,652.43,SKIPPED,SKIPPED,731.47,731.47,0
3613057,360,43820,,,,,,,Gastrojejunostomy; w/o vagotomy,6772.97,2709.19,0,6629.62,5757.02,SKIPPED,6629.62,6629.62,5757.02,5757.02,5757.02,2854.13,0,0,0,2031.89,2912.38,2912.38,5757.02
3613058,360,44799,,,,,,,Unlisted procedure; small instestine,2873.33,1149.33,0,2873.33,2442.33,SKIPPED,2873.33,2873.33,2442.33,2442.33,2442.33,1210.82,0,0,0,862,1235.53,1235.53,2442.33
3613059,975,44799,,,,,,,Unlisted procedure; small instestine,725.34,290.14,0,725.34,616.54,SKIPPED,725.34,725.34,616.54,616.54,616.54,0,355.42,355.42,0,217.6,0,0,0
3613060,278,C1781,,,,,,,BARD SOFT MESH 6X6,143.75,57.5,0,122.19,122.19,SKIPPED,109.25,109.25,122.19,122.19,122.19,60.57,70.44,70.44,0,43.12,61.81,61.81,122.19
3613061,278,C1781,,,,,,,BARD SOFT MESH 12X12,875,350,0,743.75,743.75,SKIPPED,665,665,743.75,743.75,743.75,368.72,428.75,428.75,0,262.5,376.25,376.25,743.75
3613062,360,45386,,,,,,,COLONOSCOPY W/ BALLOON DILATION,2937.02,1174.81,361.12,2937.02,2496.47,SKIPPED,2937.02,2937.02,2496.47,2496.47,2496.47,1237.66,361.12,361.12,SKIPPED,SKIPPED,1262.92,1262.92,2496.47
3613063,975,45386,,,,,,,COLONOSCOPY W/ BALLOON DILATION,431.26,172.5,0,431.26,366.57,SKIPPED,431.26,431.26,366.57,366.57,366.57,230.43,211.32,211.32,SKIPPED,SKIPPED,235.13,235.13,0
3613064,360,49540,,,,,,,RPR ABDOMINAL MUSCLE HERNIATION,12806.85,5122.74,1051.35,12806.85,10885.82,SKIPPED,12806.85,12806.85,10885.82,10885.82,10885.82,5396.81,1051.35,1051.35,SKIPPED,SKIPPED,5506.95,5506.95,10885.82
3613065,360,20200,,,,,,,MUSCLE BX SUPERFICIAL,4236.75,1694.7,414.14,4236.75,3601.24,SKIPPED,4236.75,4236.75,3601.24,3601.24,3601.24,1785.36,414.14,414.14,SKIPPED,SKIPPED,1821.8,1821.8,3601.24
3613066,975,20200,,,,,,,MUSCLE BX SUPERFICIAL,188.71,75.48,0,188.71,160.4,SKIPPED,188.71,188.71,160.4,160.4,160.4,101.42,92.47,92.47,SKIPPED,SKIPPED,103.49,103.49,0
3613067,360,43659,,,,,,,"UNLISTED LAPROSCOPIC PROCEDURE,STOMACH",11514.3,4605.72,0,11514.3,9787.16,SKIPPED,11514.3,11514.3,9787.16,9787.16,9787.16,4852.13,0,0,0,3454.29,4951.15,4951.15,9787.16
3613068,360,43830,,,,,,,"GASTROSTOMY,OPEN,W/O CONSTRUCTION GASTRI",5424.51,2169.8,0,5424.51,4610.83,SKIPPED,5424.51,5424.51,4610.83,4610.83,4610.83,2285.89,0,0,0,1627.35,2332.54,2332.54,4610.83
3613069,360,36002,,,,,,,INJ PROCEDURE PERCUTANEOUS TRT EXTREMITY,1125.6,450.24,254.87,1125.6,956.76,SKIPPED,1125.6,1125.6,956.76,956.76,956.76,474.33,254.87,254.87,SKIPPED,SKIPPED,484.01,484.01,956.76
3613070,975,36002,,,,,,,INJ PROCEDURE PERCUTANEOUS TRT EXTREMITY,210.19,84.08,0,210.19,178.66,SKIPPED,210.19,210.19,178.66,178.66,178.66,112.1,102.99,102.99,SKIPPED,SKIPPED,114.39,114.39,0
3613071,270,,,,,,,,Plunepen Elite,78.55,31.42,0,66.77,66.77,SKIPPED,59.7,59.7,66.77,66.77,66.77,33.1,38.49,38.49,0,23.56,33.78,33.78,66.77
3613072,272,,,,,,,,intracept rf probe,11050,4420,0,9392.5,9392.5,SKIPPED,8398,8398,9392.5,9392.5,9392.5,4656.47,5414.5,5414.5,0,3315,4751.5,4751.5,9392.5
3613073,272,,,,,,,,INSTRACEPT ACCESS INST.,4700,1880,0,3995,3995,SKIPPED,3572,3572,3995,3995,3995,1980.58,2303,2303,0,1410,2021,2021,3995
3613074,272,,,,,,,,INTRACEPT ACCESS INST. ADDTL LEVEL,1750,700,0,1487.5,1487.5,SKIPPED,1330,1330,1487.5,1487.5,1487.5,737.45,857.5,857.5,0,525,752.5,752.5,1487.5
3613075,272,,,,,,,,"RF GENERATOR, PROCEDURE FEE",687.5,275,0,584.38,584.38,SKIPPED,522.5,522.5,584.38,584.38,584.38,289.72,336.88,336.88,0,206.25,295.63,295.63,584.38
3613076,276,V2632,,,,,,,AcrySof IQ IOL,1354,541.6,0,1150.9,1150.9,SKIPPED,1029.04,1029.04,1150.9,1150.9,1150.9,570.58,663.46,663.46,0,406.2,582.22,582.22,1150.9
3613077,272,,,,,,,,SI JOINT ALLOGRAFT SPACER 22MM,21250,8500,0,18062.5,18062.5,SKIPPED,16150,16150,18062.5,18062.5,18062.5,8954.75,10412.5,10412.5,0,6375,9137.5,9137.5,18062.5
3613078,278,C1734,,,,,,,VIVEX BIOLOGICS CANCELLOUS CRUSHED 05CC,337.5,135,0,286.88,286.88,SKIPPED,256.5,256.5,286.88,286.88,286.88,142.23,165.38,165.38,0,101.25,145.13,145.13,286.88
3613079,360,43774,,,,,,,LAP REMOVAL GASTRIC RESTRICTIVE PX REMOV,11319,4527.6,0,11319,9621.15,SKIPPED,11319,11319,9621.15,9621.15,9621.15,4769.83,0,0,0,3395.7,4867.17,4867.17,9621.15
3613080,975,43774,,,,,,,LAP REMOVAL GASTRIC RESTRICTIVE PX REMOV,1937.59,775.04,0,1937.59,1646.95,SKIPPED,1937.59,1937.59,1646.95,1646.95,1646.95,1039.84,949.42,949.42,0,581.28,1061.06,1061.06,0
3613081,360,43270,,,,,,,"EGD W/ABLATION OF TUMORS,POLYPS, OR OTH.",3731.06,1492.42,414.14,3731.06,3171.4,SKIPPED,3731.06,3731.06,3171.4,3171.4,3171.4,1572.27,414.14,414.14,SKIPPED,SKIPPED,1604.36,1604.36,3171.4
3613082,975,43270,,,,,,,"EGD W/ABLATION OF TUMORS,POLYPS, OR OTH.",456.1,182.44,0,456.1,387.68,SKIPPED,456.1,456.1,387.68,387.68,387.68,244.77,223.49,223.49,SKIPPED,SKIPPED,249.77,249.77,0
3613083,360,20525,,,,,,,"REMOVAL OF FOREIGN BODY-MUSCLE,DEEP/COMP",6337.54,2535.02,582.36,6337.54,5386.91,SKIPPED,6337.54,6337.54,5386.91,5386.91,5386.91,2670.64,582.36,582.36,SKIPPED,SKIPPED,2725.14,2725.14,5386.91
3613084,975,20525,,,,,,,"REMOVAL OF FOREIGN BODY-MUSCLE,DEEP/COMP",500.96,200.38,0,500.96,425.82,SKIPPED,500.96,500.96,425.82,425.82,425.82,268.84,245.47,245.47,SKIPPED,SKIPPED,274.33,274.33,0
3613085,360,27301,,,,,,,"INCISION/DRAIN HEMATOMA,DEEP,THIGH/KNEE",7067.55,2827.02,582.36,7067.55,6007.42,SKIPPED,7067.55,7067.55,6007.42,6007.42,6007.42,2978.27,582.36,582.36,SKIPPED,SKIPPED,3039.05,3039.05,6007.42
3613086,975,27301,,,,,,,"INCISION/DRAIN HEMATOMA,DEEP,THIGH/KNEE",1031.6,412.64,0,1031.6,876.86,SKIPPED,1031.6,1031.6,876.86,876.86,876.86,553.63,505.48,505.48,SKIPPED,SKIPPED,564.93,564.93,0
3613087,360,64795,,,,,,,BX OF NERVE,5972.24,2388.9,510.13,5972.24,5076.4,SKIPPED,5972.24,5972.24,5076.4,5076.4,5076.4,2516.7,510.13,510.13,SKIPPED,SKIPPED,2568.06,2568.06,5076.4
3613088,975,64795,,,,,,,BX OF NERVE,379.3,151.72,0,379.3,322.4,SKIPPED,379.3,379.3,322.4,322.4,322.4,204.12,185.86,185.86,SKIPPED,SKIPPED,208.29,208.29,0
3613089,360,55040,,,,,,,"REMOVAL OF HYDROCELE, UNILATERAL",7824.78,3129.91,867.38,7824.78,6651.06,SKIPPED,7824.78,7824.78,6651.06,6651.06,6651.06,3297.37,867.38,867.38,SKIPPED,SKIPPED,3364.66,3364.66,6651.06
3613090,975,55040,,,,,,,"REMOVAL OF HYDROCELE, UNILATERAL",690.04,276.02,0,690.04,586.53,SKIPPED,690.04,690.04,586.53,586.53,586.53,370.32,338.12,338.12,SKIPPED,SKIPPED,377.88,377.88,0
3613091,278,,,,,,,,SOLIA S (ALL SIZES),11611.1,4644.44,0,9869.44,9869.44,SKIPPED,8824.44,8824.44,9869.44,9869.44,9869.44,4892.91,5689.44,5689.44,0,3483.33,4992.77,4992.77,9869.44
3613092,360,44320,,,,,,,COLOSTOMY OR SKIN LEVEL CECOSTOMY,8251.95,3300.78,0,7014.16,7014.16,SKIPPED,5934.13,5934.13,7014.16,7014.16,7014.16,3477.37,0,0,0,2475.58,3548.34,3548.34,7014.16
3613093,360,22900,,,,,,,"EXCISION TUMOR, SOFT TISSUE OF ABD WALL",6091.31,2436.52,582.36,6091.31,5177.61,SKIPPED,6091.31,6091.31,5177.61,5177.61,5177.61,2566.87,582.36,582.36,SKIPPED,SKIPPED,2619.26,2619.26,5177.61
3613094,975,22900,,,,,,,"EXCISION TUMOR, SOFT TISSUE OF ABD WALL",1146.12,458.45,0,1146.12,974.2,SKIPPED,1146.12,1146.12,974.2,974.2,974.2,615.09,561.6,561.6,SKIPPED,SKIPPED,627.64,627.64,0
3613095,360,44950,,,,,,,OPEN APPENDECTOMY,9448.95,3779.58,0,9448.95,8031.61,SKIPPED,9448.95,9448.95,8031.61,8031.61,8031.61,3981.79,0,0,0,2834.68,4063.05,4063.05,8031.61
3613096,272,,,,,,,,Pledgets (Reference # PCP20),36.82,14.73,0,31.3,31.3,SKIPPED,27.98,27.98,31.3,31.3,31.3,15.51,18.04,18.04,0,11.05,15.83,15.83,31.3
3613097,278,C1713,,,,,,,MINUTEMAN G3R INTERLAMINAR FUSION DEVICE,21250,8500,0,18062.5,18062.5,SKIPPED,16150,16150,18062.5,18062.5,18062.5,8954.75,10412.5,10412.5,0,6375,9137.5,9137.5,18062.5
3613098,272,,,,,,,,CONMED DURACLIP 235cm/ 2.8mm,442.22,176.89,0,375.89,375.89,SKIPPED,336.09,336.09,375.89,375.89,375.89,186.35,216.69,216.69,0,132.67,190.15,190.15,375.89
3613099,272,,,,,,,,HUMERAL AUGMENTED TRAY,20000,8000,0,17000,17000,SKIPPED,15200,15200,17000,17000,17000,8428,9800,9800,0,6000,8600,8600,17000
3613100,272,,,,,,,,CEMEX SYSTEM GENTA FAST,1575,630,0,1338.75,1338.75,SKIPPED,1197,1197,1338.75,1338.75,1338.75,663.7,771.75,771.75,0,472.5,677.25,677.25,1338.75
3613101,278,C1734,,,,,,,CEMENT RESTRICTOR(8-13mm/Tecres),262.5,105,0,223.12,223.12,SKIPPED,199.5,199.5,223.12,223.12,223.12,110.62,128.62,128.62,0,78.75,112.88,112.88,223.12
3613102,278,,,,,,,,CORDIS OPTEASE VENA CAVA CATH,7125,2850,0,6056.25,6056.25,SKIPPED,5415,5415,6056.25,6056.25,6056.25,3002.48,3491.25,3491.25,0,2137.5,3063.75,3063.75,6056.25
3613103,272,,,,,,,,COLD SNARE PN:711115,62.5,25,0,53.12,53.12,SKIPPED,47.5,47.5,53.12,53.12,53.12,26.34,30.62,30.62,0,18.75,26.88,26.88,53.12
3613104,272,,,,,,,,MEDIUM ROTATABLE SNARE PN:01-25-230,87.5,35,0,74.38,74.38,SKIPPED,66.5,66.5,74.38,74.38,74.38,36.88,42.88,42.88,0,26.25,37.63,37.63,74.38
3613105,272,,,,,,,,HOT BIOPSY FORCEP PN:000854,84.97,33.99,0,72.22,72.22,SKIPPED,64.58,64.58,72.22,72.22,72.22,35.81,41.64,41.64,0,25.49,36.54,36.54,72.22
3613106,272,,,,,,,,DetachaTip Handle (Ref #: 1-1010),331.5,132.6,0,281.78,281.78,SKIPPED,251.94,251.94,281.78,281.78,281.78,139.7,162.44,162.44,0,99.45,142.55,142.55,281.78
3613107,272,,,,,,,,LaparoVue Visibility System(Scope Cleane,95.48,38.19,0,81.16,81.16,SKIPPED,72.56,72.56,81.16,81.16,81.16,40.24,46.79,46.79,0,28.64,41.06,41.06,81.16
3613108,360,49320,,,,,,,DIAG LAPARO SEPERATE PROC.,9054.42,3621.77,1051.35,9054.42,7696.26,SKIPPED,9054.42,9054.42,7696.26,7696.26,7696.26,3815.53,1051.35,1051.35,SKIPPED,SKIPPED,3893.4,3893.4,7696.26
3620001,271,,,,,,,,EBICE W/BACK PAD,359.1,143.64,0,305.24,305.24,SKIPPED,272.92,272.92,305.24,305.24,305.24,151.32,175.96,175.96,0,107.73,154.41,154.41,305.24
3620002,399,86891,,,,,,,AUTO BLOOD OP SALVAGE,2085.07,834.03,0,2055.65,1772.31,SKIPPED,2055.65,2055.65,1772.31,1772.31,1772.31,878.65,1021.68,1021.68,0,625.52,896.58,896.58,1772.31
3620003,391,36430,,,,,,,BLOOD TRANSFUSION SVC,1822.8,729.12,0,1549.38,1549.38,SKIPPED,167.58,167.58,1549.38,1549.38,1549.38,768.12,893.17,893.17,0,546.84,783.8,783.8,1549.38
3620005,278,,,,,,,,CANCELLOUS SHEET,3071,1228.4,0,2610.35,2610.35,SKIPPED,2333.96,2333.96,2610.35,2610.35,2610.35,1294.12,1504.79,1504.79,0,921.3,1320.53,1320.53,2610.35
3620006,278,,,,,,,,INDUX,4688,1875.2,0,3984.8,3984.8,SKIPPED,3562.88,3562.88,3984.8,3984.8,3984.8,1975.52,2297.12,2297.12,0,1406.4,2015.84,2015.84,3984.8
3620007,278,,,,,,,,CAN CUBES 15CC 4-10MM,694,277.6,0,589.9,589.9,SKIPPED,527.44,527.44,589.9,589.9,589.9,292.45,340.06,340.06,0,208.2,298.42,298.42,589.9
3620008,278,,,,,,,,SpF PLUS MINI MESH CATH60,19429,7771.6,0,16514.65,16514.65,SKIPPED,14766.04,14766.04,16514.65,16514.65,16514.65,8187.38,9520.21,9520.21,0,5828.7,8354.47,8354.47,16514.65
3620009,278,,,,,,,,STR SPACE 7H-18H 25L CVX,15628,6251.2,0,13283.8,13283.8,SKIPPED,11877.28,11877.28,13283.8,13283.8,13283.8,6585.64,7657.72,7657.72,0,4688.4,6720.04,6720.04,13283.8
3620010,278,,,,,,,,STR SPACE 7H-18H 20L CVX,11288,4515.2,0,9594.8,9594.8,SKIPPED,8578.88,8578.88,9594.8,9594.8,9594.8,4756.76,5531.12,5531.12,0,3386.4,4853.84,4853.84,9594.8
3620011,278,,,,,,,,6.5MM 20-55MM SCREW REDUC,5064,2025.6,0,4304.4,4304.4,SKIPPED,3848.64,3848.64,4304.4,4304.4,4304.4,2133.97,2481.36,2481.36,0,1519.2,2177.52,2177.52,4304.4
3620012,278,,,,,,,,PLUGS,1028,411.2,0,873.8,873.8,SKIPPED,781.28,781.28,873.8,873.8,873.8,433.2,503.72,503.72,0,308.4,442.04,442.04,873.8
3620013,278,,,,,,,,30MM-90MM PRE-CURV ROD,1505,602,0,1279.25,1279.25,SKIPPED,1143.8,1143.8,1279.25,1279.25,1279.25,634.21,737.45,737.45,0,451.5,647.15,647.15,1279.25
3620014,278,,,,,,,,CROSS CONNECT XXSM-LARGE,4455,1782,0,3786.75,3786.75,SKIPPED,3385.8,3385.8,3786.75,3786.75,3786.75,1877.34,2182.95,2182.95,0,1336.5,1915.65,1915.65,3786.75
3620015,278,,,,,,,,6.5MM MULTI-AX SCREW,4445,1778,0,3778.25,3778.25,SKIPPED,3378.2,3378.2,3778.25,3778.25,3778.25,1873.12,2178.05,2178.05,0,1333.5,1911.35,1911.35,3778.25
3620016,278,,,,,,,,TISSEEL FIBRIN SEAL FROZEN,818,327.2,0,695.3,695.3,SKIPPED,621.68,621.68,695.3,695.3,695.3,344.71,400.82,400.82,0,245.4,351.74,351.74,695.3
3620017,278,,,,,,,,INTERGRO 10CC (PUTTY),3972,1588.8,0,3376.2,3376.2,SKIPPED,3018.72,3018.72,3376.2,3376.2,3376.2,1673.8,1946.28,1946.28,0,1191.6,1707.96,1707.96,3376.2
3620023,360,63030,,,,,,,LOW BACK DISK SURGERY,24342.19,9736.88,1051.35,24342.19,20690.86,SKIPPED,24342.19,24342.19,20690.86,20690.86,20690.86,10257.8,1051.35,1051.35,SKIPPED,SKIPPED,10467.14,10467.14,20690.86
3620025,278,,,,,,,,CANC CUBES 30CC,1268,507.2,0,1077.8,1077.8,SKIPPED,963.68,963.68,1077.8,1077.8,1077.8,534.34,621.32,621.32,0,380.4,545.24,545.24,1077.8
3620026,360,22551,,,,,,,NECK SPINE FUSE & REMOVE,23557.16,9422.86,1051.35,23557.16,20023.59,SKIPPED,23557.16,23557.16,20023.59,20023.59,20023.59,9926.99,1051.35,1051.35,SKIPPED,SKIPPED,10129.58,10129.58,20023.59
3620027,360,22845,,,,,,,INSERT SPINE FIXATION DEVICE,11745.43,4698.17,0,9983.62,9983.62,SKIPPED,0,0,9983.62,9983.62,9983.62,4949.52,0,0,0,3523.63,5050.53,5050.53,9983.62
3620028,360,20931,,,,,,,SP BONE ALGRFT STRUCT,13737.35,5494.94,0,11676.75,11676.75,SKIPPED,0,0,11676.75,11676.75,11676.75,5788.92,0,0,0,4121.2,5907.06,5907.06,11676.75
3620029,360,22842,,,,,,,INSERT SPINE FIXATION DEVICE,11849.27,4739.71,0,10071.88,10071.88,SKIPPED,0,0,10071.88,10071.88,10071.88,4993.29,0,0,0,3554.78,5095.19,5095.19,10071.88
3620030,360,63042,,,,,,,LAMINOTOMY SINGLE LUMBAR,24633.79,9853.52,1051.35,24633.79,20938.72,SKIPPED,24633.79,24633.79,20938.72,20938.72,20938.72,10380.68,1051.35,1051.35,SKIPPED,SKIPPED,10592.53,10592.53,20938.72
3620031,360,22851,,,,,,,APPLY SPINE PROSTH DEVICE,13461.02,5384.41,0,11441.87,11441.87,SKIPPED,10230.38,10230.38,11441.87,11441.87,11441.87,5672.48,0,0,0,4038.31,5788.24,5788.24,11441.87
3620032,360,63044,,,,,,,LAMINOTOMY ADDL LUMBAR,11293.81,4517.52,0,9599.74,9599.74,SKIPPED,0,0,9599.74,9599.74,9599.74,4759.21,0,0,0,3388.14,4856.34,4856.34,9599.74
3620033,360,20975,,,,,,,ELECTRICAL BONE STIMULATION,13468.93,5387.57,0,11448.59,11448.59,SKIPPED,0,0,11448.59,11448.59,11448.59,5675.81,0,0,0,4040.68,5791.64,5791.64,11448.59
3620034,360,38220,,,,,,,BONE MARROW ASPIRATION,7235.6,2894.24,97.87,6150.26,6150.26,SKIPPED,591.66,591.66,6150.26,6150.26,6150.26,3049.08,97.87,97.87,SKIPPED,SKIPPED,3111.31,3111.31,6150.26
3620035,360,20930,,,,,,,SP BONE ALGRFT MORSEL ADD-ON,12572.27,5028.91,0,10686.43,10686.43,SKIPPED,0,0,10686.43,10686.43,10686.43,5297.96,0,0,0,3771.68,5406.08,5406.08,10686.43
3620036,360,22830,,,,,,,EXPLORATION OF SPINAL FUSION,14125.04,5650.02,0,12006.28,12006.28,SKIPPED,4023.11,4023.11,12006.28,12006.28,12006.28,5952.29,0,0,0,4237.51,6073.77,6073.77,12006.28
3620037,360,63047,,,,,,,REMOVE SPINE LAMINA 1 LMBAR,23299.74,9319.9,1051.35,23299.74,19804.78,SKIPPED,23299.74,23299.74,19804.78,19804.78,19804.78,9818.51,1051.35,1051.35,SKIPPED,SKIPPED,10018.89,10018.89,19804.78
3620038,360,22840,,,,,,,INSERT SPINE FAXATION DEVICE,11754.67,4701.87,0,9991.47,9991.47,SKIPPED,0,0,9991.47,9991.47,9991.47,4953.42,0,0,0,3526.4,5054.51,5054.51,9991.47
3620039,360,22552,,,,,,,ADDL NECK SPINE FUSION,11678.69,4671.48,0,9926.89,9926.89,SKIPPED,0,0,9926.89,9926.89,9926.89,4921.4,0,0,0,3503.61,5021.84,5021.84,9926.89
3620040,360,63048,,,,,,,REMOVE SPINAL LAMINA ADD-ON,14590.45,5836.18,0,12401.88,12401.88,SKIPPED,0,0,12401.88,12401.88,12401.88,6148.41,0,0,0,4377.14,6273.89,6273.89,12401.88
3620041,360,20936,,,,,,,SP BONE AGRFT LOCAL ADD-ON,11610.48,4644.19,0,9868.91,9868.91,SKIPPED,0,0,9868.91,9868.91,9868.91,4892.66,0,0,0,3483.14,4992.51,4992.51,9868.91
3620042,360,20975,,,,,,,ELECTRICAL BONE STIMULATION,13468.93,5387.57,0,11448.59,11448.59,SKIPPED,0,0,11448.59,11448.59,11448.59,5675.81,0,0,0,4040.68,5791.64,5791.64,11448.59
3620043,360,22846,,,,,,,INSERT SPINE FIXATION DEVICE,11678.69,4671.48,0,9926.89,9926.89,SKIPPED,3777.63,3777.63,9926.89,9926.89,9926.89,4921.4,0,0,0,3503.61,5021.84,5021.84,9926.89
3620044,360,64721,,,,,,,CARPAL TUNNEL SURGERY,13043.85,5217.54,510.13,11087.27,11087.27,SKIPPED,7649.88,7649.88,11087.27,11087.27,11087.27,5496.68,510.13,510.13,SKIPPED,SKIPPED,5608.86,5608.86,11087.27
3620045,360,63046,,,,,,,REMOVE SPINE LAMINA 1 THROU,22527.04,9010.82,1051.35,22527.04,19147.98,SKIPPED,22527.04,22527.04,19147.98,19147.98,19147.98,9492.9,1051.35,1051.35,SKIPPED,SKIPPED,9686.63,9686.63,19147.98
3620046,360,22633,,,,,,,LUMBAR SPINE FUSION COMBINED,11040,4416,0,9384,9384,SKIPPED,9183.27,9183.27,9384,9384,9384,4652.26,0,0,0,3312,4747.2,4747.2,9384
3620047,360,22634,,,,,,,SPINE FUSION EXTRA SEGMENT,7176.36,2870.54,0,6099.91,6099.91,SKIPPED,2471.85,2471.85,6099.91,6099.91,6099.91,3024.11,0,0,0,2152.91,3085.83,3085.83,6099.91
3620048,975,64721,,,,,,,CARPAL TUNNEL PROF,1204.21,481.68,0,1204.21,1023.58,SKIPPED,1204.21,1204.21,1023.58,1023.58,1023.58,477.48,590.06,590.06,SKIPPED,SKIPPED,487.22,487.22,0
3620049,272,,,,,,,,BMN NEEDLE,577.5,231,0,490.88,490.88,SKIPPED,438.9,438.9,490.88,490.88,490.88,243.36,282.98,282.98,0,173.25,248.33,248.33,490.88
3620050,360,12001,,,,,,,RPR SMP SP NK TR 2.5,6097.05,2438.82,0,5182.49,5182.49,SKIPPED,802.51,802.51,5182.49,5182.49,5182.49,2569.3,0,0,0,1829.12,2621.73,2621.73,5182.49
3620052,278,,,,,,,,CELLENTRA 15CC,13410,5364,0,11398.5,11398.5,SKIPPED,10191.6,10191.6,11398.5,11398.5,11398.5,5650.97,6570.9,6570.9,0,4023,5766.3,5766.3,11398.5
3620053,360,63707,,,,,,,REPAIR SPINAL FLUID LEAKAGE,12699.17,5079.67,0,10794.29,10794.29,SKIPPED,4570.36,4570.36,10794.29,10794.29,10794.29,5351.43,0,0,0,3809.75,5460.64,5460.64,10794.29
3620054,975,57410,,,,,,,#PELVIC EXAM UNDER ANES PROF,314.25,125.7,0,314.25,267.11,SKIPPED,314.25,314.25,267.11,267.11,267.11,115,153.98,153.98,SKIPPED,SKIPPED,117.35,117.35,0
3620055,975,63030,,,,,,,LOW BACK DISK SURGERY PROF,2313.97,925.59,0,2313.97,1966.87,SKIPPED,2313.97,2313.97,1966.87,1966.87,1966.87,1044.52,1133.85,1133.85,SKIPPED,SKIPPED,1065.84,1065.84,0
3620056,360,64721,,,,,,,CARPAL TUNNEL,13043.85,5217.54,510.13,11087.27,11087.27,SKIPPED,7649.88,7649.88,11087.27,11087.27,11087.27,5496.68,510.13,510.13,SKIPPED,SKIPPED,5608.86,5608.86,11087.27
3620058,360,63661,,,,,,,REMOVE ELTRD PREQ ARAY,11137.69,4455.08,510.13,9467.04,9467.04,SKIPPED,7649.88,7649.88,9467.04,9467.04,9467.04,4693.43,510.13,510.13,SKIPPED,SKIPPED,4789.21,4789.21,9467.04
3620059,360,63662,,,,,,,REMOVE ELTRD PLATE,12396.3,4958.52,1051.35,12396.3,10536.86,SKIPPED,12396.3,12396.3,10536.86,10536.86,10536.86,5223.8,1051.35,1051.35,SKIPPED,SKIPPED,5330.41,5330.41,10536.86
3620061,360,20680,,,,,,,REMOVAL SUPPORT IMPLANT(DEEP),11566.94,4626.78,582.36,11043.13,9831.9,SKIPPED,11043.13,11043.13,9831.9,9831.9,9831.9,4874.3,582.36,582.36,SKIPPED,SKIPPED,4973.78,4973.78,9831.9
3620062,278,,,,,,,,30MM TWO LEVEL PLATE,5750,2300,0,4887.5,4887.5,SKIPPED,4370,4370,4887.5,4887.5,4887.5,2423.05,2817.5,2817.5,0,1725,2472.5,2472.5,4887.5
3620063,278,,,,,,,,4.0 X 14 SCREWS,951,380.4,0,808.35,808.35,SKIPPED,722.76,722.76,808.35,808.35,808.35,400.75,465.99,465.99,0,285.3,408.93,408.93,808.35
3620064,360,64718,,,,,,,REVISE ULNAR NERVE @ ELBOW,18764.17,7505.67,510.13,15949.54,15949.54,SKIPPED,7649.88,7649.88,15949.54,15949.54,15949.54,7907.22,510.13,510.13,SKIPPED,SKIPPED,8068.59,8068.59,15949.54
3620065,360,10140,,,,,,,DRAINAGE OF HEMATOMA FLUID,11357.61,4543.04,88.06,9653.97,9653.97,SKIPPED,497.61,497.61,9653.97,9653.97,9653.97,4786.09,88.06,88.06,SKIPPED,SKIPPED,4883.77,4883.77,9653.97
3620066,360,97606,,,,,,,NEG PRESS WOUND>50CM,6659.35,2663.74,0,5660.45,5660.45,SKIPPED,1476.3,1476.3,5660.45,5660.45,5660.45,2806.25,0,0,0,1997.8,2863.52,2863.52,5660.45
3620067,360,20938,,,,,,,SP BONE AGRFT STRUCT ADD-ON,11948.59,4779.44,0,10156.3,10156.3,SKIPPED,0,0,10156.3,10156.3,10156.3,5035.13,0,0,0,3584.58,5137.89,5137.89,10156.3
3620068,278,,,,,,,,CELLENTRA 10CC,10733,4293.2,0,9123.05,9123.05,SKIPPED,8157.08,8157.08,9123.05,9123.05,9123.05,4522.89,5259.17,5259.17,0,3219.9,4615.19,4615.19,9123.05
3620069,278,,,,,,,,CELLENTRA 5CC,5895,2358,0,5010.75,5010.75,SKIPPED,4480.2,4480.2,5010.75,5010.75,5010.75,2484.15,2888.55,2888.55,0,1768.5,2534.85,2534.85,5010.75
3620070,360,22600,,,,,,,POSTERIOR NECK SPINAL FUSION,27905.1,11162.04,0,23719.34,23719.34,SKIPPED,6384.14,6384.14,23719.34,23719.34,23719.34,11759.21,0,0,0,8371.53,11999.19,11999.19,23719.34
3620071,360,63045,,,,,,,REMOVAL SPINE LAMINAL 1 CRVL,22807.92,9123.17,1051.35,22807.92,19386.73,SKIPPED,22807.92,22807.92,19386.73,19386.73,19386.73,9611.26,1051.35,1051.35,SKIPPED,SKIPPED,9807.41,9807.41,19386.73
3620072,360,22614,,,,,,,SPINE FUSION EXTRA SEGMENT,11763.93,4705.57,0,9999.34,9999.34,SKIPPED,0,0,9999.34,9999.34,9999.34,4957.32,0,0,0,3529.18,5058.49,5058.49,9999.34
3620073,360,22610,,,,,,,THORX SPINE FUSION,19779.15,7911.66,0,16812.28,16812.28,SKIPPED,6257.98,6257.98,16812.28,16812.28,16812.28,8334.93,0,0,0,5933.74,8505.03,8505.03,16812.28
3620074,278,,,,,,,,BMN NEEDLE(JAMSHIDI),775,310,0,658.75,658.75,SKIPPED,589,589,658.75,658.75,658.75,326.58,379.75,379.75,0,232.5,333.25,333.25,658.75
3620075,360,22010,,,,,,,I&D P-SPINE C/T/CERV-THOR,7120.22,2848.09,0,6052.19,6052.19,SKIPPED,4694.76,4694.76,6052.19,6052.19,6052.19,3000.46,0,0,0,2136.07,3061.69,3061.69,6052.19
3620076,360,11042,,,,,,,DEB SUBQ TIS 20sq CM/<,8937.53,3575.01,129.16,7596.9,7596.9,SKIPPED,1476.3,1476.3,7596.9,7596.9,7596.9,3766.28,129.16,129.16,SKIPPED,SKIPPED,3843.14,3843.14,7596.9
3620078,360,63081,,,,,,,RMVL VERT BODY DCMPN CRVL,21126.49,8450.6,0,17957.52,17957.52,SKIPPED,8716.2,8716.2,17957.52,17957.52,17957.52,8902.7,0,0,0,6337.95,9084.39,9084.39,17957.52
3620079,278,,,,,,,,"FIBULA SEGMENT,UMTB-CORPECTOMY(45-0047)",1865,746,0,1585.25,1585.25,SKIPPED,1417.4,1417.4,1585.25,1585.25,1585.25,785.91,913.85,913.85,0,559.5,801.95,801.95,1585.25
3620080,360,10060,,,,,,,DRAINAGE OF SKIN ABCESS,6704.39,2681.76,0,5698.73,5698.73,SKIPPED,347.13,347.13,5698.73,5698.73,5698.73,2825.23,60.34,60.34,0,2011.32,2882.89,2882.89,5698.73
3620081,360,22852,,,,,,,REMOVE SPINE FIXATION DEVICE,16251.49,6500.6,0,13813.77,13813.77,SKIPPED,3429.88,3429.88,13813.77,13813.77,13813.77,6848.38,0,0,0,4875.45,6988.14,6988.14,13813.77
3620082,278,,,,,,,,12x25x10 ZYSTON SPACER,14884,5953.6,0,12651.4,12651.4,SKIPPED,11311.84,11311.84,12651.4,12651.4,12651.4,6272.12,7293.16,7293.16,0,4465.2,6400.12,6400.12,12651.4
3620083,360,63040,,,,,,,LAMINOTOMY SINGLE CERVICAL,21843.32,8737.33,0,21843.32,18566.82,SKIPPED,21843.32,21843.32,18566.82,18566.82,18566.82,9204.78,0,0,0,6553,9392.63,9392.63,18566.82
3620084,360,63035,,,,,,,SPINAL DISK SURGERY ADD-ON,15431.23,6172.49,0,13116.55,13116.55,SKIPPED,0,0,13116.55,13116.55,13116.55,6502.72,0,0,0,4629.37,6635.43,6635.43,13116.55
3620085,360,63688,,,,,,,REVISE/REMOVE NEURORECEIVER,6762.01,2704.8,1051.35,6762.01,5747.71,SKIPPED,6762.01,6762.01,5747.71,5747.71,5747.71,2849.51,1051.35,1051.35,SKIPPED,SKIPPED,2907.66,2907.66,5747.71
3620086,360,10180,,,,,,,I&D CPLX POSTOP WND,13048.53,5219.41,582.36,11091.25,11091.25,SKIPPED,11043.13,11043.13,11091.25,11091.25,11091.25,5498.65,582.36,582.36,SKIPPED,SKIPPED,5610.87,5610.87,11091.25
3620087,270,,,,,,,,PROCARE ARM ELEVATION PILLOW,341.78,136.71,0,290.51,290.51,SKIPPED,259.75,259.75,290.51,290.51,290.51,144.03,167.47,167.47,0,102.53,146.97,146.97,290.51
3620088,278,,,,,,,,CREO 6.5x45 SCREW,4043,1617.2,0,3436.55,3436.55,SKIPPED,3072.68,3072.68,3436.55,3436.55,3436.55,1703.72,1981.07,1981.07,0,1212.9,1738.49,1738.49,3436.55
3620089,278,,,,,,,,55MM ROD,903,361.2,0,767.55,767.55,SKIPPED,686.28,686.28,767.55,767.55,767.55,380.52,442.47,442.47,0,270.9,388.29,388.29,767.55
3620090,278,,,,,,,,CREO THREADED LOCKING CAP,1100,440,0,935,935,SKIPPED,836,836,935,935,935,463.54,539,539,0,330,473,473,935
3620091,278,,,,,,,,40 MM ROD,1034,413.6,0,878.9,878.9,SKIPPED,785.84,785.84,878.9,878.9,878.9,435.73,506.66,506.66,0,310.2,444.62,444.62,878.9
3620092,278,,,,,,,,50mm ROD(GLOBUS MEDICAL),903,361.2,0,767.55,767.55,SKIPPED,686.28,686.28,767.55,767.55,767.55,380.52,442.47,442.47,0,270.9,388.29,388.29,767.55
3620093,278,,,,,,,,CREO 7.5/60(ALL SIZE) DOD SCREW,4843,1937.2,0,4116.55,4116.55,SKIPPED,3680.68,3680.68,4116.55,4116.55,4116.55,2040.84,2373.07,2373.07,0,1452.9,2082.49,2082.49,4116.55
3620094,278,,,,,,,,70mm ROD(GLOBUS MEDICAL),1847.5,739,0,1570.38,1570.38,SKIPPED,1404.1,1404.1,1570.38,1570.38,1570.38,778.54,905.28,905.28,0,554.25,794.43,794.43,1570.38
3620095,278,,,,,,,,48-60 CROSS CONNECTOR,2979,1191.6,0,2532.15,2532.15,SKIPPED,2264.04,2264.04,2532.15,2532.15,2532.15,1255.35,1459.71,1459.71,0,893.7,1280.97,1280.97,2532.15
3620096,278,,,,,,,,40mm ROD (Globus Medical),903,361.2,0,767.55,767.55,SKIPPED,686.28,686.28,767.55,767.55,767.55,380.52,442.47,442.47,0,270.9,388.29,388.29,767.55
3620097,278,,,,,,,,4.2x14mm VRSD SCREW,1221,488.4,0,1037.85,1037.85,SKIPPED,927.96,927.96,1037.85,1037.85,1037.85,514.53,598.29,598.29,0,366.3,525.03,525.03,1037.85
3620098,278,,,,,,,,XTEND 24mm PLATE,8211,3284.4,0,6979.35,6979.35,SKIPPED,6240.36,6240.36,6979.35,6979.35,6979.35,3460.12,4023.39,4023.39,0,2463.3,3530.73,3530.73,6979.35
3620099,272,,,,,,,,VUEPASS MINIMALLY INVASIVE SYSTEM,3402,1360.8,0,2891.7,2891.7,SKIPPED,2585.52,2585.52,2891.7,2891.7,2891.7,1433.6,1666.98,1666.98,0,1020.6,1462.86,1462.86,2891.7
3620100,360,22849,,,,,,,REINSERT SPINAL FIXATION,16296.53,6518.61,0,13852.05,13852.05,SKIPPED,6431.88,6431.88,13852.05,13852.05,13852.05,6867.36,0,0,0,4888.96,7007.51,7007.51,13852.05
3620101,278,,,,,,,,13x25 ZYSTON STRAIGHT,14586,5834.4,0,12398.1,12398.1,SKIPPED,11085.36,11085.36,12398.1,12398.1,12398.1,6146.54,7147.14,7147.14,0,4375.8,6271.98,6271.98,12398.1
3620102,278,,,,,,,,SCREWS ALL SIZES(L2 SURGICAL),2755,1102,0,2341.75,2341.75,SKIPPED,2093.8,2093.8,2341.75,2341.75,2341.75,1160.96,1349.95,1349.95,0,826.5,1184.65,1184.65,2341.75
3620103,278,,,,,,,,SET SCREWS(L2 SURGICAL),953,381.2,0,810.05,810.05,SKIPPED,724.28,724.28,810.05,810.05,810.05,401.59,466.97,466.97,0,285.9,409.79,409.79,810.05
3620104,278,,,,,,,,RODS ALL SIZES(L2 SURGICAL),3397.5,1359,0,2887.88,2887.88,SKIPPED,2582.1,2582.1,2887.88,2887.88,2887.88,1431.71,1664.78,1664.78,0,1019.25,1460.93,1460.93,2887.88
3620105,278,,,,,,,,37MM TWO LVL PLATE(L2 SURGICAL),4817,1926.8,0,4094.45,4094.45,SKIPPED,3660.92,3660.92,4094.45,4094.45,4094.45,2029.88,2360.33,2360.33,0,1445.1,2071.31,2071.31,4094.45
3620106,278,,,,,,,,3.5 MM SCREWS(L2 SURGICAL),971,388.4,0,825.35,825.35,SKIPPED,737.96,737.96,825.35,825.35,825.35,409.18,475.79,475.79,0,291.3,417.53,417.53,825.35
3620107,278,,,,,,,,4.0MM SCREWS(L2 SURGICAL),971,388.4,0,825.35,825.35,SKIPPED,737.96,737.96,825.35,825.35,825.35,409.18,475.79,475.79,0,291.3,417.53,417.53,825.35
3620108,278,,,,,,,,40MM TI CURVED ROD(L2 SURGICAL),3397.5,1359,0,2887.88,2887.88,SKIPPED,2582.1,2582.1,2887.88,2887.88,2887.88,1431.71,1664.78,1664.78,0,1019.25,1460.93,1460.93,2887.88
3620109,278,,,,,,,,TRIPOLE SPINE STIM KIT INCLD. LEAD/CABLE,110447,44178.8,0,93879.95,93879.95,SKIPPED,83939.72,83939.72,93879.95,93879.95,93879.95,46542.37,54119.03,54119.03,0,33134.1,47492.21,47492.21,93879.95
3620110,278,,,,,,,,1 LEVEL PLATE(L2 SURGICAL),4410,1764,0,3748.5,3748.5,SKIPPED,3351.6,3351.6,3748.5,3748.5,3748.5,1858.37,2160.9,2160.9,0,1323,1896.3,1896.3,3748.5
3620111,278,,,,,,,,VELOFIX CAGE(L2 SURGICAL),14884,5953.6,0,12651.4,12651.4,SKIPPED,11311.84,11311.84,12651.4,12651.4,12651.4,6272.12,7293.16,7293.16,0,4465.2,6400.12,6400.12,12651.4
3620112,272,,,,,,,,OSTEO SELECT 10.0 CC PUTTY,3034.5,1213.8,0,2579.32,2579.32,SKIPPED,2306.22,2306.22,2579.32,2579.32,2579.32,1278.74,1486.9,1486.9,0,910.35,1304.84,1304.84,2579.32
3620113,272,,,,,,,,OSTEO SPONGE STRIP 50x20x7mm,4872,1948.8,0,4141.2,4141.2,SKIPPED,3702.72,3702.72,4141.2,4141.2,4141.2,2053.06,2387.28,2387.28,0,1461.6,2094.96,2094.96,4141.2
3620114,272,,,,,,,,50x10MM 3 DEMIN STRIP,3591,1436.4,0,3052.35,3052.35,SKIPPED,2729.16,2729.16,3052.35,3052.35,3052.35,1513.25,1759.59,1759.59,0,1077.3,1544.13,1544.13,3052.35
3620116,278,,,,,,,,3.5x16 Self Drilling,971,388.4,0,825.35,825.35,SKIPPED,737.96,737.96,825.35,825.35,825.35,409.18,475.79,475.79,0,291.3,417.53,417.53,825.35
3620117,278,,,,,,,,45MM TWO LEVEL PLATE(L2 SURGICAL),4817,1926.8,0,4094.45,4094.45,SKIPPED,3660.92,3660.92,4094.45,4094.45,4094.45,2029.88,2360.33,2360.33,0,1445.1,2071.31,2071.31,4094.45
3620118,360,22850,,,,,,,RMV SPINAL FIXATION DEVICE,14762.78,5905.11,0,12548.36,12548.36,SKIPPED,3573.09,3573.09,12548.36,12548.36,12548.36,6221.04,0,0,0,4428.83,6348,6348,12548.36
3620120,272,,,,,,,,BMA NEEDLE(L2 SURGICAL),546,218.4,0,464.1,464.1,SKIPPED,414.96,414.96,464.1,464.1,464.1,230.08,267.54,267.54,0,163.8,234.78,234.78,464.1
3620121,272,,,,,,,,DBM STRIP LRG 51x20x5,2576.7,1030.68,0,2190.2,2190.2,SKIPPED,1958.29,1958.29,2190.2,2190.2,2190.2,1085.82,1262.58,1262.58,0,773.01,1107.98,1107.98,2190.2
3620122,272,,,,,,,,50x10 DEMIN STRIP,3591,1436.4,0,3052.35,3052.35,SKIPPED,2729.16,2729.16,3052.35,3052.35,3052.35,1513.25,1759.59,1759.59,0,1077.3,1544.13,1544.13,3052.35
3620123,360,22855,,,,,,,RMV SPINE FIXATION DEVICE,12993.19,5197.28,0,11044.21,11044.21,SKIPPED,5482.36,5482.36,11044.21,11044.21,11044.21,5475.33,0,0,0,3897.96,5587.07,5587.07,11044.21
3620124,278,,,,,,,,VARIABLE SELF-DRILLING 12MM-16MM,2313,925.2,0,1966.05,1966.05,SKIPPED,1757.88,1757.88,1966.05,1966.05,1966.05,974.7,1133.37,1133.37,0,693.9,994.59,994.59,1966.05
3620125,278,,,,,,,,CERVICAL CORTICAL SPACER,6500,2600,0,5525,5525,SKIPPED,4940,4940,5525,5525,5525,2739.1,3185,3185,0,1950,2795,2795,5525
3620126,278,,,,,,,,T-LINK COLLECT 40-50,4313,1725.2,0,3666.05,3666.05,SKIPPED,3277.88,3277.88,3666.05,3666.05,3666.05,1817.5,2113.37,2113.37,0,1293.9,1854.59,1854.59,3666.05
3620127,278,,,,,,,,26MMx10MMx8MM SCREWS,14175,5670,0,12048.75,12048.75,SKIPPED,10773,10773,12048.75,12048.75,12048.75,5973.34,6945.75,6945.75,0,4252.5,6095.25,6095.25,12048.75
3620128,278,,,,,,,,3 DEMIN CORTICAL FIBERS+10CC OSTEOVIVE,14438,5775.2,0,12272.3,12272.3,SKIPPED,10972.88,10972.88,12272.3,12272.3,12272.3,6084.17,7074.62,7074.62,0,4331.4,6208.34,6208.34,12272.3
3620129,278,,,,,,,,TWO LVL PLATE,5750,2300,0,4887.5,4887.5,SKIPPED,4370,4370,4887.5,4887.5,4887.5,2423.05,2817.5,2817.5,0,1725,2472.5,2472.5,4887.5
3620130,360,63075,,,,,,,DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NT,18370.99,7348.4,0,18370.99,15615.34,SKIPPED,18370.99,18370.99,15615.34,15615.34,15615.34,7741.54,0,0,0,5511.3,7899.53,7899.53,15615.34
3620131,278,,,,,,,,STAND-ALONE CERVICAL CAGE(RENOVIS),20463,8185.2,0,17393.55,17393.55,SKIPPED,15551.88,15551.88,17393.55,17393.55,17393.55,8623.11,10026.87,10026.87,0,6138.9,8799.09,8799.09,17393.55
3620132,278,,,,,,,,LOCKING COVER PLATE(RENOVIS),4825,1930,0,4101.25,4101.25,SKIPPED,3667,3667,4101.25,4101.25,4101.25,2033.26,2364.25,2364.25,0,1447.5,2074.75,2074.75,4101.25
3620133,278,,,,,,,,SELF DRILLING SCREWS(RENOVIS),1175,470,0,998.75,998.75,SKIPPED,893,893,998.75,998.75,998.75,495.14,575.75,575.75,0,352.5,505.25,505.25,998.75
3620134,278,,,,,,,,REDUCTION SCREWS,4488,1795.2,0,3814.8,3814.8,SKIPPED,3410.88,3410.88,3814.8,3814.8,3814.8,1891.24,2199.12,2199.12,0,1346.4,1929.84,1929.84,3814.8
3620135,278,,,,,,,,STD SCREWS,3938,1575.2,0,3347.3,3347.3,SKIPPED,2992.88,2992.88,3347.3,3347.3,3347.3,1659.47,1929.62,1929.62,0,1181.4,1693.34,1693.34,3347.3
3620136,278,,,,,,,,LUMBAR INTERBODY IMPLANT,14175,5670,0,12048.75,12048.75,SKIPPED,10773,10773,12048.75,12048.75,12048.75,5973.34,6945.75,6945.75,0,4252.5,6095.25,6095.25,12048.75
3620137,360,22859,,,,,,,INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O A,9624.18,3849.67,0,8180.55,8180.55,SKIPPED,0,0,8180.55,8180.55,8180.55,4055.63,0,0,0,2887.25,4138.4,4138.4,8180.55
3620138,278,,,,,,,,POLYAXIAL SCREW-ALL SIZES(CHOICE SPINE),3938,1575.2,0,3347.3,3347.3,SKIPPED,2992.88,2992.88,3347.3,3347.3,3347.3,1659.47,1929.62,1929.62,0,1181.4,1693.34,1693.34,3347.3
3620139,360,22853,,,,,,,INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC,13515.82,5406.33,0,11488.45,11488.45,SKIPPED,0,0,11488.45,11488.45,11488.45,5695.56,0,0,0,4054.75,5811.8,5811.8,11488.45
3620140,272,,,,,,,,BROKEN SCREW EXTRACTOR(ALL SIZES),980,392,0,833,833,SKIPPED,744.8,744.8,833,833,833,412.97,480.2,480.2,0,294,421.4,421.4,833
3620141,360,0275T,,,,,,,PERQ LAMOT/LAM LUMABR,18537.99,7415.2,0,18537.99,15757.29,SKIPPED,18537.99,18537.99,15757.29,15757.29,15757.29,7811.91,0,0,0,5561.4,7971.34,7971.34,15757.29
3620142,278,,,,,,,,circular star locks,907.5,363,0,771.38,771.38,SKIPPED,689.7,689.7,771.38,771.38,771.38,382.43,444.68,444.68,0,272.25,390.23,390.23,771.38
3620143,278,,,,,,,,CROSS LINK(ALL SIZES),4312.5,1725,0,3665.62,3665.62,SKIPPED,3277.5,3277.5,3665.62,3665.62,3665.62,1817.29,2113.12,2113.12,0,1293.75,1854.38,1854.38,3665.62
3620144,278,,,,,,,,STRATOGEN FLOW,10325,4130,0,8776.25,8776.25,SKIPPED,7847,7847,8776.25,8776.25,8776.25,4350.96,5059.25,5059.25,0,3097.5,4439.75,4439.75,8776.25
3620145,278,,,,,,,,STRATOFUSE DBM 100,3612.5,1445,0,3070.62,3070.62,SKIPPED,2745.5,2745.5,3070.62,3070.62,3070.62,1522.31,1770.12,1770.12,0,1083.75,1553.38,1553.38,3070.62
3620146,278,,,,,,,,STRATOFUSE FIBER PUTTY,4112.5,1645,0,3495.62,3495.62,SKIPPED,3125.5,3125.5,3495.62,3495.62,3495.62,1733.01,2015.12,2015.12,0,1233.75,1768.38,1768.38,3495.62
3620147,278,,,,,,,,STRATOFUSE SPONGES,6812.5,2725,0,5790.62,5790.62,SKIPPED,5177.5,5177.5,5790.62,5790.62,5790.62,2870.79,3338.12,3338.12,0,2043.75,2929.38,2929.38,5790.62
3620148,278,,,,,,,,30MM 2-LEVEL PLATE,5750,2300,0,4887.5,4887.5,SKIPPED,4370,4370,4887.5,4887.5,4887.5,2423.05,2817.5,2817.5,0,1725,2472.5,2472.5,4887.5
3620149,975,63688,,,,,,,REVISE/REMOVE NEURORECEIVER,889.36,355.74,0,889.36,755.96,SKIPPED,889.36,889.36,755.96,755.96,755.96,403.34,435.79,435.79,SKIPPED,SKIPPED,411.57,411.57,0
3620150,975,63030,,,,,,,LOW BACK DISC SURGERY PROF,2313.97,925.59,0,2313.97,1966.87,SKIPPED,2313.97,2313.97,1966.87,1966.87,1966.87,1044.52,1133.85,1133.85,SKIPPED,SKIPPED,1065.84,1065.84,0
3620151,975,22551,,,,,,,NECK SPINE FUSE & REMOVE,4079.81,1631.92,0,4079.81,3467.84,SKIPPED,4079.81,4079.81,3467.84,3467.84,3467.84,1810.93,1999.11,1999.11,SKIPPED,SKIPPED,1847.89,1847.89,0
3620152,975,22845,,,,,,,INSERT SPINE FIXATION DEVICE,1755.1,702.04,0,1491.84,1491.84,SKIPPED,0,0,1491.84,1491.84,1491.84,766.87,860,860,0,526.53,782.52,782.52,0
3620153,975,22853,,,,,,,INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC,603.45,241.38,0,512.93,512.93,SKIPPED,0,0,512.93,512.93,512.93,272.38,295.69,295.69,0,181.04,277.94,277.94,0
3620154,975,22612,,,,,,,ARTHRODESIS POSTERIOR LUMBAR,3797.93,1519.17,0,3797.93,3228.24,SKIPPED,3797.93,3797.93,3228.24,3228.24,3228.24,1699.9,1860.99,1860.99,SKIPPED,SKIPPED,1734.59,1734.59,0
3620155,975,22614,,,,,,,ARTHRODESIS POSTERIOR LUMBAR EACH ADDL,940.94,376.38,0,799.8,799.8,SKIPPED,0,0,799.8,799.8,799.8,412.66,461.06,461.06,0,282.28,421.08,421.08,0
3620156,975,22842,,,,,,,POSTERIOR SEGMENTAL INSTR. 3-6 VERT,1836.79,734.72,0,1561.27,1561.27,SKIPPED,0,0,1561.27,1561.27,1561.27,805.53,900.03,900.03,0,551.04,821.97,821.97,0
3620157,975,63047,,,,,,,LAM FACETECTOMY 1 SEG,2628.32,1051.33,0,2628.32,2234.07,SKIPPED,2628.32,2628.32,2234.07,2234.07,2234.07,1182.7,1287.88,1287.88,SKIPPED,SKIPPED,1206.84,1206.84,0
3620158,975,63048,,,,,,,LAM FACETECTOMY 1 SEG EA CEV/THER/LMBR,508.54,203.42,0,432.26,432.26,SKIPPED,0,0,432.26,432.26,432.26,222.34,249.18,249.18,0,152.56,226.88,226.88,0
3620160,975,63707,,,,,,,RPR DURAL/CEREROSPINAL FLUID,2199.99,880,0,2199.99,1869.99,SKIPPED,2199.99,2199.99,1869.99,1869.99,1869.99,1002.97,1078,1078,0,660,1023.44,1023.44,0
3620161,975,22830,,,,,,,EXPORATION SPINAL FLUID,1941.77,776.71,0,1941.77,1650.5,SKIPPED,1941.77,1941.77,1650.5,1650.5,1650.5,883.03,951.47,951.47,0,582.53,901.05,901.05,0
3620162,360,22558,,,,,,,ARTHRODESIS ANTERIOR INTERBODY LUMBAR,5681.28,2272.51,0,5681.28,4829.09,SKIPPED,5681.28,5681.28,4829.09,4829.09,4829.09,2394.09,0,0,0,1704.38,2442.95,2442.95,4829.09
3620163,975,22558,,,,,,,ARTHRODESIS ANTERIOR INTERBODY LUMBAR,3675.76,1470.3,0,3675.76,3124.4,SKIPPED,3675.76,3675.76,3124.4,3124.4,3124.4,1639.76,1801.12,1801.12,0,1102.73,1673.22,1673.22,0
3620164,360,22585,,,,,,,ARTHRODESIS ANTERIOR INTERBODY EA ADDL,2212.22,884.89,0,1880.39,1880.39,SKIPPED,0,0,1880.39,1880.39,1880.39,932.22,0,0,0,663.67,951.25,951.25,1880.39
3620165,975,22585,,,,,,,ARTHRODESIS ANTERIOR INTERBODY EA ADDL,790.25,316.1,0,671.71,671.71,SKIPPED,0,0,671.71,671.71,671.71,344.96,387.22,387.22,0,237.08,352,352,0
3620166,360,97605,,,,,,,NEG PRESS WND TX =50CM,345.21,138.08,0,345.21,293.43,SKIPPED,345.21,345.21,293.43,293.43,293.43,145.47,0,0,0,103.56,148.44,148.44,293.43
3620167,975,97605,,,,,,,NEG PRESS WND TX =50CM,62.88,25.15,0,62.88,53.45,SKIPPED,62.88,62.88,53.45,53.45,53.45,27.87,30.81,30.81,0,18.86,28.44,28.44,0
3620168,360,69990,,,,,,,MICROSURGERY ADD-ON,3400.99,1360.4,0,2890.84,2890.84,SKIPPED,0,0,2890.84,2890.84,2890.84,1433.18,0,0,0,1020.3,1462.43,1462.43,2890.84
3620169,975,69990,,,,,,,MICROSURGERY ADD-ON,524.09,209.64,0,445.48,445.48,SKIPPED,0,0,445.48,445.48,445.48,225.78,256.8,256.8,0,157.23,230.39,230.39,0
3620170,975,20936,,,,,,,SP BONE AGRFT ADD0ON,711.07,284.43,0,604.41,604.41,SKIPPED,0,0,604.41,604.41,604.41,0,348.42,348.42,0,213.32,0,0,0
3620171,278,,,,,,,,iFUSE IMPLANT SYSTEM,8750,3500,0,7437.5,7437.5,SKIPPED,6650,6650,7437.5,7437.5,7437.5,3687.25,4287.5,4287.5,0,2625,3762.5,3762.5,7437.5
3620172,278,,,,,,,,CLUSTERHOLE ACETABULAS SHELL,3375,1350,0,2868.75,2868.75,SKIPPED,2565,2565,2868.75,2868.75,2868.75,1422.22,1653.75,1653.75,0,1012.5,1451.25,1451.25,2868.75
3620173,278,,,,,,,,POLYETHYLENE INSERT,2750,1100,0,2337.5,2337.5,SKIPPED,2090,2090,2337.5,2337.5,2337.5,1158.85,1347.5,1347.5,0,825,1182.5,1182.5,2337.5
3620174,278,,,,,,,,ACETABULAR DOME HOLE PLUG,530,212,0,450.5,450.5,SKIPPED,402.8,402.8,450.5,450.5,450.5,223.34,259.7,259.7,0,159,227.9,227.9,450.5
3620175,278,,,,,,,,ACCOLADE 127 NECK ANGLE HIP STEM,6875,2750,0,5843.75,5843.75,SKIPPED,5225,5225,5843.75,5843.75,5843.75,2897.12,3368.75,3368.75,0,2062.5,2956.25,2956.25,5843.75
3620176,278,,,,,,,,BIOLOX DELTA CERAMIC V40 FEMORAL HEAD,2750,1100,0,2337.5,2337.5,SKIPPED,2090,2090,2337.5,2337.5,2337.5,1158.85,1347.5,1347.5,0,825,1182.5,1182.5,2337.5
3620177,278,,,,,,,,6.5MM LOW PRO HEX SCREW,195,78,0,165.75,165.75,SKIPPED,148.2,148.2,165.75,165.75,165.75,82.17,95.55,95.55,0,58.5,83.85,83.85,165.75
3620178,278,,,,,,,,SEA SPINE SPACER,10716,4286.4,0,9108.6,9108.6,SKIPPED,8144.16,8144.16,9108.6,9108.6,9108.6,4515.72,5250.84,5250.84,0,3214.8,4607.88,4607.88,9108.6
3620179,278,,,,,,,,10CC OSTEOSTRAND PLUS,10715,4286,0,9107.75,9107.75,SKIPPED,8143.4,8143.4,9107.75,9107.75,9107.75,4515.3,5250.35,5250.35,0,3214.5,4607.45,4607.45,9107.75
3620180,272,,,,,,,,POSTERIOR SITE PREP,3397.5,1359,0,2887.88,2887.88,SKIPPED,2582.1,2582.1,2887.88,2887.88,2887.88,1431.71,1664.78,1664.78,0,1019.25,1460.93,1460.93,2887.88
3620181,278,,,,,,,,5.5X35MM MARINER SCREWS,2771.25,1108.5,0,2355.56,2355.56,SKIPPED,2106.15,2106.15,2355.56,2355.56,2355.56,1167.81,1357.91,1357.91,0,831.38,1191.64,1191.64,2355.56
3620182,278,,,,,,,,MARINER POLUAXIAL HEAD,5462.5,2185,0,4643.12,4643.12,SKIPPED,4151.5,4151.5,4643.12,4643.12,4643.12,2301.9,2676.62,2676.62,0,1638.75,2348.88,2348.88,4643.12
3620183,278,,,,,,,,SEA SPINE SET SCREWS,1385,554,0,1177.25,1177.25,SKIPPED,1052.6,1052.6,1177.25,1177.25,1177.25,583.64,678.65,678.65,0,415.5,595.55,595.55,1177.25
3620184,278,,,,,,,,6.5X35MM MARINER SCREWS,5462.5,2185,0,4643.12,4643.12,SKIPPED,4151.5,4151.5,4643.12,4643.12,4643.12,2301.9,2676.62,2676.62,0,1638.75,2348.88,2348.88,4643.12
3620185,278,,,,,,,,60MM ROD,1846.25,738.5,0,1569.31,1569.31,SKIPPED,1403.15,1403.15,1569.31,1569.31,1569.31,778.01,904.66,904.66,0,553.88,793.89,793.89,1569.31
3620186,272,,,,,,,,BONE MARROW ASPERATION TIP,613.75,245.5,0,521.69,521.69,SKIPPED,466.45,466.45,521.69,521.69,521.69,258.63,300.74,300.74,0,184.12,263.91,263.91,521.69
3620187,272,,,,,,,,ROTRACTOR ILLUMINATOR,1379.5,551.8,0,1172.58,1172.58,SKIPPED,1048.42,1048.42,1172.58,1172.58,1172.58,581.33,675.96,675.96,0,413.85,593.19,593.19,1172.58
3620188,278,,,,,,,,6.5X45MM NEW PORT SCREWS,4001.25,1600.5,0,3401.06,3401.06,SKIPPED,3040.95,3040.95,3401.06,3401.06,3401.06,1686.13,1960.61,1960.61,0,1200.38,1720.54,1720.54,3401.06
3620189,278,,,,,,,,7.5X452MM NEW PORT SCREWS,4001.25,1600.5,0,3401.06,3401.06,SKIPPED,3040.95,3040.95,3401.06,3401.06,3401.06,1686.13,1960.61,1960.61,0,1200.38,1720.54,1720.54,3401.06
3620190,278,,,,,,,,CAP/ROD COMBO NEW PORT MIS,2907.25,1162.9,0,2471.16,2471.16,SKIPPED,2209.51,2209.51,2471.16,2471.16,2471.16,1225.12,1424.55,1424.55,0,872.18,1250.12,1250.12,2471.16
3620191,278,,,,,,,,MIS CAP NEW PORT,1162.12,464.85,0,987.8,987.8,SKIPPED,883.21,883.21,987.8,987.8,987.8,489.72,569.44,569.44,0,348.64,499.71,499.71,987.8
3620192,272,,,,,,,,TUBE RETRACTOR MOD,3463.75,1385.5,0,2944.19,2944.19,SKIPPED,2632.45,2632.45,2944.19,2944.19,2944.19,1459.62,1697.24,1697.24,0,1039.12,1489.41,1489.41,2944.19
3620193,272,,,,,,,,MIS POSTERIOR SITE PREP KIT,3463.75,1385.5,0,2944.19,2944.19,SKIPPED,2632.45,2632.45,2944.19,2944.19,2944.19,1459.62,1697.24,1697.24,0,1039.12,1489.41,1489.41,2944.19
3620194,278,,,,,,,,SEA SPINE GUIDE WIRE,396.25,158.5,0,336.81,336.81,SKIPPED,301.15,301.15,336.81,336.81,336.81,166.98,194.16,194.16,0,118.88,170.39,170.39,336.81
3620195,272,,,,,,,,ANTERIOR DISC PREP,3397.5,1359,0,2887.88,2887.88,SKIPPED,2582.1,2582.1,2887.88,2887.88,2887.88,1431.71,1664.78,1664.78,0,1019.25,1460.93,1460.93,2887.88
3620196,278,,,,,,,,16X14X6MM 7 DEGREE NO PROFILE,11827.5,4731,0,10053.38,10053.38,SKIPPED,8988.9,8988.9,10053.38,10053.38,10053.38,4984.11,5795.48,5795.48,0,3548.25,5085.83,5085.83,10053.38
3620197,272,,,,,,,,12MM SELF DRILLING VARIABLE,942.5,377,0,801.12,801.12,SKIPPED,716.3,716.3,801.12,801.12,801.12,397.17,461.82,461.82,0,282.75,405.28,405.28,801.12
3620198,272,,,,,,,,6MM COVER NO PROFILE,1397.5,559,0,1187.88,1187.88,SKIPPED,1062.1,1062.1,1187.88,1187.88,1187.88,588.91,684.78,684.78,0,419.25,600.93,600.93,1187.88
3620199,272,,,,,,,,ANTERIOR SITE PREP KIT,3397.5,1359,0,2887.88,2887.88,SKIPPED,2582.1,2582.1,2887.88,2887.88,2887.88,1431.71,1664.78,1664.78,0,1019.25,1460.93,1460.93,2887.88
3620200,975,22552,,,,,,,Surgical Assist-ADDL NECK SPINE FUSION,153.07,61.23,0,426.26,130.11,SKIPPED,0,0,130.11,130.11,130.11,417.73,75,75,0,45.92,426.26,426.26,0
3620201,975,22585,,,,,,,Surgical Assist-ANTERIOR INTERBODY EA AD,126.43,50.57,0,352,107.47,SKIPPED,0,0,107.47,107.47,107.47,344.96,61.95,61.95,0,37.93,352,352,0
3620202,975,22558,,,,,,,Surgical Assist-ANTERIOR INTERBODY,588.12,235.25,0,1673.22,499.9,SKIPPED,588.12,588.12,499.9,499.9,499.9,1639.76,288.18,288.18,0,176.44,1673.22,1673.22,0
3620203,975,22612,,,,,,,Surgical Assist-POSTERIOR LUMBAR,607.67,243.07,0,1734.59,516.52,SKIPPED,607.67,607.67,516.52,516.52,516.52,1699.9,297.76,297.76,SKIPPED,SKIPPED,1734.59,1734.59,0
3620204,975,22614,,,,,,,Surgical Assist-POSTERIOR LUMBAR EA ADDT,150.55,60.22,0,421.08,127.97,SKIPPED,0,0,127.97,127.97,127.97,412.66,73.77,73.77,0,45.16,421.08,421.08,0
3620205,975,22830,,,,,,,Surgical Assist-EXPORATION SPINAL FLUID,310.68,124.27,0,901.05,264.08,SKIPPED,310.68,310.68,264.08,264.08,264.08,883.03,152.23,152.23,0,93.2,901.05,901.05,0
3620206,975,22845,,,,,,,Surgical Assist-INSER SPINE FIXATION,280.82,112.33,0,782.52,238.7,SKIPPED,0,0,238.7,238.7,238.7,766.87,137.6,137.6,0,84.25,782.52,782.52,0
3620207,975,22853,,,,,,,Surgical Assist-INSJ BIOMCHN DEV INTERVE,96.55,38.62,0,277.94,82.07,SKIPPED,0,0,82.07,82.07,82.07,272.38,47.31,47.31,0,28.96,277.94,277.94,0
3620208,975,63047,,,,,,,Surgical Assist-LAM FACETECTOMY 1 SEG,420.53,168.21,0,1206.84,357.45,SKIPPED,420.53,420.53,357.45,357.45,357.45,1182.7,206.06,206.06,SKIPPED,SKIPPED,1206.84,1206.84,0
3620209,975,63048,,,,,,,Surgical Assist-LAM FACETECTOMY 1 SEG EA,81.36,32.54,0,226.88,69.16,SKIPPED,0,0,69.16,69.16,69.16,222.34,39.87,39.87,0,24.41,226.88,226.88,0
3620210,975,63030,,,,,,,Surgical Assist-LOW BACK DISC SURG,370.23,148.09,0,1065.84,314.7,SKIPPED,370.23,370.23,314.7,314.7,314.7,1044.52,181.41,181.41,SKIPPED,SKIPPED,1065.84,1065.84,0
3620211,975,69990,,,,,,,Surgical Assist-MICROSURGERY ADD ON,83.85,33.54,0,230.39,71.27,SKIPPED,0,0,71.27,71.27,71.27,225.78,41.09,41.09,0,25.16,230.39,230.39,0
3620212,975,22551,,,,,,,Surgical Assist-NECK SPINE FUSE/RMV,652.76,261.1,0,1847.89,554.85,SKIPPED,652.76,652.76,554.85,554.85,554.85,1810.93,319.85,319.85,SKIPPED,SKIPPED,1847.89,1847.89,0
3620213,975,97605,,,,,,,Surgical Assist-NEG PRESS WND TX= 50CM,10.07,4.03,0,28.44,8.56,SKIPPED,10.07,10.07,8.56,8.56,8.56,27.87,4.93,4.93,0,3.02,28.44,28.44,0
3620214,975,22842,,,,,,,Surgical Assist-POSTERIOR SEG INSTR 3-6,293.88,117.55,0,821.97,249.8,SKIPPED,0,0,249.8,249.8,249.8,805.53,144,144,0,88.16,821.97,821.97,0
3620215,975,63688,,,,,,,Surgical Assist-REVISE/RMV NEURO RECEIVE,142.3,56.92,0,411.57,120.96,SKIPPED,142.3,142.3,120.96,120.96,120.96,403.34,69.73,69.73,SKIPPED,SKIPPED,411.57,411.57,0
3620216,975,63707,,,,,,,Surgical Assist-RPR DURAL/CEREROSPINAL F,351.99,140.8,0,1023.44,299.19,SKIPPED,351.99,351.99,299.19,299.19,299.19,1002.97,172.48,172.48,0,105.6,1023.44,1023.44,0
3620217,975,20936,,,,,,,Surgical Assist-SP BONE AGRFT ADD-ON,113.77,45.51,0,96.7,96.7,SKIPPED,0,0,96.7,96.7,96.7,0,55.75,55.75,0,34.13,0,0,0
3620218,272,,,,,,,,MIS 3.0 MATCHHEAD BUR,722.3,288.92,0,613.96,613.96,SKIPPED,548.95,548.95,613.96,613.96,613.96,304.38,353.93,353.93,0,216.69,310.59,310.59,613.96
3620219,272,,,,,,,,3.0 NEURO MATCHEAD BUR,1822.5,729,0,1549.12,1549.12,SKIPPED,1385.1,1385.1,1549.12,1549.12,1549.12,768.01,893.02,893.02,0,546.75,783.68,783.68,1549.12
3620220,278,,,,,,,,DURASEAL SEALANT 5ML,3562.5,1425,0,3028.12,3028.12,SKIPPED,2707.5,2707.5,3028.12,3028.12,3028.12,1501.24,1745.62,1745.62,0,1068.75,1531.88,1531.88,3028.12
3620221,272,,,,,,,,DURASEAL TIP APPLICATOR,715.2,286.08,0,607.92,607.92,SKIPPED,543.55,543.55,607.92,607.92,607.92,301.39,350.45,350.45,0,214.56,307.54,307.54,607.92
3620222,272,,,,,,,,DISPOSIBLE PEDICTE SCREW PROBE,882.5,353,0,750.12,750.12,SKIPPED,670.7,670.7,750.12,750.12,750.12,371.89,432.42,432.42,0,264.75,379.48,379.48,750.12
3620223,278,,,,,,,,OSTEOSTRAND PLUS 5CC,7752.5,3101,0,6589.62,6589.62,SKIPPED,5891.9,5891.9,6589.62,6589.62,6589.62,3266.91,3798.72,3798.72,0,2325.75,3333.58,3333.58,6589.62
3620224,975,63035,,,,,,,LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/L,459.5,183.8,0,390.58,390.58,SKIPPED,0,0,390.58,390.58,390.58,201.85,225.16,225.16,0,137.85,205.97,205.97,0
3620225,278,,,,,,,,12 HOLE DISTAL FEMUR LT.,12330,4932,0,10480.5,10480.5,SKIPPED,9370.8,9370.8,10480.5,10480.5,10480.5,5195.86,6041.7,6041.7,0,3699,5301.9,5301.9,10480.5
3620226,975,63035,,,,,,,SurgicalAssist-lamnotmy w/dcmprsn nrv ea,73.51,29.4,0,205.97,62.48,SKIPPED,0,0,62.48,62.48,62.48,201.85,36.02,36.02,0,22.05,205.97,205.97,0
3620227,278,,,,,,,,6.5 MAVINEY CORTICAL,4002.5,1601,0,3402.12,3402.12,SKIPPED,3041.9,3041.9,3402.12,3402.12,3402.12,1686.66,1961.22,1961.22,0,1200.75,1721.08,1721.08,3402.12
3620228,278,,,,,,,,POLYAXIAL HEADS,5462.5,2185,0,4643.12,4643.12,SKIPPED,4151.5,4151.5,4643.12,4643.12,4643.12,2301.9,2676.62,2676.62,0,1638.75,2348.88,2348.88,4643.12
3620229,360,22856,,,,,,,TOTAL ISC ARTHROPLASTY CERVICAL,19045.76,7618.3,0,19045.76,16188.9,SKIPPED,19045.76,19045.76,16188.9,16188.9,16188.9,8025.89,1051.35,1051.35,0,5713.73,8189.68,8189.68,16188.9
3620230,975,22856,,,,,,,TOTAL ISC ARTHROPLASTY CERVICAL,3908.26,1563.3,0,3908.26,3322.02,SKIPPED,3908.26,3908.26,3322.02,3322.02,3322.02,1738.53,1915.05,1915.05,0,1172.48,1774.01,1774.01,0
3620231,278,,,,,,,,SHORELINE PLATE (ALL SIZES),4632.5,1853,0,3937.62,3937.62,SKIPPED,3520.7,3520.7,3937.62,3937.62,3937.62,1952.14,2269.92,2269.92,0,1389.75,1991.98,1991.98,3937.62
3620232,278,,,,,,,,SHORELINE 10 DEGREE,11827.5,4731,0,10053.38,10053.38,SKIPPED,8988.9,8988.9,10053.38,10053.38,10053.38,4984.11,5795.48,5795.48,0,3548.25,5085.83,5085.83,10053.38
3620233,278,,,,,,,,ZVplasty 5mm System,17337.5,6935,0,14736.88,14736.88,SKIPPED,13176.5,13176.5,14736.88,14736.88,14736.88,7306.03,8495.38,8495.38,0,5201.25,7455.13,7455.13,14736.88
3620234,278,,,,,,,,PRODISC 5MM XL DEEP IMPLANT,17000,6800,0,14450,14450,SKIPPED,12920,12920,14450,14450,14450,7163.8,8330,8330,0,5100,7310,7310,14450
3620235,272,,,,,,,,MILLING BIT W/ 2.35MMX 33.5MM SHAFT,1022.5,409,0,869.12,869.12,SKIPPED,777.1,777.1,869.12,869.12,869.12,430.89,501.02,501.02,0,306.75,439.68,439.68,869.12
3620236,278,,,,,,,,INSERTER TIP F/LARGE & LG DEEP IMPLANTS,1150,460,0,977.5,977.5,SKIPPED,874,874,977.5,977.5,977.5,484.61,563.5,563.5,0,345,494.5,494.5,977.5
3620237,278,,,,,,,,NUT(2 PACK),368,147.2,0,312.8,312.8,SKIPPED,279.68,279.68,312.8,312.8,312.8,155.08,180.32,180.32,0,110.4,158.24,158.24,312.8
3620238,278,,,,,,,,PRODISC NON-STERILE DISPS. SCREWS (ALL),1224,489.6,0,1040.4,1040.4,SKIPPED,930.24,930.24,1040.4,1040.4,1040.4,515.79,599.76,599.76,0,367.2,526.32,526.32,1040.4
3620239,975,22856,,,,,,,SurgicalAssist:Total isc arthroplasty ce,625.32,250.13,0,1774.01,531.52,SKIPPED,625.32,625.32,531.52,531.52,531.52,1738.53,306.41,306.41,0,187.6,1774.01,1774.01,0
3620240,278,,,,,,,,VERTIFLEX SUPERIOR ISD-10MM,8750,3500,0,7437.5,7437.5,SKIPPED,6650,6650,7437.5,7437.5,7437.5,3687.25,4287.5,4287.5,0,2625,3762.5,3762.5,7437.5
3620241,272,,,,,,,,VERTIFLEX SUPERIOR ISD KIT,8750,3500,0,7437.5,7437.5,SKIPPED,6650,6650,7437.5,7437.5,7437.5,3687.25,4287.5,4287.5,0,2625,3762.5,3762.5,7437.5
3620242,272,,,,,,,,VERTIFLEX INSTRUMENT PLATFORM KIT,26250,10500,0,22312.5,22312.5,SKIPPED,19950,19950,22312.5,22312.5,22312.5,11061.75,12862.5,12862.5,0,7875,11287.5,11287.5,22312.5
3620243,272,,,,,,,,4.9 Drill Bit,2202.5,881,0,1872.12,1872.12,SKIPPED,1673.9,1673.9,1872.12,1872.12,1872.12,928.14,1079.22,1079.22,0,660.75,947.08,947.08,1872.12
3620244,272,,,,,,,,COUNTERSINK,1110,444,0,943.5,943.5,SKIPPED,843.6,843.6,943.5,943.5,943.5,467.75,543.9,543.9,0,333,477.3,477.3,943.5
3620245,360,22511,,,,,,,PERQ VERTEBROPLASTY UNI/BI INJECTION LUM,7227.93,2891.17,867.38,7227.93,6143.74,SKIPPED,7227.93,7227.93,6143.74,6143.74,6143.74,3045.85,867.38,867.38,SKIPPED,SKIPPED,3108.01,3108.01,6143.74
3620246,975,22511,,,,,,,PERQ VERTEBROPLASTY UNI/BI INJECTION LUM,947.79,379.12,0,947.79,805.62,SKIPPED,947.79,947.79,805.62,805.62,805.62,442.94,464.42,464.42,SKIPPED,SKIPPED,451.98,451.98,0
3620247,975,22511,,,,,,,SurgicalAssist:PERQ VERTEBROPLASTY UNI/B,151.64,60.66,0,451.98,128.89,SKIPPED,151.64,151.64,128.89,128.89,128.89,442.94,74.3,74.3,SKIPPED,SKIPPED,451.98,451.98,0
3620248,360,22869,,,,,,,INSJ STABLJ DEV W/O DCMPRN LUMBAR SINGLE,8968.89,3587.56,0,8968.89,7623.56,SKIPPED,8968.89,8968.89,7623.56,7623.56,7623.56,3779.49,0,0,0,2690.67,3856.62,3856.62,7623.56
3620249,975,22869,,,,,,,INSJ STABLJ DEV W/O DCMPRN LUMBAR SINGLE,1061.77,424.71,0,1061.77,902.5,SKIPPED,1061.77,1061.77,902.5,902.5,902.5,479.42,520.27,520.27,0,318.53,489.2,489.2,0
3620250,975,22869,,,,,,,SurgicalAssist:INSJ STABLJ DEV W/O DCMPR,169.88,67.95,0,489.2,144.4,SKIPPED,169.88,169.88,144.4,144.4,144.4,479.42,83.24,83.24,0,50.96,489.2,489.2,0
3620251,278,,,,,,,,7MM 2 HOLE SHORELINE PLATE,4632.5,1853,0,3937.62,3937.62,SKIPPED,3520.7,3520.7,3937.62,3937.62,3937.62,1952.14,2269.92,2269.92,0,1389.75,1991.98,1991.98,3937.62
3620252,360,22870,,,,,,,INSJ STABLJ DEV W/O DCMPRSN NRV ROOT,3754.57,1501.83,0,3191.38,3191.38,SKIPPED,0,0,3191.38,3191.38,3191.38,1582.18,0,0,0,1126.37,1614.47,1614.47,3191.38
3620253,975,22870,,,,,,,INSJ STABLJ DEV W/O DCMPRSN NRV ROOT,2610.95,1044.38,0,2219.31,2219.31,SKIPPED,0,0,2219.31,2219.31,2219.31,130.99,1279.37,1279.37,0,783.28,133.66,133.66,0
3620254,360,63020,,,,,,,LAMINOTOMY W/DCMPRSN RV ROOT,15188.04,6075.22,1051.35,15188.04,12909.83,SKIPPED,15188.04,15188.04,12909.83,12909.83,12909.83,6400.24,1051.35,1051.35,SKIPPED,SKIPPED,6530.86,6530.86,12909.83
3620255,975,63020,,,,,,,LAMINOTOMY W/DCMPRSN RV ROOT,2610.95,1044.38,0,2610.95,2219.31,SKIPPED,2610.95,2610.95,2219.31,2219.31,2219.31,1239.37,1279.37,1279.37,SKIPPED,SKIPPED,1264.66,1264.66,0
3620256,360,22510,,,,,,,PERQ CERVICOTHORACIC INJECT,8395.1,3358.04,867.38,8395.1,7135.84,SKIPPED,8395.1,8395.1,7135.84,7135.84,7135.84,3537.69,867.38,867.38,SKIPPED,SKIPPED,3609.89,3609.89,7135.84
3620257,975,22510,,,,,,,PERQ CERVICOTHORACIC INJECT,1004.76,401.9,0,1004.76,854.05,SKIPPED,1004.76,1004.76,854.05,854.05,854.05,470.56,492.33,492.33,SKIPPED,SKIPPED,480.16,480.16,0
3620258,360,22870,,,,,,,INJS STABLJ DEV W/O DCMPRN,3754.57,1501.83,0,3191.38,3191.38,SKIPPED,0,0,3191.38,3191.38,3191.38,1582.18,0,0,0,1126.37,1614.47,1614.47,3191.38
3620259,975,22870,,,,,,,INJS STABLJ DEV W/O DCMPRN,288.65,115.46,0,245.35,245.35,SKIPPED,0,0,245.35,245.35,245.35,130.99,141.44,141.44,0,86.6,133.66,133.66,0
3620260,360,22510,,,,,,,PERQ VERTEBROPLASTYUNI/BI INJ,8395.1,3358.04,867.38,8395.1,7135.84,SKIPPED,8395.1,8395.1,7135.84,7135.84,7135.84,3537.69,867.38,867.38,SKIPPED,SKIPPED,3609.89,3609.89,7135.84
3620261,975,22510,,,,,,,PERQ VERTEBROPLASTYUNI/BI INJ,1004.76,401.9,0,1004.76,854.05,SKIPPED,1004.76,1004.76,854.05,854.05,854.05,470.56,492.33,492.33,SKIPPED,SKIPPED,480.16,480.16,0
3620262,975,63046,,,,,,,REMOVE SPINE LAM 1 THOR,3402.58,1361.03,0,3402.58,2892.19,SKIPPED,3402.58,3402.58,2892.19,2892.19,2892.19,1310.45,1667.26,1667.26,SKIPPED,SKIPPED,1337.19,1337.19,0
3620263,360,22512,,,,,,,PERQ VERTEBROPLASTY ADDL CERVICOTHOR/LUM,4968.23,1987.29,0,4223,4223,SKIPPED,0,0,4223,4223,4223,2093.61,0,0,0,1490.47,2136.34,2136.34,4223
3620264,975,22512,,,,,,,PERQ VERTEBROPLASTY ADDL CERVICOTHOR/LUM,439.5,175.8,0,373.58,373.58,SKIPPED,0,0,373.58,373.58,373.58,223.47,215.36,215.36,0,131.85,228.03,228.03,0
3620265,360,24670,,,,,,,Closed treatment of ulnar fx (olecranon),577.71,231.08,87.17,577.71,491.05,SKIPPED,577.71,577.71,491.05,491.05,491.05,243.45,87.17,87.17,SKIPPED,SKIPPED,248.42,248.42,491.05
3620266,975,24670,,,,,,,Closed treatment of ulnar fx (olecranon),577.43,230.97,0,577.43,490.82,SKIPPED,577.43,577.43,490.82,490.82,490.82,297.48,282.94,282.94,SKIPPED,SKIPPED,303.55,303.55,0
3620267,278,C1713,,,,,,,APEX PINS (ALL SIZES),1635,654,0,1389.75,1389.75,SKIPPED,1242.6,1242.6,1389.75,1389.75,1389.75,688.99,801.15,801.15,0,490.5,703.05,703.05,1389.75
3620268,278,C1734,,,,,,,5 PIN CLAMP 300,7940,3176,0,6749,6749,SKIPPED,6034.4,6034.4,6749,6749,6749,3345.92,3890.6,3890.6,0,2382,3414.2,3414.2,6749
3620269,278,C1734,,,,,,,BAR TO BAR CLAMPS,13950,5580,0,11857.5,11857.5,SKIPPED,10602,10602,11857.5,11857.5,11857.5,5878.53,6835.5,6835.5,0,4185,5998.5,5998.5,11857.5
3620270,278,C1734,,,,,,,11X500 BARS,4760,1904,0,4046,4046,SKIPPED,3617.6,3617.6,4046,4046,4046,2005.86,2332.4,2332.4,0,1428,2046.8,2046.8,4046
3620271,278,C1713,,,,,,,BLUE PIN CAPS,1000,400,0,850,850,SKIPPED,760,760,850,850,850,421.4,490,490,0,300,430,430,850
3620272,278,C1820,,,,,,,AZURE XT DR MRI SURE SCAN,19557.35,7822.94,0,16623.75,16623.75,SKIPPED,14863.59,14863.59,16623.75,16623.75,16623.75,8241.47,9583.1,9583.1,0,5867.2,8409.66,8409.66,16623.75
3620273,278,E0749,,,,,,,Medtronic Spinal Cord Stim Kit( A/L/S),93867.5,37547,0,79787.38,79787.38,SKIPPED,1065.77,1065.77,79787.38,79787.38,79787.38,39555.77,45995.08,45995.08,0,28160.25,40363.03,40363.03,79787.38
3620274,360,22513,,,,,,,PERQ VERTEBRAL AUGMENTATION,12452.21,4980.88,1051.35,12452.21,10584.38,SKIPPED,12452.21,12452.21,10584.38,10584.38,10584.38,5247.36,1051.35,1051.35,SKIPPED,SKIPPED,5354.45,5354.45,10584.38
3630001,360,25565,,,,,,,TREAT FX EXTRA-ARTICUL,15044.99,6018,510.13,12788.24,12788.24,SKIPPED,6412.22,6412.22,12788.24,12788.24,12788.24,6339.96,510.13,510.13,SKIPPED,SKIPPED,6469.35,6469.35,12788.24
3630002,975,25607,,,,,,,TREAT FX EXTRA-ARTICUL PROF,2092.04,836.82,0,2092.04,1778.23,SKIPPED,2092.04,2092.04,1778.23,1778.23,1778.23,808.68,1025.1,1025.1,SKIPPED,SKIPPED,825.18,825.18,0
3630003,360,26605,,,,,,,TREAT METACARPAL FX,1152.49,461,87.17,1020.78,979.62,SKIPPED,1020.78,1020.78,979.62,979.62,979.62,485.66,87.17,87.17,SKIPPED,SKIPPED,495.57,495.57,979.62
3630004,975,26605,,,,,,,TREAT METACARPAL FX PROF,866.79,346.72,0,866.79,736.77,SKIPPED,866.79,866.79,736.77,736.77,736.77,331.1,424.73,424.73,SKIPPED,SKIPPED,337.86,337.86,0
3630005,272,,,,,,,,2.0 PEG DRIVER,78,31.2,0,66.3,66.3,SKIPPED,59.28,59.28,66.3,66.3,66.3,32.87,38.22,38.22,0,23.4,33.54,33.54,66.3
3630006,360,23700,,,,,,,FIXATION OF SHOULDER,4525.51,1810.2,510.13,4525.51,3846.68,SKIPPED,4525.51,4525.51,3846.68,3846.68,3846.68,1907.05,510.13,510.13,SKIPPED,SKIPPED,1945.97,1945.97,3846.68
3630007,975,23700,,,,,,,FIXATION OF SHOULDER PROF,556.95,222.78,0,556.95,473.41,SKIPPED,556.95,556.95,473.41,473.41,473.41,214.28,272.91,272.91,SKIPPED,SKIPPED,218.65,218.65,0
3630008,360,20610,,,,,,,DRAIN / INJ JOINT/BURSA,1474.64,589.86,0,1253.44,1253.44,SKIPPED,138.51,138.51,1253.44,1253.44,1253.44,621.42,24.83,24.83,0,442.39,634.1,634.1,1253.44
3630009,975,20610,,,,,,,DRAIN / INJ JOINT/BURSA PROF,166.44,66.58,0,141.47,141.47,SKIPPED,138.51,138.51,141.47,141.47,141.47,49.19,81.56,81.56,0,49.93,50.19,50.19,0
3630010,278,,,,,,,,HOLE PLATE,3208,1283.2,0,2726.8,2726.8,SKIPPED,2438.08,2438.08,2726.8,2726.8,2726.8,1351.85,1571.92,1571.92,0,962.4,1379.44,1379.44,2726.8
3630011,278,,,,,,,,2.8/4.0 DRILL BIT,235,94,0,199.75,199.75,SKIPPED,178.6,178.6,199.75,199.75,199.75,99.03,115.15,115.15,0,70.5,101.05,101.05,199.75
3630012,278,,,,,,,,K-WIRE all sizes,750,300,0,637.5,637.5,SKIPPED,570,570,637.5,637.5,637.5,316.05,367.5,367.5,0,225,322.5,322.5,637.5
3630013,278,,,,,,,,3.8/3.5 SCREWS,265,106,0,225.25,225.25,SKIPPED,201.4,201.4,225.25,225.25,225.25,111.67,129.85,129.85,0,79.5,113.95,113.95,225.25
3630014,278,,,,,,,,LOCKING SCREW CAPS,168,67.2,0,142.8,142.8,SKIPPED,127.68,127.68,142.8,142.8,142.8,70.8,82.32,82.32,0,50.4,72.24,72.24,142.8
3630015,278,,,,,,,,THREADED PEGS(ALL SIZES),265,106,0,225.25,225.25,SKIPPED,201.4,201.4,225.25,225.25,225.25,111.67,129.85,129.85,0,79.5,113.95,113.95,225.25
3630016,278,,,,,,,,4.0 DRILL LONG/SHORT,238,95.2,0,202.3,202.3,SKIPPED,180.88,180.88,202.3,202.3,202.3,100.29,116.62,116.62,0,71.4,102.34,102.34,202.3
3630017,278,,,,,,,,PEGS (ALL SIZES),220,88,0,187,187,SKIPPED,167.2,167.2,187,187,187,92.71,107.8,107.8,0,66,94.6,94.6,187
3630018,278,,,,,,,,SPECIAL SUTURE MAXBRAID,60,24,0,51,51,SKIPPED,45.6,45.6,51,51,51,25.28,29.4,29.4,0,18,25.8,25.8,51
3630019,360,26615,,,,,,,TREATMENT METACARPAL FX,11852.22,4740.89,867.38,11852.22,10074.39,SKIPPED,11852.22,11852.22,10074.39,10074.39,10074.39,4994.52,867.38,867.38,SKIPPED,SKIPPED,5096.45,5096.45,10074.39
3630020,975,26615,,,,,,,TREATMENT METACARPAL FX PROF,1630.23,652.09,0,1630.23,1385.7,SKIPPED,1630.23,1630.23,1385.7,1385.7,1385.7,631.93,798.81,798.81,SKIPPED,SKIPPED,644.83,644.83,0
3630021,278,,,,,,,,11 MM CARBON FIBER ROD,955,382,0,811.75,811.75,SKIPPED,725.8,725.8,811.75,811.75,811.75,402.44,467.95,467.95,0,286.5,410.65,410.65,811.75
3630022,278,,,,,,,,OPEN ADJ CLAMP,710,284,0,603.5,603.5,SKIPPED,539.6,539.6,603.5,603.5,603.5,299.19,347.9,347.9,0,213,305.3,305.3,603.5
3630023,278,,,,,,,,LG COMBI CLAMP,2365,946,0,2010.25,2010.25,SKIPPED,1797.4,1797.4,2010.25,2010.25,2010.25,996.61,1158.85,1158.85,0,709.5,1016.95,1016.95,2010.25
3630024,278,,,,,,,,5.0 MM SCHANZ SCREW (ALL SIZES),633,253.2,0,538.05,538.05,SKIPPED,481.08,481.08,538.05,538.05,538.05,266.75,310.17,310.17,0,189.9,272.19,272.19,538.05
3630025,278,,,,,,,,1/3 TUBULAR -7 HOLE,1457.5,583,0,1238.88,1238.88,SKIPPED,1107.7,1107.7,1238.88,1238.88,1238.88,614.2,714.18,714.18,0,437.25,626.73,626.73,1238.88
3630026,278,,,,,,,,3.5 CORTEX SCREW (ALL SIZES),150,60,0,127.5,127.5,SKIPPED,114,114,127.5,127.5,127.5,63.21,73.5,73.5,0,45,64.5,64.5,127.5
3630027,278,,,,,,,,3.5 LOCKING SCREWS (ALL SIZES),375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3630028,278,,,,,,,,4.0 CANNULATED SCREWS (ALL SIZES),690,276,0,586.5,586.5,SKIPPED,524.4,524.4,586.5,586.5,586.5,290.77,338.1,338.1,0,207,296.7,296.7,586.5
3630029,278,,,,,,,,MARXMEN- CURVED,858,343.2,0,729.3,729.3,SKIPPED,652.08,652.08,729.3,729.3,729.3,361.56,420.42,420.42,0,257.4,368.94,368.94,729.3
3630030,278,,,,,,,,MARXMEN-STRAIGHT,858,343.2,0,729.3,729.3,SKIPPED,652.08,652.08,729.3,729.3,729.3,361.56,420.42,420.42,0,257.4,368.94,368.94,729.3
3630031,278,,,,,,,,16 MM WASHER LOC EXT,1148,459.2,0,975.8,975.8,SKIPPED,872.48,872.48,975.8,975.8,975.8,483.77,562.52,562.52,0,344.4,493.64,493.64,975.8
3630032,278,,,,,,,,6x64 WASHER LOC SCREW,400,160,0,340,340,SKIPPED,304,304,340,340,340,168.56,196,196,0,120,172,172,340
3630033,360,27814,,,,,,,TREATMENT ANKLE FX,15346.65,6138.66,1051.35,15346.65,13044.65,SKIPPED,15346.65,15346.65,13044.65,13044.65,13044.65,6467.08,1051.35,1051.35,SKIPPED,SKIPPED,6599.06,6599.06,13044.65
3630034,975,27814,,,,,,,TREATMENT ANKLE FX PROF,2214.79,885.92,0,2214.79,1882.57,SKIPPED,2214.79,2214.79,1882.57,1882.57,1882.57,835.95,1085.25,1085.25,SKIPPED,SKIPPED,853.01,853.01,0
3630035,360,27552,,,,,,,TREATMENT KNEE DISLOCATION,5150.4,2060.16,510.13,5150.4,4377.84,SKIPPED,5150.4,5150.4,4377.84,4377.84,4377.84,2170.38,510.13,510.13,SKIPPED,SKIPPED,2214.67,2214.67,4377.84
3630036,975,27552,,,,,,,TREATMENT KNEE DISLOCATION PROF,1783.4,713.36,0,1783.4,1515.89,SKIPPED,1783.4,1783.4,1515.89,1515.89,1515.89,695.41,873.87,873.87,SKIPPED,SKIPPED,709.6,709.6,0
3630037,278,,,,,,,,DISTAL CLAVICAL PLATE,5323,2129.2,0,4524.55,4524.55,SKIPPED,4045.48,4045.48,4524.55,4524.55,4524.55,2243.11,2608.27,2608.27,0,1596.9,2288.89,2288.89,4524.55
3630038,278,,,,,,,,2.4mm LOCKING SCREW (ALL SIZES),350,140,0,297.5,297.5,SKIPPED,266,266,297.5,297.5,297.5,147.49,171.5,171.5,0,105,150.5,150.5,297.5
3630039,278,,,,,,,,2.7mm LCP PLATE 8 HOLE,861.25,344.5,0,732.06,732.06,SKIPPED,654.55,654.55,732.06,732.06,732.06,362.93,422.01,422.01,0,258.38,370.34,370.34,732.06
3630040,278,,,,,,,,2.7mm CORTEX SCREWS (ALL SIZES),362.5,145,0,308.12,308.12,SKIPPED,275.5,275.5,308.12,308.12,308.12,152.76,177.62,177.62,0,108.75,155.88,155.88,308.12
3630041,278,,,,,,,,2.7mm LOCKING SCREWS (ALL SIZES),308.75,123.5,0,262.44,262.44,SKIPPED,234.65,234.65,262.44,262.44,262.44,130.1,151.29,151.29,0,92.62,132.76,132.76,262.44
3630042,360,29882,,,,,,,KNEE ARTHROSCOPY W/ MENISCUS REPAIR,9034.64,3613.86,867.38,9034.64,7679.44,SKIPPED,9034.64,9034.64,7679.44,7679.44,7679.44,3807.2,867.38,867.38,SKIPPED,SKIPPED,3884.9,3884.9,7679.44
3630043,975,29882,,,,,,,KNEE ARTHROSCOPY W/ MENISCUS REPAIR PROF,2004.93,801.97,0,2004.93,1704.19,SKIPPED,2004.93,2004.93,1704.19,1704.19,1704.19,752.22,982.42,982.42,SKIPPED,SKIPPED,767.57,767.57,0
3630044,360,20900,,,,,,,REMOVAL OF BONE FOR GRAFT,6292.57,2517.03,1051.35,6292.57,5348.68,SKIPPED,6292.57,6292.57,5348.68,5348.68,5348.68,2651.69,1051.35,1051.35,SKIPPED,SKIPPED,2705.81,2705.81,5348.68
3630045,975,20900,,,,,,,REMOVAL OF BONE FOR GRAFT PROF,552.54,221.02,0,552.54,469.66,SKIPPED,552.54,552.54,469.66,469.66,469.66,197.01,270.74,270.74,SKIPPED,SKIPPED,201.03,201.03,0
3630046,360,23605,,,,,,,TRT HUMERUS FX(CLOSED),3989.2,1595.68,510.13,3989.2,3390.82,SKIPPED,3989.2,3989.2,3390.82,3390.82,3390.82,1681.05,510.13,510.13,SKIPPED,SKIPPED,1715.36,1715.36,3390.82
3630047,975,23605,,,,,,,TRT HUMERUS FX(CLOSED) PROF,1205.55,482.22,0,1205.55,1024.72,SKIPPED,1205.55,1205.55,1024.72,1024.72,1024.72,471.62,590.72,590.72,SKIPPED,SKIPPED,481.24,481.24,0
3630048,360,23615,,,,,,,TRT HUMERUS FX(OPEN),19273.53,7709.41,1051.35,19273.53,16382.5,SKIPPED,19273.53,19273.53,16382.5,16382.5,16382.5,8121.87,1051.35,1051.35,SKIPPED,SKIPPED,8287.62,8287.62,16382.5
3630049,975,23615,,,,,,,TRT HUMERUS FX(OPEN) PROF,2532.39,1012.96,0,2532.39,2152.53,SKIPPED,2532.39,2532.39,2152.53,2152.53,2152.53,963.64,1240.87,1240.87,SKIPPED,SKIPPED,983.31,983.31,0
3630050,360,29876,,,,,,,KNEE ARTHROSCOPY(MEDIAL & LATERAL),8470.35,3388.14,867.38,8470.35,7199.8,SKIPPED,8470.35,8470.35,7199.8,7199.8,7199.8,3569.4,867.38,867.38,SKIPPED,SKIPPED,3642.25,3642.25,7199.8
3630051,975,29876,,,,,,,KNEE ARTHROSCOPY (MEDIAL & LATERAL) PROF,1879.35,751.74,0,1879.35,1597.45,SKIPPED,1879.35,1879.35,1597.45,1597.45,1597.45,713.51,920.88,920.88,SKIPPED,SKIPPED,728.07,728.07,0
3630052,360,25575,,,,,,,TREAT FX RADIUS/ULNAR,20121.14,8048.46,1051.35,20121.14,17102.97,SKIPPED,20121.14,20121.14,17102.97,17102.97,17102.97,8479.05,1051.35,1051.35,SKIPPED,SKIPPED,8652.09,8652.09,17102.97
3630053,975,25575,,,,,,,TREAT FX RADIUS/ULNAR PROF,2570.84,1028.34,0,2570.84,2185.21,SKIPPED,2570.84,2570.84,2185.21,2185.21,2185.21,987.01,1259.71,1259.71,SKIPPED,SKIPPED,1007.15,1007.15,0
3630054,278,,,,,,,,3.5 VA LOCKING SCREW (ALL SIZES),503,201.2,0,427.55,427.55,SKIPPED,382.28,382.28,427.55,427.55,427.55,211.96,246.47,246.47,0,150.9,216.29,216.29,427.55
3630055,278,,,,,,,,PROXIMAL TIBIA PLATE 8 HOLE,8365,3346,0,7110.25,7110.25,SKIPPED,6357.4,6357.4,7110.25,7110.25,7110.25,3525.01,4098.85,4098.85,0,2509.5,3596.95,3596.95,7110.25
3630056,278,,,,,,,,3.5 POSTEROMEDIAL PROX PLATE TIB 2 HOLE,3148,1259.2,0,2675.8,2675.8,SKIPPED,2392.48,2392.48,2675.8,2675.8,2675.8,1326.57,1542.52,1542.52,0,944.4,1353.64,1353.64,2675.8
3630057,360,27758,,,,,,,TRT TIBIA FX,16577.13,6630.85,1051.35,16577.13,14090.56,SKIPPED,16577.13,16577.13,14090.56,14090.56,14090.56,6985.61,1051.35,1051.35,SKIPPED,SKIPPED,7128.17,7128.17,14090.56
3630058,975,27758,,,,,,,TRT TIBIA FX PROF,2545.79,1018.32,0,2545.79,2163.92,SKIPPED,2545.79,2545.79,2163.92,2163.92,2163.92,977.72,1247.44,1247.44,SKIPPED,SKIPPED,997.67,997.67,0
3630059,360,27570,,,,,,,FIXATION OF KNEE JOINT,3361.23,1344.49,510.13,3361.23,2857.05,SKIPPED,3361.23,3361.23,2857.05,2857.05,2857.05,1416.42,510.13,510.13,SKIPPED,SKIPPED,1445.33,1445.33,2857.05
3630060,975,27570,,,,,,,FIXATION OF KNEE JOINT PROF,427.1,170.84,0,427.1,363.04,SKIPPED,427.1,427.1,363.04,363.04,363.04,166.88,209.28,209.28,SKIPPED,SKIPPED,170.29,170.29,0
3630061,360,29806,,,,,,,SHOULDER ARTHROSCOPY,11642.09,4656.84,1051.35,11642.09,9895.78,SKIPPED,11642.09,11642.09,9895.78,9895.78,9895.78,4905.98,1051.35,1051.35,SKIPPED,SKIPPED,5006.1,5006.1,9895.78
3630062,975,29806,,,,,,,SHOULDER ARTHROSCOPY PROF,3045.24,1218.1,0,3045.24,2588.45,SKIPPED,3045.24,3045.24,2588.45,2588.45,2588.45,1153.89,1492.17,1492.17,SKIPPED,SKIPPED,1177.44,1177.44,0
3630063,360,77071,,,,,,,X-RAY STRESS VIEW,500.93,200.37,0,425.79,425.79,SKIPPED,315.57,315.57,425.79,425.79,425.79,211.09,0,0,0,39.88,215.4,215.4,425.79
3630064,975,77071,,,,,,,X-RAY STRESS VIEW PROF,142.6,57.04,0,142.6,121.21,SKIPPED,142.6,142.6,121.21,121.21,121.21,61.01,101.93,101.93,0,39.88,62.26,62.26,0
3630065,360,27792,,,,,,,TRT ANKLE FX,13746.98,5498.79,1051.35,13746.98,11684.93,SKIPPED,13746.98,13746.98,11684.93,11684.93,11684.93,5792.98,1051.35,1051.35,SKIPPED,SKIPPED,5911.2,5911.2,11684.93
3630066,975,27792,,,,,,,TRT ANKLE FX PROF,1870.38,748.15,0,1870.38,1589.82,SKIPPED,1870.38,1870.38,1589.82,1589.82,1589.82,707.28,916.49,916.49,SKIPPED,SKIPPED,721.71,721.71,0
3630067,360,29807,,,,,,,SHOULDER ARTHROSCOPY,10320.35,4128.14,1051.35,10320.35,8772.3,SKIPPED,10320.35,10320.35,8772.3,8772.3,8772.3,4349,1051.35,1051.35,SKIPPED,SKIPPED,4437.75,4437.75,8772.3
3630068,975,29807,,,,,,,SHOULDER ARTHROSCOPY PROF,2966.58,1186.63,0,2966.58,2521.59,SKIPPED,2966.58,2966.58,2521.59,2521.59,2521.59,1125.84,1453.62,1453.62,SKIPPED,SKIPPED,1148.82,1148.82,0
3630069,360,26055,,,,,,,INCISE FINGER TENDON SHEATH,5208.16,2083.26,510.13,5208.16,4426.94,SKIPPED,5208.16,5208.16,4426.94,4426.94,4426.94,2194.72,510.13,510.13,SKIPPED,SKIPPED,2239.51,2239.51,4426.94
3630070,975,26055,,,,,,,INCISE FINGER TENDON SHEATH PROF,1100.31,440.12,0,1100.31,935.26,SKIPPED,1100.31,1100.31,935.26,935.26,935.26,320.44,539.15,539.15,SKIPPED,SKIPPED,326.98,326.98,0
3630071,360,27618,,,,,,,EXC LEG/ANKLE TUM <3CM,7137.63,2855.05,414.14,6403.14,6066.99,SKIPPED,6403.14,6403.14,6066.99,6066.99,6066.99,3007.8,414.14,414.14,SKIPPED,SKIPPED,3069.18,3069.18,6066.99
3630072,975,27618,,,,,,,EXC LEG/ANKLE TUM<3CM PROF,1102.63,441.05,0,1102.63,937.24,SKIPPED,1102.63,1102.63,937.24,937.24,937.24,334.75,540.29,540.29,SKIPPED,SKIPPED,341.58,341.58,0
3630073,360,24999,,,,,,,UPPER ARM/ELBOW SURG UNSPEC.,3724.8,1489.92,0,3166.08,3166.08,SKIPPED,1020.78,1020.78,3166.08,3166.08,3166.08,1569.63,0,0,0,1117.44,1601.66,1601.66,3166.08
3630074,975,24999,,,,,,,UPPER AMR/ELBOW SURG UNSPEC PROF,554.13,221.65,0,554.13,471.01,SKIPPED,554.13,554.13,471.01,471.01,471.01,0,271.52,271.52,0,166.24,0,0,0
3630075,360,29875,,,,,,,KNEE ARTHROSCOPY,8120.86,3248.34,867.38,8120.86,6902.73,SKIPPED,8120.86,8120.86,6902.73,6902.73,6902.73,3422.13,867.38,867.38,SKIPPED,SKIPPED,3491.97,3491.97,6902.73
3630076,975,29875,,,,,,,KNEE ARTHROSCOPY PROF,1427.2,570.88,0,1427.2,1213.12,SKIPPED,1427.2,1427.2,1213.12,1213.12,1213.12,543.16,699.33,699.33,SKIPPED,SKIPPED,554.24,554.24,0
3630078,360,26727,,,,,,,TRT FINGER FX,8377.22,3350.89,867.38,8377.22,7120.64,SKIPPED,8377.22,8377.22,7120.64,7120.64,7120.64,3530.16,867.38,867.38,SKIPPED,SKIPPED,3602.2,3602.2,7120.64
3630079,975,26727,,,,,,,TRT FINGER FX PROF,1337.82,535.13,0,1337.82,1137.15,SKIPPED,1337.82,1337.82,1137.15,1137.15,1137.15,523.43,655.53,655.53,SKIPPED,SKIPPED,534.11,534.11,0
3630080,360,27766,,,,,,,OPTX MEDICAL ANKLE FX,12330.89,4932.36,1051.35,12330.89,10481.26,SKIPPED,12330.89,12330.89,10481.26,10481.26,10481.26,5196.23,1051.35,1051.35,SKIPPED,SKIPPED,5302.28,5302.28,10481.26
3630081,975,27766,,,,,,,OPTX MEDIAL ANKLE FX PROF,1761.17,704.47,0,1761.17,1496.99,SKIPPED,1761.17,1761.17,1496.99,1496.99,1496.99,663.1,862.97,862.97,SKIPPED,SKIPPED,676.63,676.63,0
3630082,360,27524,,,,,,,TRT KNEE CAP FX,17157.79,6863.12,1051.35,17157.79,14584.12,SKIPPED,17157.79,17157.79,14584.12,14584.12,14584.12,7230.29,1051.35,1051.35,SKIPPED,SKIPPED,7377.85,7377.85,14584.12
3630083,975,27524,,,,,,,TRT KNEE CAP FX PROF,2175.11,870.04,0,2175.11,1848.84,SKIPPED,2175.11,2175.11,1848.84,1848.84,1848.84,823.1,1065.8,1065.8,SKIPPED,SKIPPED,839.9,839.9,0
3630084,360,36556,,,,,,,INSERT NON-TUNNEL CV CATH,3780.95,1512.38,414.14,3780.95,3213.81,SKIPPED,3780.95,3780.95,3213.81,3213.81,3213.81,1593.29,414.14,414.14,SKIPPED,SKIPPED,1625.81,1625.81,3213.81
3630085,975,36556,,,,,,,INSERT NON-TUNNEL CV CATH PROF,354.5,141.8,0,354.5,301.32,SKIPPED,354.5,354.5,301.32,301.32,301.32,91.88,173.7,173.7,SKIPPED,SKIPPED,93.76,93.76,0
3630086,360,25111,,,,,,,REMOVAL WRIST TENDON LESION,7456.83,2982.73,510.13,6412.22,6338.31,SKIPPED,6412.22,6412.22,6338.31,6338.31,6338.31,3142.31,510.13,510.13,SKIPPED,SKIPPED,3206.44,3206.44,6338.31
3630087,975,25111,,,,,,,REMOVE WRIST TENDON LESION,913.03,365.21,0,913.03,776.08,SKIPPED,913.03,913.03,776.08,776.08,776.08,357.19,447.38,447.38,SKIPPED,SKIPPED,364.48,364.48,0
3630088,360,27496,,,,,,,DECOMPRESSION OF THIGH/KNEE,8864.73,3545.89,867.38,8864.73,7535.02,SKIPPED,8864.73,8864.73,7535.02,7535.02,7535.02,3735.59,867.38,867.38,SKIPPED,SKIPPED,3811.83,3811.83,7535.02
3630089,975,27496,,,,,,,DECOMPRESSION OF THIGH/KNEE,1563.09,625.24,0,1563.09,1328.63,SKIPPED,1563.09,1563.09,1328.63,1328.63,1328.63,601.36,765.91,765.91,SKIPPED,SKIPPED,613.63,613.63,0
3630090,360,29874,,,,,,,KNEE ARTHROSCOPY(REMOVE LOOSE BODY),10955.42,4382.17,867.38,10955.42,9312.11,SKIPPED,10955.42,10955.42,9312.11,9312.11,9312.11,4616.61,867.38,867.38,SKIPPED,SKIPPED,4710.83,4710.83,9312.11
3630091,975,29874,,,,,,,KNEE ARTHROSCOPY(REMOVE LOOSE BODY),1551.28,620.51,0,1551.28,1318.59,SKIPPED,1551.28,1551.28,1318.59,1318.59,1318.59,586.52,760.13,760.13,SKIPPED,SKIPPED,598.49,598.49,0
3630092,360,24341,,,,,,,RPR ARM TENDON,12565.81,5026.32,1051.35,12565.81,10680.94,SKIPPED,12565.81,12565.81,10680.94,10680.94,10680.94,5295.23,1051.35,1051.35,SKIPPED,SKIPPED,5403.3,5403.3,10680.94
3630093,975,24341,,,,,,,RPR ARM TENDON PROF,2143.89,857.56,0,2143.89,1822.31,SKIPPED,2143.89,2143.89,1822.31,1822.31,1822.31,815.04,1050.51,1050.51,SKIPPED,SKIPPED,831.67,831.67,0
3630094,360,11042,,,,,,,DEB SUBQ TISSUE 20 SQ CM/<,2872.23,1148.89,129.16,2441.4,2441.4,SKIPPED,1476.3,1476.3,2441.4,2441.4,2441.4,1210.36,129.16,129.16,SKIPPED,SKIPPED,1235.06,1235.06,2441.4
3630095,975,11042,,,,,,,DEB SUBQ TISSUE 20 SQ CM/<,223.13,89.25,0,223.13,189.66,SKIPPED,223.13,223.13,189.66,189.66,189.66,65.59,109.33,109.33,SKIPPED,SKIPPED,66.93,66.93,0
3630096,360,11045,,,,,,,DEB SUBQ TISSE ADD-ON,1400.67,560.27,0,1190.57,1190.57,SKIPPED,0,0,1190.57,1190.57,1190.57,590.24,0,0,0,420.2,602.29,602.29,1190.57
3630097,975,11045,,,,,,,DEB SUBQ TISSUE ADD-ON,95.29,38.12,0,81,81,SKIPPED,0,0,81,81,81,28.25,46.69,46.69,0,28.59,28.83,28.83,0
3630098,360,23120,,,,,,,PARTIAL REMOVAL COLLAR BONE,7087.37,2834.95,867.38,7087.37,6024.26,SKIPPED,7087.37,7087.37,6024.26,6024.26,6024.26,2986.62,867.38,867.38,SKIPPED,SKIPPED,3047.57,3047.57,6024.26
3630099,975,23120,,,,,,,PATIAL REMOVAL COLLAR BONE,1681.29,672.52,0,1681.29,1429.1,SKIPPED,1681.29,1681.29,1429.1,1429.1,1429.1,643.59,823.83,823.83,SKIPPED,SKIPPED,656.72,656.72,0
3630100,360,29822,,,,,,,SHOULDER ARTHROSCOPY DEBRIDMENT,7764.12,3105.65,867.38,7764.12,6599.5,SKIPPED,7764.12,7764.12,6599.5,6599.5,6599.5,3271.8,867.38,867.38,SKIPPED,SKIPPED,3338.57,3338.57,6599.5
3630101,975,29822,,,,,,,SHOULDER ARTHROSCOPY DEBRIDEMENT,1631.16,652.46,0,1631.16,1386.49,SKIPPED,1631.16,1631.16,1386.49,1386.49,1386.49,592.49,799.27,799.27,SKIPPED,SKIPPED,604.58,604.58,0
3630102,278,,,,,,,,TOTAL KNEE UNVS.TIBIAL BASEPLATE-STRYKER,11877.5,4751,0,10095.88,10095.88,SKIPPED,9026.9,9026.9,10095.88,10095.88,10095.88,5005.18,5819.98,5819.98,0,3563.25,5107.33,5107.33,10095.88
3630103,278,,,,,,,,SYMMETRIC PATELLA-STRYKER,2460,984,0,2091,2091,SKIPPED,1869.6,1869.6,2091,2091,2091,1036.64,1205.4,1205.4,0,738,1057.8,1057.8,2091
3630104,278,,,,,,,,POSTERIOR STABILIZED FEMORAL-STRYKER,7204,2881.6,0,6123.4,6123.4,SKIPPED,5475.04,5475.04,6123.4,6123.4,6123.4,3035.77,3529.96,3529.96,0,2161.2,3097.72,3097.72,6123.4
3630105,278,,,,,,,,TIBIAL BEARING INSERT-STRYKER,7494,2997.6,0,6369.9,6369.9,SKIPPED,5695.44,5695.44,6369.9,6369.9,6369.9,3157.97,3672.06,3672.06,0,2248.2,3222.42,3222.42,6369.9
3630106,278,,,,,,,,FEMORAL DISTAL FIXATION PEG-STRYKER,1605,642,0,1364.25,1364.25,SKIPPED,1219.8,1219.8,1364.25,1364.25,1364.25,676.35,786.45,786.45,0,481.5,690.15,690.15,1364.25
3630107,278,C1734,,,,,,,ANTIBIOTIC SIMPLEX(BONE CEMENT)-STRYKER,951,380.4,0,808.35,808.35,SKIPPED,722.76,722.76,808.35,808.35,808.35,400.75,465.99,465.99,0,285.3,408.93,408.93,808.35
3630108,272,,,,,,,,OSCILLATING SAW BLADE 19MM-ZIMMER,92.6,37.04,0,78.71,78.71,SKIPPED,70.38,70.38,78.71,78.71,78.71,39.02,45.37,45.37,0,27.78,39.82,39.82,78.71
3630109,272,,,,,,,,RECIPRCATING SAW BLADE 13MM-ZIMMER,32,12.8,0,27.2,27.2,SKIPPED,24.32,24.32,27.2,27.2,27.2,13.48,15.68,15.68,0,9.6,13.76,13.76,27.2
3630110,272,,,,,,,,PULSAVAXC PLUS WOUND DEBRID,71.7,28.68,0,60.94,60.94,SKIPPED,54.49,54.49,60.94,60.94,60.94,30.21,35.13,35.13,0,21.51,30.83,30.83,60.94
3630111,272,,,,,,,,ADVANCED CEMENT MIXING BOWL,140,56,0,119,119,SKIPPED,106.4,106.4,119,119,119,59,68.6,68.6,0,42,60.2,60.2,119
3630112,270,,,,,,,,CONTIPLEX CONTINUOUS NERVE BLOCK,85.68,34.27,0,72.83,72.83,SKIPPED,65.12,65.12,72.83,72.83,72.83,36.1,41.98,41.98,0,25.7,36.84,36.84,72.83
3630113,278,,,,,,,,STERILE KNEE INSTR. DISP. HEADLESS PINS,1537.5,615,0,1306.88,1306.88,SKIPPED,1168.5,1168.5,1306.88,1306.88,1306.88,647.91,753.38,753.38,0,461.25,661.13,661.13,1306.88
3630114,272,,,,,,,,ON Q PUMP-SINGLE,920.6,368.24,0,782.51,782.51,SKIPPED,699.66,699.66,782.51,782.51,782.51,387.94,451.09,451.09,0,276.18,395.86,395.86,782.51
3630115,272,,,,,,,,ON Q PUMP-DUAL,1111.3,444.52,0,944.6,944.6,SKIPPED,844.59,844.59,944.6,944.6,944.6,468.3,544.54,544.54,0,333.39,477.86,477.86,944.6
3630116,360,27440,,,,,,,REVISION OF KNEE JOINT(TOTAL KNEE),22900.63,9160.25,1051.35,22900.63,19465.54,SKIPPED,22900.63,22900.63,19465.54,19465.54,19465.54,9650.32,1051.35,1051.35,SKIPPED,SKIPPED,9847.27,9847.27,19465.54
3630117,975,27440,,,,,,,REVISION OF KNEE JOINT(TOTAL KNEE) PROF,2304.84,921.94,0,2304.84,1959.11,SKIPPED,2304.84,2304.84,1959.11,1959.11,1959.11,870.7,1129.37,1129.37,SKIPPED,SKIPPED,888.47,888.47,0
3630118,360,20680,,,,,,,REMOVAL OF SUPPORT IMPLANT,5823.67,2329.47,582.36,5823.67,4950.12,SKIPPED,5823.67,5823.67,4950.12,4950.12,4950.12,2454.1,582.36,582.36,SKIPPED,SKIPPED,2504.18,2504.18,4950.12
3630119,975,20680,,,,,,,REMOVAL OF SUPPORT IMPLANT,1410.19,564.08,0,1410.19,1198.66,SKIPPED,1410.19,1410.19,1198.66,1198.66,1198.66,456.9,690.99,690.99,SKIPPED,SKIPPED,466.22,466.22,0
3630120,360,11043,,,,,,,DEB MUSC/FASCIA 20SQ CM/<,3865.9,1546.36,200.91,3286.02,3286.02,SKIPPED,2318.95,2318.95,3286.02,3286.02,3286.02,1629.09,200.91,200.91,SKIPPED,SKIPPED,1662.34,1662.34,3286.02
3630121,975,11043,,,,,,,DEB MUSC/FASCIA 20 SQ CM/<,560.2,224.08,0,560.2,476.17,SKIPPED,560.2,560.2,476.17,476.17,476.17,166.79,274.5,274.5,SKIPPED,SKIPPED,170.19,170.19,0
3630122,360,20103,,,,,,,EXPLORE WOUND EXTREMITY,4370.31,1748.12,246.58,3714.76,3714.76,SKIPPED,2721.04,2721.04,3714.76,3714.76,3714.76,1841.65,246.58,246.58,SKIPPED,SKIPPED,1879.23,1879.23,3714.76
3630123,975,20103,,,,,,,EXPLORE WOUND EXTREMITY,1004.67,401.87,0,1004.67,853.97,SKIPPED,1004.67,1004.67,853.97,853.97,853.97,374.96,492.29,492.29,SKIPPED,SKIPPED,382.61,382.61,0
3630126,360,23455,,,,,,,REPAIR SHOULDER CAPSULE,18570.24,7428.1,1051.35,18570.24,15784.7,SKIPPED,18570.24,18570.24,15784.7,15784.7,15784.7,7825.5,1051.35,1051.35,SKIPPED,SKIPPED,7985.2,7985.2,15784.7
3630127,975,23455,,,,,,,REPAIR SHOULDER CAPSULE,2898.76,1159.5,0,2898.76,2463.95,SKIPPED,2898.76,2898.76,2463.95,2463.95,2463.95,1081.6,1420.39,1420.39,SKIPPED,SKIPPED,1103.67,1103.67,0
3630128,360,20600,,,,,,,DRAIN/INJ JOINT W/O US,1196.71,478.68,0,1017.2,1017.2,SKIPPED,109.44,109.44,1017.2,1017.2,1017.2,504.3,19.92,19.92,0,359.01,514.59,514.59,1017.2
3630129,975,20600,,,,,,,DRAIN /INJ JOINT W/O US,103.46,41.38,0,103.46,87.94,SKIPPED,103.46,103.46,87.94,87.94,87.94,38.96,50.7,50.7,0,31.04,39.76,39.76,0
3630130,360,11044,,,,,,,DEB BONE 20 SQ CM/<,4717.56,1887.02,414.14,4717.56,4009.93,SKIPPED,4717.56,4717.56,4009.93,4009.93,4009.93,1987.98,414.14,414.14,SKIPPED,SKIPPED,2028.55,2028.55,4009.93
3630131,975,11044,,,,,,,DEB BONE 20 SQ CM/<,676.62,270.65,0,676.62,575.13,SKIPPED,676.62,676.62,575.13,575.13,575.13,243.61,331.54,331.54,SKIPPED,SKIPPED,248.58,248.58,0
36301313,270,,,,,,,,TPS POWER,219,87.6,0,186.15,186.15,SKIPPED,166.44,166.44,186.15,186.15,186.15,92.29,107.31,107.31,0,65.7,94.17,94.17,186.15
3630132,360,13132,,,,,,,CMPLX RPR 2.6CM-7.5CM,2462.96,985.18,200.91,2318.95,2093.52,SKIPPED,2318.95,2318.95,2093.52,2093.52,2093.52,1037.89,200.91,200.91,SKIPPED,SKIPPED,1059.07,1059.07,2093.52
3630133,975,13132,,,,,,,CMPLX RPR 2.6CM-7.5CM,908.72,363.49,0,908.72,772.41,SKIPPED,908.72,908.72,772.41,772.41,772.41,329.75,445.27,445.27,SKIPPED,SKIPPED,336.48,336.48,0
3630134,360,13133,,,,,,,CMPLX RPR EACH ADTL 5CM OR LESS,1555.85,622.34,0,1322.47,1322.47,SKIPPED,0,0,1322.47,1322.47,1322.47,655.64,0,0,0,466.76,669.02,669.02,1322.47
3630135,975,13133,,,,,,,CMPLX RPR EACH ADTL 5CM OR LESS,381.12,152.45,0,323.95,323.95,SKIPPED,0,0,323.95,323.95,323.95,136.17,186.75,186.75,0,114.34,138.95,138.95,0
3630136,360,25609,,,,,,,TREAT FX RADIAL 3+ FRAG,16349.58,6539.83,1051.35,16349.58,13897.14,SKIPPED,16349.58,16349.58,13897.14,13897.14,13897.14,6889.71,1051.35,1051.35,SKIPPED,SKIPPED,7030.32,7030.32,13897.14
3630137,975,25609,,,,,,,TREAT FX RADIAL 3+ FRAG,3021.52,1208.61,0,3021.52,2568.29,SKIPPED,3021.52,3021.52,2568.29,2568.29,2568.29,1147.83,1480.54,1480.54,SKIPPED,SKIPPED,1171.26,1171.26,0
3630138,360,27337,,,,,,,EXC THIGH/KNEE LES SC 3+CM,8717.06,3486.82,582.36,8717.06,7409.5,SKIPPED,8717.06,8717.06,7409.5,7409.5,7409.5,3673.37,582.36,582.36,SKIPPED,SKIPPED,3748.34,3748.34,7409.5
3630139,975,27337,,,,,,,EXC THIGH/KNEE LES SC 3+CM,1211.6,484.64,0,1211.6,1029.86,SKIPPED,1211.6,1211.6,1029.86,1029.86,1029.86,456.88,593.68,593.68,SKIPPED,SKIPPED,466.2,466.2,0
3630140,278,,,,,,,,ON Q PAIN PUMP(SILVER SOAKER),2090,836,0,1776.5,1776.5,SKIPPED,1588.4,1588.4,1776.5,1776.5,1776.5,880.73,1024.1,1024.1,0,627,898.7,898.7,1776.5
3630141,360,27347,,,,,,,REMOVE KNEE CYST,6837.18,2734.87,867.38,6837.18,5811.6,SKIPPED,6837.18,6837.18,5811.6,5811.6,5811.6,2881.19,867.38,867.38,SKIPPED,SKIPPED,2939.99,2939.99,5811.6
3630142,975,27347,,,,,,,REMOVE KNEE CYST,1454.94,581.98,0,1454.94,1236.7,SKIPPED,1454.94,1454.94,1236.7,1236.7,1236.7,576.75,712.92,712.92,SKIPPED,SKIPPED,588.52,588.52,0
3630143,360,28476,,,,,,,PERCUTANEOUS SKELETAL FIXATION,5748.08,2299.23,867.38,5748.08,4885.87,SKIPPED,5748.08,5748.08,4885.87,4885.87,4885.87,2422.24,867.38,867.38,SKIPPED,SKIPPED,2471.67,2471.67,4885.87
3630144,975,28476,,,,,,,PERCUTANEOUS SKELETAL FIXATION PROF,962.46,384.98,0,962.46,818.09,SKIPPED,962.46,962.46,818.09,818.09,818.09,430.88,471.61,471.61,SKIPPED,SKIPPED,439.67,439.67,0
3630145,360,27860,,,,,,,FIXATION OF ANKLE JOINT,3651.48,1460.59,867.38,3651.48,3103.76,SKIPPED,3651.48,3651.48,3103.76,3103.76,3103.76,1538.74,867.38,867.38,SKIPPED,SKIPPED,1570.14,1570.14,3103.76
3630146,975,27860,,,,,,,FIXATION OF ANKLE JOINT PROF,478.41,191.36,0,478.41,406.65,SKIPPED,478.41,478.41,406.65,406.65,406.65,182.02,234.42,234.42,SKIPPED,SKIPPED,185.73,185.73,0
3630147,360,26725,,,,,,,TRT FINGER FX,1063.77,425.51,87.17,904.2,904.2,SKIPPED,531.76,531.76,904.2,904.2,904.2,448.27,87.17,87.17,SKIPPED,SKIPPED,457.42,457.42,904.2
3630148,975,26725,,,,,,,TRT FINGER FX PROF,824.57,329.83,0,700.88,700.88,SKIPPED,531.76,531.76,700.88,700.88,700.88,337.59,404.04,404.04,SKIPPED,SKIPPED,344.48,344.48,0
3630149,360,27340,,,,,,,REMOVE KNEE CAP BURSA,8406.03,3362.41,867.38,8406.03,7145.13,SKIPPED,8406.03,8406.03,7145.13,7145.13,7145.13,3542.3,867.38,867.38,SKIPPED,SKIPPED,3614.59,3614.59,7145.13
3630150,975,27340,,,,,,,REMOVE KNEE CAP BURSA,1020.23,408.09,0,1020.23,867.2,SKIPPED,1020.23,1020.23,867.2,867.2,867.2,412.24,499.91,499.91,SKIPPED,SKIPPED,420.65,420.65,0
3630151,360,27380,,,,,,,REPAIR KNEE CAP TENDON,12047.61,4819.04,1051.35,12047.61,10240.47,SKIPPED,12047.61,12047.61,10240.47,10240.47,10240.47,5076.86,1051.35,1051.35,SKIPPED,SKIPPED,5180.47,5180.47,10240.47
3630152,975,27380,,,,,,,REPAIR KNEE CAP TENDON,1632.24,652.9,0,1632.24,1387.4,SKIPPED,1632.24,1632.24,1387.4,1387.4,1387.4,687.5,799.8,799.8,SKIPPED,SKIPPED,701.53,701.53,0
3630153,360,27630,,,,,,,REMOVAL OF TENDON LESION,7506.94,3002.78,867.38,7506.94,6380.9,SKIPPED,7506.94,7506.94,6380.9,6380.9,6380.9,3163.42,867.38,867.38,SKIPPED,SKIPPED,3227.98,3227.98,6380.9
3630154,975,27630,,,,,,,REMOVAL OF TENDON LESION PROF,1007.49,403,0,1007.49,856.37,SKIPPED,1007.49,1007.49,856.37,856.37,856.37,394.4,493.67,493.67,SKIPPED,SKIPPED,402.45,402.45,0
3630155,360,64718,,,,,,,REVISE ULNAR NERVE-ELBOW,8414.47,3365.79,510.13,7649.88,7152.3,SKIPPED,7649.88,7649.88,7152.3,7152.3,7152.3,3545.86,510.13,510.13,SKIPPED,SKIPPED,3618.22,3618.22,7152.3
3630156,975,64718,,,,,,,REVISE ULNAR NERVE-ELBOW,1625.27,650.11,0,1625.27,1381.48,SKIPPED,1625.27,1625.27,1381.48,1381.48,1381.48,657.12,796.38,796.38,SKIPPED,SKIPPED,670.53,670.53,0
3630158,270,27407,,,,,,,OSTEOSET,1633.8,653.52,688.48,1633.8,1388.73,SKIPPED,1633.8,1633.8,1388.73,1388.73,1388.73,688.48,800.56,800.56,SKIPPED,SKIPPED,702.53,702.53,1388.73
3630159,360,29805,,,,,,,SHOULDER ARTHROSCOPY DX,6398.16,2559.26,867.38,6398.16,5438.44,SKIPPED,6398.16,6398.16,5438.44,5438.44,5438.44,2696.19,867.38,867.38,SKIPPED,SKIPPED,2751.21,2751.21,5438.44
3630160,975,29805,,,,,,,SHOULDER ARTHROSCOPY DX,1301.63,520.65,0,1301.63,1106.39,SKIPPED,1301.63,1301.63,1106.39,1106.39,1106.39,513.46,637.8,637.8,SKIPPED,SKIPPED,523.94,523.94,0
3630161,360,23410,,,,,,,RPR ROTATOR CUFF,7748.48,3099.39,1051.35,7748.48,6586.21,SKIPPED,7748.48,7748.48,6586.21,6586.21,6586.21,3265.21,1051.35,1051.35,SKIPPED,SKIPPED,3331.85,3331.85,6586.21
3630162,975,23410,,,,,,,RPR ROTATOR CUFF,1667.55,667.02,0,1667.55,1417.42,SKIPPED,1667.55,1667.55,1417.42,1417.42,1417.42,894.92,817.1,817.1,SKIPPED,SKIPPED,913.18,913.18,0
3630163,360,23130,,,,,,,RMV SHOULDER BONE PART.,9157.41,3662.96,867.38,9157.41,7783.8,SKIPPED,9157.41,9157.41,7783.8,7783.8,7783.8,3858.94,867.38,867.38,SKIPPED,SKIPPED,3937.69,3937.69,7783.8
3630164,975,23130,,,,,,,RMV SHOULDER BONE PART.,1678.75,671.5,0,1678.75,1426.94,SKIPPED,1678.75,1678.75,1426.94,1426.94,1426.94,678.8,822.59,822.59,SKIPPED,SKIPPED,692.65,692.65,0
3630165,360,23430,,,,,,,RPR BICEPS TENDON,8027.59,3211.04,1051.35,8027.59,6823.45,SKIPPED,8027.59,8027.59,6823.45,6823.45,6823.45,3382.82,1051.35,1051.35,SKIPPED,SKIPPED,3451.86,3451.86,6823.45
3630166,975,23430,,,,,,,RPR BICEPS TENDON,2061.48,824.59,0,2061.48,1752.26,SKIPPED,2061.48,2061.48,1752.26,1752.26,1752.26,814.14,1010.13,1010.13,SKIPPED,SKIPPED,830.76,830.76,0
3630167,360,25110,,,,,,,RMV WRIST TENDON LESION,6673.94,2669.58,510.13,6412.22,5672.85,SKIPPED,6412.22,6412.22,5672.85,5672.85,5672.85,2812.39,510.13,510.13,SKIPPED,SKIPPED,2869.79,2869.79,5672.85
3630168,975,25110,,,,,,,RMV WRIST TENDON LESION,932.98,373.19,0,932.98,793.03,SKIPPED,932.98,932.98,793.03,793.03,793.03,382.19,457.16,457.16,SKIPPED,SKIPPED,389.99,389.99,0
3630169,360,25118,,,,,,,EXCISE WRIST TENDON SHEATH,6761.19,2704.48,510.13,6412.22,5747.01,SKIPPED,6412.22,6412.22,5747.01,5747.01,5747.01,2849.16,510.13,510.13,SKIPPED,SKIPPED,2907.31,2907.31,5747.01
3630170,975,25118,,,,,,,EXCISE WRIST TENDON SHEATH,1041.24,416.5,0,1041.24,885.05,SKIPPED,1041.24,1041.24,885.05,885.05,885.05,421.49,510.21,510.21,SKIPPED,SKIPPED,430.09,430.09,0
3630171,278,,,,,,,,TOTAL KNEE IMPLANTS/SUPPLY(BULK) BIOMET,17868.75,7147.5,0,15188.44,15188.44,SKIPPED,13580.25,13580.25,15188.44,15188.44,15188.44,7529.89,8755.69,8755.69,0,5360.62,7683.56,7683.56,15188.44
3630172,360,29879,,,,,,,KNEE ARTHROSCOPY-multiple drilling or mi,4733.48,1893.39,867.38,4733.48,4023.46,SKIPPED,4733.48,4733.48,4023.46,4023.46,4023.46,1994.69,867.38,867.38,SKIPPED,SKIPPED,2035.4,2035.4,4023.46
3630173,975,29879,,,,,,,KNEE ARTHROSCOPY-multiple drilling or mi,1833.51,733.4,0,1833.51,1558.48,SKIPPED,1833.51,1833.51,1558.48,1558.48,1558.48,722.08,898.42,898.42,SKIPPED,SKIPPED,736.82,736.82,0
3630174,360,25600,,,,,,,TREAT FRACTURE RADIUS/ULNA,904.84,361.94,87.17,769.11,769.11,SKIPPED,531.76,531.76,769.11,769.11,769.11,381.3,87.17,87.17,SKIPPED,SKIPPED,389.08,389.08,769.11
3630175,975,25600,,,,,,,TREAT FRACTURE RADIUS/ULNA,844.27,337.71,0,717.63,717.63,SKIPPED,531.76,531.76,717.63,717.63,717.63,360.06,413.69,413.69,SKIPPED,SKIPPED,367.41,367.41,0
3630176,278,,,,,,,,PALACOX R+G 1x40 SINGLE,853,341.2,0,725.05,725.05,SKIPPED,648.28,648.28,725.05,725.05,725.05,359.45,417.97,417.97,0,255.9,366.79,366.79,725.05
3630177,360,24201,,,,,,,RMVL OF ARM FOREIGN BODY(deep),5511.68,2204.67,582.36,5511.68,4684.93,SKIPPED,5511.68,5511.68,4684.93,4684.93,4684.93,2322.62,582.36,582.36,SKIPPED,SKIPPED,2370.02,2370.02,4684.93
3630178,975,24201,,,,,,,RMVL OF ARM FOREIGN BODY(deep),863.24,345.3,0,863.24,733.75,SKIPPED,863.24,863.24,733.75,733.75,733.75,400.22,422.99,422.99,SKIPPED,SKIPPED,408.39,408.39,0
3630179,360,23412,,,,,,,RPR CRONIC ROTATOR CUFF,11742.32,4696.93,1051.35,11742.32,9980.97,SKIPPED,11742.32,11742.32,9980.97,9980.97,9980.97,4948.22,1051.35,1051.35,SKIPPED,SKIPPED,5049.2,5049.2,9980.97
3630180,975,23412,,,,,,,RPR CRONIC ROTATOR CUFF,2344.23,937.69,0,2344.23,1992.6,SKIPPED,2344.23,2344.23,1992.6,1992.6,1992.6,929.65,1148.67,1148.67,SKIPPED,SKIPPED,948.62,948.62,0
3630181,360,27635,,,,,,,REMOVE LOWER LEG BONE LESION,5618.62,2247.45,867.38,5618.62,4775.83,SKIPPED,5618.62,5618.62,4775.83,4775.83,4775.83,2367.69,867.38,867.38,SKIPPED,SKIPPED,2416.01,2416.01,4775.83
3630182,975,27635,,,,,,,REMOVE LOWER LEG BONE LESION,1615.35,646.14,0,1615.35,1373.05,SKIPPED,1615.35,1615.35,1373.05,1373.05,1373.05,635.07,791.52,791.52,SKIPPED,SKIPPED,648.03,648.03,0
3630183,360,28118,,,,,,,REMOVAL OF HEEL BONE,4509.83,1803.93,867.38,4509.83,3833.36,SKIPPED,4509.83,4509.83,3833.36,3833.36,3833.36,1900.45,867.38,867.38,SKIPPED,SKIPPED,1939.23,1939.23,3833.36
3630184,975,28118,,,,,,,REMOVAL OF HEEL BONE,1144.04,457.62,0,1144.04,972.43,SKIPPED,1144.04,1144.04,972.43,972.43,972.43,461.34,560.58,560.58,SKIPPED,SKIPPED,470.76,470.76,0
3630185,360,29800,,,,,,,JAW ARTHROSCOPY,5065.56,2026.22,867.38,5065.56,4305.73,SKIPPED,5065.56,5065.56,4305.73,4305.73,4305.73,2134.63,867.38,867.38,SKIPPED,SKIPPED,2178.19,2178.19,4305.73
3630186,975,29800,,,,,,,JAW ARTHROSCOPY,1404.3,561.72,0,1404.3,1193.66,SKIPPED,1404.3,1404.3,1193.66,1193.66,1193.66,579.87,688.11,688.11,SKIPPED,SKIPPED,591.7,591.7,0
3630187,360,20550,,,,,,,INJ TENDON SHEATH/LIGAMENT,619.13,247.65,20.78,526.26,526.26,SKIPPED,114.57,114.57,526.26,526.26,526.26,260.91,20.78,20.78,SKIPPED,SKIPPED,266.23,266.23,526.26
3630188,975,20550,,,,,,,INJ TENDON SHEATH/LIGAMENT,142.25,56.9,0,120.91,120.91,SKIPPED,114.57,114.57,120.91,120.91,120.91,42.7,69.7,69.7,SKIPPED,SKIPPED,43.57,43.57,0
3630189,360,27535,,,,,,,TRT KNEE FX,10373.15,4149.26,0,8817.18,8817.18,SKIPPED,4408.38,4408.38,8817.18,8817.18,8817.18,4371.24,0,0,0,3111.94,4460.45,4460.45,8817.18
3630190,975,27535,,,,,,,TRT KNEE FX,2479.32,991.73,0,2479.32,2107.42,SKIPPED,2479.32,2479.32,2107.42,2107.42,2107.42,976.04,1214.87,1214.87,0,743.8,995.96,995.96,0
3630191,278,,,,,,,,3.5MM VALCP PROX TIBIA PLATE GHOLE LEFT,5053,2021.2,0,4295.05,4295.05,SKIPPED,3840.28,3840.28,4295.05,4295.05,4295.05,2129.33,2475.97,2475.97,0,1515.9,2172.79,2172.79,4295.05
3630192,360,97605,,,,,,,NEG PRESS WOUND TX >/=50CM,443.32,177.33,0,443.32,376.82,SKIPPED,443.32,443.32,376.82,376.82,376.82,186.82,0,0,0,133,190.63,190.63,376.82
3630193,975,97605,,,,,,,NEG PRESS WOUND TX >/=50CM,83.1,33.24,0,83.1,70.64,SKIPPED,83.1,83.1,70.64,70.64,70.64,27.87,40.72,40.72,0,24.93,28.44,28.44,0
3630194,360,26600,,,,,,,TRT METACARPAL FX,751.4,300.56,87.17,638.69,638.69,SKIPPED,531.76,531.76,638.69,638.69,638.69,316.64,87.17,87.17,SKIPPED,SKIPPED,323.1,323.1,638.69
3630195,975,26600,,,,,,,TRT METACARPAL FX,790.8,316.32,0,672.18,672.18,SKIPPED,531.76,531.76,672.18,672.18,672.18,318.39,387.49,387.49,SKIPPED,SKIPPED,324.89,324.89,0
3630196,360,29870,,,,,,,KNEE ARTHROSCOPY DX,6465.7,2586.28,867.38,6465.7,5495.84,SKIPPED,6465.7,6465.7,5495.84,5495.84,5495.84,2724.64,867.38,867.38,SKIPPED,SKIPPED,2780.25,2780.25,5495.84
3630197,975,29870,,,,,,,KNEE ARTHROSCOPY DX,1459.13,583.65,0,1459.13,1240.26,SKIPPED,1459.13,1459.13,1240.26,1240.26,1240.26,446.2,714.97,714.97,SKIPPED,SKIPPED,455.31,455.31,0
3630198,360,27248,,,,,,,TREAT THIGH FRACTURE,11463.72,4585.49,0,9744.16,9744.16,SKIPPED,3649.8,3649.8,9744.16,9744.16,9744.16,4830.81,0,0,0,3439.12,4929.4,4929.4,9744.16
3630199,975,27248,,,,,,,TREAT THIGH FRACTURE,2047.4,818.96,0,2047.4,1740.29,SKIPPED,2047.4,2047.4,1740.29,1740.29,1740.29,813.95,1003.23,1003.23,0,614.22,830.56,830.56,0
3630200,278,,,,,,,,LCP DHHS COMPRESSION SCREEN,143,57.2,0,121.55,121.55,SKIPPED,108.68,108.68,121.55,121.55,121.55,60.26,70.07,70.07,0,42.9,61.49,61.49,121.55
3630201,272,,,,,,,,REAMER(SYNTHES 338.332),3547.5,1419,0,3015.38,3015.38,SKIPPED,2696.1,2696.1,3015.38,3015.38,3015.38,1494.92,1738.28,1738.28,0,1064.25,1525.43,1525.43,3015.38
3630202,360,27170,,,,,,,REPAIR/GRAFT FEMUR HEAD/NECK,21810.06,8724.02,0,18538.55,18538.55,SKIPPED,5782.36,5782.36,18538.55,18538.55,18538.55,9190.76,0,0,0,6543.02,9378.33,9378.33,18538.55
3630203,975,27170,,,,,,,REPAIR/GRAFT FEMUR HEAD/NECK,3249.07,1299.63,0,3249.07,2761.71,SKIPPED,3249.07,3249.07,2761.71,2761.71,2761.71,1266.04,1592.04,1592.04,0,974.72,1291.88,1291.88,0
3630204,360,26608,,,,,,,TRT METACARPAL FX,5705.86,2282.34,867.38,5705.86,4849.98,SKIPPED,5705.86,5705.86,4849.98,4849.98,4849.98,2404.45,867.38,867.38,SKIPPED,SKIPPED,2453.52,2453.52,4849.98
3630205,975,26608,,,,,,,TRT METACARPAL FX,1297.37,518.95,0,1297.37,1102.76,SKIPPED,1297.37,1297.37,1102.76,1102.76,1102.76,531.64,635.71,635.71,SKIPPED,SKIPPED,542.49,542.49,0
3630206,360,25565,,,,,,,TRT FX RADIUS/ULNA,1249.51,499.8,510.13,1249.51,1062.08,SKIPPED,1249.51,1249.51,1062.08,1062.08,1062.08,526.54,510.13,510.13,SKIPPED,SKIPPED,537.29,537.29,1062.08
3630207,975,25565,,,,,,,TRT FX RADIUS/ULNA,1408.58,563.43,0,1408.58,1197.29,SKIPPED,1408.58,1408.58,1197.29,1197.29,1197.29,513.98,690.2,690.2,SKIPPED,SKIPPED,524.47,524.47,0
3630208,360,29851,,,,,,,KNEE ARTHROSCOPY,776.73,310.69,327.31,776.73,660.22,SKIPPED,776.73,776.73,660.22,660.22,660.22,327.31,510.13,510.13,SKIPPED,SKIPPED,333.99,333.99,660.22
3630209,975,29851,,,,,,,KNEE ARTHROSCOPY,2445.56,978.22,0,2445.56,2078.73,SKIPPED,2445.56,2445.56,2078.73,2078.73,2078.73,1011.16,1198.32,1198.32,SKIPPED,SKIPPED,1031.8,1031.8,0
3630210,278,,,,,,,,5.0 LCP SCREWS(ALL SIZES)-SYNTHES,940,376,0,799,799,SKIPPED,714.4,714.4,799,799,799,396.12,460.6,460.6,0,282,404.2,404.2,799
3630211,360,28289,,,,,,,RPR HALLUX RIGIDUS,10167.71,4067.08,867.38,10167.71,8642.55,SKIPPED,10167.71,10167.71,8642.55,8642.55,8642.55,4284.68,867.38,867.38,SKIPPED,SKIPPED,4372.12,4372.12,8642.55
3630212,975,28289,,,,,,,RPR HALLUX RIGIDUS,1592.84,637.14,0,1592.84,1353.91,SKIPPED,1592.84,1592.84,1353.91,1353.91,1353.91,503.12,780.49,780.49,SKIPPED,SKIPPED,513.39,513.39,0
3630213,360,20220,,,,,,,BONE BIOPSY TROCAR/NEEDLE,2750.95,1100.38,414.14,2750.95,2338.31,SKIPPED,2750.95,2750.95,2338.31,2338.31,2338.31,1159.25,414.14,414.14,SKIPPED,SKIPPED,1182.91,1182.91,2338.31
3630214,975,20220,,,,,,,BONE BIOPSY TROCAR/NEEDLE,260.77,104.31,0,260.77,221.65,SKIPPED,260.77,260.77,221.65,221.65,221.65,95.48,127.78,127.78,SKIPPED,SKIPPED,97.43,97.43,0
3630215,278,,,,,,,,VERASENSE 63(BMT-VGCR 63) CR,1824,729.6,0,1550.4,1550.4,SKIPPED,1386.24,1386.24,1550.4,1550.4,1550.4,768.63,893.76,893.76,0,547.2,784.32,784.32,1550.4
3630216,278,,,,,,,,VERASENSE 71(BMT-VGCR 71) CR,1824,729.6,0,1550.4,1550.4,SKIPPED,1386.24,1386.24,1550.4,1550.4,1550.4,768.63,893.76,893.76,0,547.2,784.32,784.32,1550.4
3630217,278,,,,,,,,VERASENSE 79(BMT-VGCR 79) CR,1824,729.6,0,1550.4,1550.4,SKIPPED,1386.24,1386.24,1550.4,1550.4,1550.4,768.63,893.76,893.76,0,547.2,784.32,784.32,1550.4
3630218,278,,,,,,,,VERASENSE 63(BMT-VGPS 63) PS,1824,729.6,0,1550.4,1550.4,SKIPPED,1386.24,1386.24,1550.4,1550.4,1550.4,768.63,893.76,893.76,0,547.2,784.32,784.32,1550.4
3630219,278,,,,,,,,VERASENSE 71(BMT-VGPS 71) PS,1824,729.6,0,1550.4,1550.4,SKIPPED,1386.24,1386.24,1550.4,1550.4,1550.4,768.63,893.76,893.76,0,547.2,784.32,784.32,1550.4
3630220,278,,,,,,,,VERASENSE 79(BMT-VGPS 79) PS,1824,729.6,0,1550.4,1550.4,SKIPPED,1386.24,1386.24,1550.4,1550.4,1550.4,768.63,893.76,893.76,0,547.2,784.32,784.32,1550.4
3630221,360,23415,,,,,,,RELEASE OF SHOULDER LIGAMENT,7257.97,2903.19,1051.35,7257.97,6169.27,SKIPPED,7257.97,7257.97,6169.27,6169.27,6169.27,3058.51,1051.35,1051.35,SKIPPED,SKIPPED,3120.93,3120.93,6169.27
3630222,975,23415,,,,,,,RELEASE OF SHOULDER LIGAMENT,1819.85,727.94,0,1819.85,1546.87,SKIPPED,1819.85,1819.85,1546.87,1546.87,1546.87,764.17,891.73,891.73,SKIPPED,SKIPPED,779.77,779.77,0
3630223,360,28505,,,,,,,TRT BIG TOE FX,6574.51,2629.8,867.38,6574.51,5588.33,SKIPPED,6574.51,6574.51,5588.33,5588.33,5588.33,2770.5,867.38,867.38,SKIPPED,SKIPPED,2827.04,2827.04,5588.33
3630224,975,28505,,,,,,,TRT BIG TOE FX`,1746.15,698.46,0,1746.15,1484.23,SKIPPED,1746.15,1746.15,1484.23,1484.23,1484.23,547.72,855.61,855.61,SKIPPED,SKIPPED,558.9,558.9,0
3630225,360,28496,,,,,,,TRT BIG TOE FX,5388.53,2155.41,867.38,5388.53,4580.25,SKIPPED,5388.53,5388.53,4580.25,4580.25,4580.25,2270.73,867.38,867.38,SKIPPED,SKIPPED,2317.07,2317.07,4580.25
3630226,975,28496,,,,,,,TRT BIG TOE FX,866.73,346.69,0,866.73,736.72,SKIPPED,866.73,866.73,736.72,736.72,736.72,268.6,424.7,424.7,SKIPPED,SKIPPED,274.08,274.08,0
3630227,360,26755,,,,,,,TRT FINGER FX,604.38,241.75,87.17,604.38,513.72,SKIPPED,604.38,604.38,513.72,513.72,513.72,254.68,87.17,87.17,SKIPPED,SKIPPED,259.88,259.88,513.72
3630228,975,26755,,,,,,,TRT FINGER FX,805.4,322.16,0,805.4,684.59,SKIPPED,805.4,805.4,684.59,684.59,684.59,304.44,394.65,394.65,SKIPPED,SKIPPED,310.65,310.65,0
3630229,360,26756,,,,,,,PIN FINGER FX,4924.85,1969.94,867.38,4924.85,4186.12,SKIPPED,4924.85,4924.85,4186.12,4186.12,4186.12,2075.34,867.38,867.38,SKIPPED,SKIPPED,2117.69,2117.69,4186.12
3630230,975,26756,,,,,,,PIN FINGER FX,1078.77,431.51,0,1078.77,916.95,SKIPPED,1078.77,1078.77,916.95,916.95,916.95,469.6,528.6,528.6,SKIPPED,SKIPPED,479.18,479.18,0
3630231,360,25400,,,,,,,RPR RADIUS OR ULNA,10313.37,4125.35,1051.35,10313.37,8766.36,SKIPPED,10313.37,10313.37,8766.36,8766.36,8766.36,4346.06,1051.35,1051.35,SKIPPED,SKIPPED,4434.75,4434.75,8766.36
3630232,975,25400,,,,,,,RPR RADIUS OR ULNA,2102.61,841.04,0,2102.61,1787.22,SKIPPED,2102.61,2102.61,1787.22,1787.22,1787.22,877.09,1030.28,1030.28,SKIPPED,SKIPPED,894.99,894.99,0
3630233,278,,,,,,,,LCP 9-HOLE PLATE,1160,464,0,986,986,SKIPPED,881.6,881.6,986,986,986,488.82,568.4,568.4,0,348,498.8,498.8,986
3630234,360,25071,,,,,,,EXC FOREARM LESSION SC>3CM,4800.23,1920.09,414.14,4800.23,4080.2,SKIPPED,4800.23,4800.23,4080.2,4080.2,4080.2,2022.82,414.14,414.14,SKIPPED,SKIPPED,2064.1,2064.1,4080.2
3630235,975,25071,,,,,,,EXC FOREARM LESSION SC>3CM,1114.96,445.98,0,1114.96,947.72,SKIPPED,1114.96,1114.96,947.72,947.72,947.72,462.8,546.33,546.33,SKIPPED,SKIPPED,472.24,472.24,0
3630236,360,25606,,,,,,,TRT FX DISTAL RADIAL,5807.98,2323.19,867.38,5807.98,4936.78,SKIPPED,5807.98,5807.98,4936.78,4936.78,4936.78,2447.48,867.38,867.38,SKIPPED,SKIPPED,2497.43,2497.43,4936.78
3630237,975,25606,,,,,,,TRT FX DISTAL RADIAL,1726.04,690.42,0,1726.04,1467.13,SKIPPED,1726.04,1726.04,1467.13,1467.13,1467.13,731.85,845.76,845.76,SKIPPED,SKIPPED,746.79,746.79,0
3630238,360,26320,,,,,,,RMV IMPLANT FROM HAND,4282.95,1713.18,414.14,4282.95,3640.51,SKIPPED,4282.95,4282.95,3640.51,3640.51,3640.51,1804.84,414.14,414.14,SKIPPED,SKIPPED,1841.67,1841.67,3640.51
3630239,975,26320,,,,,,,RMV IMPLANT FROM HAND,900.54,360.22,0,900.54,765.46,SKIPPED,900.54,900.54,765.46,765.46,765.46,385.8,441.26,441.26,SKIPPED,SKIPPED,393.67,393.67,0
3630240,360,20693,,,,,,,ADJ-REVISE EXTERNAL FIXATION SYST.,6448.53,2579.41,1051.35,6448.53,5481.25,SKIPPED,6448.53,6448.53,5481.25,5481.25,5481.25,2717.41,1051.35,1051.35,SKIPPED,SKIPPED,2772.87,2772.87,5481.25
3630241,975,20693,,,,,,,ADJ-REVISE EXTERNAL FIXATION SYST.,1168.57,467.43,0,1168.57,993.28,SKIPPED,1168.57,1168.57,993.28,993.28,993.28,485.21,572.6,572.6,SKIPPED,SKIPPED,495.11,495.11,0
3630242,278,,,,,,,,TRIPLE LOADED ANCHOR,948,379.2,0,805.8,805.8,SKIPPED,720.48,720.48,805.8,805.8,805.8,399.49,464.52,464.52,0,284.4,407.64,407.64,805.8
3630243,360,20690,,,,,,,APPLY BONE FIXATION DEVICE,4987.85,1995.14,1051.35,4987.85,4239.67,SKIPPED,4987.85,4987.85,4239.67,4239.67,4239.67,2101.88,1051.35,1051.35,SKIPPED,SKIPPED,2144.78,2144.78,4239.67
3630244,975,20690,,,,,,,APPLY BONE FIXATION DEVICE,1561.2,624.48,0,1561.2,1327.02,SKIPPED,1561.2,1561.2,1327.02,1327.02,1327.02,649.32,764.99,764.99,SKIPPED,SKIPPED,662.57,662.57,0
3630245,272,,,,,,,,ARISTA AH,510,204,0,433.5,433.5,SKIPPED,387.6,387.6,433.5,433.5,433.5,214.91,249.9,249.9,0,153,219.3,219.3,433.5
3630246,272,,,,,,,,WRIST JACK SYSTEM,2900,1160,0,2465,2465,SKIPPED,2204,2204,2465,2465,2465,1222.06,1421,1421,0,870,1247,1247,2465
3630247,975,25112,,,,,,,"EX GANG WRIST, RECUR",1377.01,550.8,0,1377.01,1170.46,SKIPPED,1377.01,1377.01,1170.46,1170.46,1170.46,429.24,674.73,674.73,SKIPPED,SKIPPED,438,438,0
3630248,360,28495,,,,,,,TREAT BIG TOE FRACTURE,691.49,276.6,87.17,587.77,587.77,SKIPPED,531.76,531.76,587.77,587.77,587.77,291.39,87.17,87.17,SKIPPED,SKIPPED,297.34,297.34,587.77
3630249,975,28495,,,,,,,TREAT BIG TOE FRACTURE,466.35,186.54,0,466.35,396.4,SKIPPED,466.35,466.35,396.4,396.4,396.4,164.31,228.51,228.51,SKIPPED,SKIPPED,167.66,167.66,0
3630250,360,20670,,,,,,,REMOVAL IMPLANT SUPERFICIAL SEPARATE PRO,5205.27,2082.11,414.14,5205.27,4424.48,SKIPPED,5205.27,5205.27,4424.48,4424.48,4424.48,2193.5,414.14,414.14,SKIPPED,SKIPPED,2238.27,2238.27,4424.48
3630251,975,20670,,,,,,,REMOVAL IMPLANT SUPERFICIAL SEPARATE PRO,523.15,209.26,0,523.15,444.68,SKIPPED,523.15,523.15,444.68,444.68,444.68,157.54,256.34,256.34,SKIPPED,SKIPPED,160.75,160.75,0
3630252,360,25608,,,,,,,TRT FX RAD INTRA-ARTICUL,11404.22,4561.69,1051.35,11404.22,9693.59,SKIPPED,11404.22,11404.22,9693.59,9693.59,9693.59,4805.73,1051.35,1051.35,SKIPPED,SKIPPED,4903.81,4903.81,9693.59
3630253,975,25608,,,,,,,TRT FX RAD INTRA-ARTICUL,2164.26,865.7,0,2164.26,1839.62,SKIPPED,2164.26,2164.26,1839.62,1839.62,1839.62,904.29,1060.49,1060.49,SKIPPED,SKIPPED,922.74,922.74,0
3630254,360,29867,,,,,,,ALLGRAF IMPLANT KNEE W/ SCOPE,6656.27,2662.51,0,6656.27,5657.83,SKIPPED,6656.27,6656.27,5657.83,5657.83,5657.83,2804.96,0,0,0,1996.88,2862.2,2862.2,5657.83
3630255,975,29867,,,,,,,ALLGRAF IMPLANT KNEE W/ SCOPE,3378.38,1351.35,0,3378.38,2871.62,SKIPPED,3378.38,3378.38,2871.62,2871.62,2871.62,1389.06,1655.41,1655.41,0,1013.51,1417.41,1417.41,0
3630256,360,24605,,,,,,,TRT ELBOW DISLOCATION,2366.09,946.44,510.13,2366.09,2011.18,SKIPPED,2366.09,2366.09,2011.18,2011.18,2011.18,997.07,510.13,510.13,SKIPPED,SKIPPED,1017.42,1017.42,2011.18
3630257,975,24605,,,,,,,TRT ELBOW DISLOCATION,1224.91,489.96,0,1224.91,1041.17,SKIPPED,1224.91,1224.91,1041.17,1041.17,1041.17,527.43,600.21,600.21,SKIPPED,SKIPPED,538.19,538.19,0
3630258,360,27814,,,,,,,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTUR,11547.95,4619.18,1051.35,11547.95,9815.76,SKIPPED,11547.95,11547.95,9815.76,9815.76,9815.76,4866.31,1051.35,1051.35,SKIPPED,SKIPPED,4965.62,4965.62,9815.76
3630259,975,27814,,,,,,,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTUR,2030.08,812.03,0,2030.08,1725.57,SKIPPED,2030.08,2030.08,1725.57,1725.57,1725.57,835.95,994.74,994.74,SKIPPED,SKIPPED,853.01,853.01,0
3630260,360,25607,,,,,,,TRT FX RAD EXTRA-ARTICUL,11156.29,4462.52,1051.35,11156.29,9482.85,SKIPPED,11156.29,11156.29,9482.85,9482.85,9482.85,4701.26,1051.35,1051.35,SKIPPED,SKIPPED,4797.2,4797.2,9482.85
3630261,975,25607,,,,,,,TRT FX RAD EXTRA-ARTICUL,1927.76,771.1,0,1927.76,1638.6,SKIPPED,1927.76,1927.76,1638.6,1638.6,1638.6,808.68,944.6,944.6,SKIPPED,SKIPPED,825.18,825.18,0
3630262,360,27880,,,,,,,AMPUTATION OF LOWER LEG,11441.75,4576.7,0,9725.49,9725.49,SKIPPED,4508.98,4508.98,9725.49,9725.49,9725.49,4821.55,0,0,0,3432.52,4919.95,4919.95,9725.49
3630263,975,27880,,,,,,,AMPUTATION OF LOWER LEG,2442.68,977.07,0,2442.68,2076.28,SKIPPED,2442.68,2442.68,2076.28,2076.28,2076.28,969.23,1196.91,1196.91,0,732.8,989.01,989.01,0
3630264,360,27810,,,,,,,TRT ANKLE FX,1165.9,466.36,491.31,1165.9,991.02,SKIPPED,1165.9,1165.9,991.02,991.02,991.02,491.31,510.13,510.13,SKIPPED,SKIPPED,501.34,501.34,991.02
3630265,975,27810,,,,,,,TRT ANKLE FX,1212.78,485.11,0,1212.78,1030.86,SKIPPED,1212.78,1212.78,1030.86,1030.86,1030.86,469.64,594.26,594.26,SKIPPED,SKIPPED,479.22,479.22,0
3630266,360,25000,,,,,,,INCISION TENDON SHEATH,4630.04,1852.02,510.13,4630.04,3935.53,SKIPPED,4630.04,4630.04,3935.53,3935.53,3935.53,1951.1,510.13,510.13,SKIPPED,SKIPPED,1990.92,1990.92,3935.53
3630267,975,25000,,,,,,,INCISION TENDON SHEATH,875.09,350.04,0,875.09,743.83,SKIPPED,875.09,875.09,743.83,743.83,743.83,380.32,428.79,428.79,SKIPPED,SKIPPED,388.08,388.08,0
3630268,360,27438,,,,,,,REVISE KNEECAP W/ IMPLANT,14012.05,5604.82,1051.35,14012.05,11910.24,SKIPPED,14012.05,14012.05,11910.24,11910.24,11910.24,5904.68,1051.35,1051.35,SKIPPED,SKIPPED,6025.18,6025.18,11910.24
3630269,975,27438,,,,,,,REVISE KNEECAP W/ IMPLANT,2211.16,884.46,0,2211.16,1879.49,SKIPPED,2211.16,2211.16,1879.49,1879.49,1879.49,916.69,1083.47,1083.47,SKIPPED,SKIPPED,935.4,935.4,0
3630270,360,25560,,,,,,,TRT FX RADIUS/ULNA,596.35,238.54,87.17,531.76,506.9,SKIPPED,531.76,531.76,506.9,506.9,506.9,251.3,87.17,87.17,SKIPPED,SKIPPED,256.43,256.43,506.9
3630271,975,25560,,,,,,,TRT FX RADIUS/ULNA,718.29,287.32,0,610.55,610.55,SKIPPED,531.76,531.76,610.55,610.55,610.55,287.32,351.96,351.96,SKIPPED,SKIPPED,293.18,293.18,0
3630272,272,,,,,,,,1/8IN. DRILL QUICK RELEASE REF#32-486265,400,160,0,340,340,SKIPPED,304,304,340,340,340,168.56,196,196,0,120,172,172,340
3630273,278,,,,,,,,PALACOS BONE CEMENT W/ GENTAMICIN,600,240,0,510,510,SKIPPED,456,456,510,510,510,252.84,294,294,0,180,258,258,510
3630274,278,,,,,,,,DISTAL FEMORAL PEG REF#183099,755,302,0,641.75,641.75,SKIPPED,573.8,573.8,641.75,641.75,641.75,318.16,369.95,369.95,0,226.5,324.65,324.65,641.75
3630275,272,,,,,,,,CEMENT MIXING TOWER SYSTEM,200,80,0,170,170,SKIPPED,152,152,170,170,170,84.28,98,98,0,60,86,86,170
3630276,278,,,,,,,,PS OPEN BOX FEMORAL REF#183108,5500,2200,0,4675,4675,SKIPPED,4180,4180,4675,4675,4675,2317.7,2695,2695,0,1650,2365,2365,4675
3630277,278,,,,,,,,BIOMET SERIES A THIN PATELLA REF#184784,2518.75,1007.5,0,2140.94,2140.94,SKIPPED,1914.25,1914.25,2140.94,2140.94,2140.94,1061.4,1234.19,1234.19,0,755.62,1083.06,1083.06,2140.94
3630278,278,,,,,,,,FIXED CRUCIATE TIBIAL PLATE REF#141233,3750,1500,0,3187.5,3187.5,SKIPPED,2850,2850,3187.5,3187.5,3187.5,1580.25,1837.5,1837.5,0,1125,1612.5,1612.5,3187.5
3630279,278,,,,,,,,PS TIBIAL BEARING REF# EP-183640,3250,1300,0,2762.5,2762.5,SKIPPED,2470,2470,2762.5,2762.5,2762.5,1369.55,1592.5,1592.5,0,975,1397.5,1397.5,2762.5
3630280,360,35860,,,,,,,EXPLORE LIMB VESSELS,6019.7,2407.88,0,6019.7,5116.74,SKIPPED,6019.7,6019.7,5116.74,5116.74,5116.74,2536.7,0,0,0,1805.91,2588.47,2588.47,5116.74
3630281,975,35860,,,,,,,EXPLORE LIMB VESSELS,2260.76,904.3,0,2260.76,1921.65,SKIPPED,2260.76,2260.76,1921.65,1921.65,1921.65,891.52,1107.77,1107.77,0,678.23,909.71,909.71,0
3630282,360,23470,,,,,,,RECONSTRUCT SHOULDER JOINT,15593.35,6237.34,0,15593.35,13254.35,SKIPPED,15593.35,15593.35,13254.35,13254.35,13254.35,6571.04,0,0,0,4678,6705.14,6705.14,13254.35
3630283,975,23470,,,,,,,RECONSTRUCT SHOULDER JOINT,3174.69,1269.88,0,3174.69,2698.49,SKIPPED,3174.69,3174.69,2698.49,2698.49,2698.49,1304.14,1555.6,1555.6,0,952.41,1330.75,1330.75,0
3630284,360,27620,,,,,,,EXPLORE/TREAT ANKLE JOINT,5627.07,2250.83,867.38,5627.07,4783.01,SKIPPED,5627.07,5627.07,4783.01,4783.01,4783.01,2371.25,867.38,867.38,SKIPPED,SKIPPED,2419.64,2419.64,4783.01
3630285,975,27620,,,,,,,EXPLORE/TREAT ANKLE JOINT,1196.71,478.68,0,1196.71,1017.2,SKIPPED,1196.71,1196.71,1017.2,1017.2,1017.2,494.97,586.39,586.39,SKIPPED,SKIPPED,505.07,505.07,0
3630286,360,29866,,,,,,,AUTGRFT IMPLNT KNEE W/SCOPE,8865.06,3546.02,1051.35,8865.06,7535.3,SKIPPED,8865.06,8865.06,7535.3,7535.3,7535.3,3735.74,1051.35,1051.35,SKIPPED,SKIPPED,3811.98,3811.98,7535.3
3630287,975,29866,,,,,,,AUTGRFT IMPLNT KNEE W/SCOPE,2507.75,1003.1,0,2507.75,2131.59,SKIPPED,2507.75,2507.75,2131.59,2131.59,2131.59,1145.25,1228.8,1228.8,SKIPPED,SKIPPED,1168.62,1168.62,0
3630288,360,27818,,,,,,,TRT ANKLE FX,1130.79,452.32,476.52,1130.79,961.17,SKIPPED,1130.79,1130.79,961.17,961.17,961.17,476.52,510.13,510.13,SKIPPED,SKIPPED,486.24,486.24,961.17
3630289,975,27818,,,,,,,TRT ANKLE FX,1199.21,479.68,0,1199.21,1019.33,SKIPPED,1199.21,1199.21,1019.33,1019.33,1019.33,482.07,587.61,587.61,SKIPPED,SKIPPED,491.91,491.91,0
3630290,360,25075,,,,,,,EXC TUMOR SOFT TISSUE FOREARM <3CM,2639.35,1055.74,414.14,2639.35,2243.45,SKIPPED,2639.35,2639.35,2243.45,2243.45,2243.45,1112.22,414.14,414.14,SKIPPED,SKIPPED,1134.92,1134.92,2243.45
3630291,975,25075,,,,,,,EXC TUMOR SOFT TISSUE FOREARM <3CM,1175.22,470.09,0,1175.22,998.94,SKIPPED,1175.22,1175.22,998.94,998.94,998.94,345.77,575.86,575.86,SKIPPED,SKIPPED,352.83,352.83,0
3630292,360,25071,,,,,,,EXC TUMOR SOFT TISSUE FOREARM >3CM,4520.6,1808.24,414.14,4520.6,3842.51,SKIPPED,4520.6,4520.6,3842.51,3842.51,3842.51,1904.98,414.14,414.14,SKIPPED,SKIPPED,1943.86,1943.86,3842.51
3630293,975,25071,,,,,,,EXC TUMOR SOFT TISSUE FOREARM >3CM,1065.7,426.28,0,1065.7,905.84,SKIPPED,1065.7,1065.7,905.84,905.84,905.84,462.8,522.19,522.19,SKIPPED,SKIPPED,472.24,472.24,0
3630294,272,,,,,,,,HAND TRAY,117,46.8,0,99.45,99.45,SKIPPED,88.92,88.92,99.45,99.45,99.45,49.3,57.33,57.33,0,35.1,50.31,50.31,99.45
3630295,272,,,,,,,,HAND TABLE,219,87.6,0,186.15,186.15,SKIPPED,166.44,166.44,186.15,186.15,186.15,92.29,107.31,107.31,0,65.7,94.17,94.17,186.15
3630296,272,,,,,,,,STRYKER HELMENTS,98.17,39.27,0,83.44,83.44,SKIPPED,74.61,74.61,83.44,83.44,83.44,41.37,48.1,48.1,0,29.45,42.21,42.21,83.44
3630297,272,,,,,,,,ORTHO MINOR TRAY,597,238.8,0,507.45,507.45,SKIPPED,453.72,453.72,507.45,507.45,507.45,251.58,292.53,292.53,0,179.1,256.71,256.71,507.45
3630298,270,,,,,,,,FRACTURE BED,2175,870,0,1848.75,1848.75,SKIPPED,1653,1653,1848.75,1848.75,1848.75,916.54,1065.75,1065.75,0,652.5,935.25,935.25,1848.75
3630299,272,,,,,,,,BLACK WELL LEG HOLDER,195,78,0,165.75,165.75,SKIPPED,148.2,148.2,165.75,165.75,165.75,82.17,95.55,95.55,0,58.5,83.85,83.85,165.75
3630300,272,,,,,,,,SANDBAG,27,10.8,0,22.95,22.95,SKIPPED,20.52,20.52,22.95,22.95,22.95,11.38,13.23,13.23,0,8.1,11.61,11.61,22.95
3630301,272,,,,,,,,JACKSON TABLE FLAT PLATE,375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3630302,272,,,,,,,,WIXSTON POSITIONER,1212,484.8,0,1030.2,1030.2,SKIPPED,921.12,921.12,1030.2,1030.2,1030.2,510.74,593.88,593.88,0,363.6,521.16,521.16,1030.2
3630303,272,,,,,,,,CANDY CANE STIRRUP,98,39.2,0,83.3,83.3,SKIPPED,74.48,74.48,83.3,83.3,83.3,41.3,48.02,48.02,0,29.4,42.14,42.14,83.3
3630304,272,,,,,,,,POLAR ICE,276,110.4,0,234.6,234.6,SKIPPED,209.76,209.76,234.6,234.6,234.6,116.31,135.24,135.24,0,82.8,118.68,118.68,234.6
3630305,270,,,,,,,,CPM MACHINE,456,182.4,0,387.6,387.6,SKIPPED,346.56,346.56,387.6,387.6,387.6,192.16,223.44,223.44,0,136.8,196.08,196.08,387.6
3630306,270,,,,,,,,PENTAX TOWER,975,390,0,828.75,828.75,SKIPPED,741,741,828.75,828.75,828.75,410.86,477.75,477.75,0,292.5,419.25,419.25,828.75
3630307,270,,,,,,,,UNDERWATER BOVIE,79,31.6,0,67.15,67.15,SKIPPED,60.04,60.04,67.15,67.15,67.15,33.29,38.71,38.71,0,23.7,33.97,33.97,67.15
3630308,270,,,,,,,,CONMED ARTHROSCOPY PUMP,716,286.4,0,608.6,608.6,SKIPPED,544.16,544.16,608.6,608.6,608.6,301.72,350.84,350.84,0,214.8,307.88,307.88,608.6
3630310,272,,,,,,,,ANGLED CURETTES,168,67.2,0,142.8,142.8,SKIPPED,127.68,127.68,142.8,142.8,142.8,70.8,82.32,82.32,0,50.4,72.24,72.24,142.8
3630311,272,,,,,,,,BLUNT HOHMANN RETRACTORS,372,148.8,0,316.2,316.2,SKIPPED,282.72,282.72,316.2,316.2,316.2,156.76,182.28,182.28,0,111.6,159.96,159.96,316.2
3630312,270,,,,,,,,BEACH CHAIR POOSITIONER,171,68.4,0,145.35,145.35,SKIPPED,129.96,129.96,145.35,145.35,145.35,72.06,83.79,83.79,0,51.3,73.53,73.53,145.35
3630313,270,,,,,,,,SHOULDER POSIOTIONER,145.33,58.13,0,123.53,123.53,SKIPPED,110.45,110.45,123.53,123.53,123.53,61.24,71.21,71.21,0,43.6,62.49,62.49,123.53
3630314,360,25295,,,,,,,RELEASE WRIST/FOREARM TENDON,3043.93,1217.57,867.38,3043.93,2587.34,SKIPPED,3043.93,3043.93,2587.34,2587.34,2587.34,1282.71,867.38,867.38,SKIPPED,SKIPPED,1308.89,1308.89,2587.34
3630315,975,25295,,,,,,,RELEASE WRIST/FOREARM TENDON,1247.65,499.06,0,1247.65,1060.5,SKIPPED,1247.65,1247.65,1060.5,1060.5,1060.5,579.22,611.35,611.35,SKIPPED,SKIPPED,591.04,591.04,0
3630316,360,24342,,,,,,,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO,10242.16,4096.86,1051.35,10242.16,8705.84,SKIPPED,10242.16,10242.16,8705.84,8705.84,8705.84,4316.05,1051.35,1051.35,SKIPPED,SKIPPED,4404.13,4404.13,8705.84
3630317,975,24342,,,,,,,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO,1942.51,777,0,1942.51,1651.13,SKIPPED,1942.51,1942.51,1651.13,1651.13,1651.13,847.5,951.83,951.83,SKIPPED,SKIPPED,864.8,864.8,0
3630318,360,26951,,,,,,,AMPUTATION OF FINGER/THUMB,4995.38,1998.15,867.38,4995.38,4246.07,SKIPPED,4995.38,4995.38,4246.07,4246.07,4246.07,2105.05,867.38,867.38,SKIPPED,SKIPPED,2148.01,2148.01,4246.07
3630319,975,26951,,,,,,,AMPUTATION OF FINGER/THUMB,1606.84,642.74,0,1606.84,1365.81,SKIPPED,1606.84,1606.84,1365.81,1365.81,1365.81,782.17,787.35,787.35,SKIPPED,SKIPPED,798.13,798.13,0
3630320,360,29819,,,,,,,ARTHROSCOPY SHOULDER SURGICAL REMOVAL LO,5629.68,2251.87,867.38,5629.68,4785.23,SKIPPED,5629.68,5629.68,4785.23,4785.23,4785.23,2372.34,867.38,867.38,SKIPPED,SKIPPED,2420.76,2420.76,4785.23
3630321,975,29819,,,,,,,ARTHROSCOPY SHOULDER SURGICAL REMOVAL LO,1467.72,587.09,0,1467.72,1247.56,SKIPPED,1467.72,1467.72,1247.56,1247.56,1247.56,642.45,719.18,719.18,SKIPPED,SKIPPED,655.56,655.56,0
3630322,360,27125,,,,,,,PARTIAL HIP REPLACEMENT,11228.73,4491.49,0,9544.42,9544.42,SKIPPED,5576.12,5576.12,9544.42,9544.42,9544.42,4731.78,0,0,0,3368.62,4828.35,4828.35,9544.42
3630323,975,27125,,,,,,,PARTIAL HIP REPLACEMENT,2856.33,1142.53,0,2856.33,2427.88,SKIPPED,2856.33,2856.33,2427.88,2427.88,2427.88,1229.1,1399.6,1399.6,0,856.9,1254.18,1254.18,0
3630324,360,25545,,,,,,,TRT FX OF ULNA,9990.73,3996.29,1051.35,9990.73,8492.12,SKIPPED,9990.73,9990.73,8492.12,8492.12,8492.12,4210.09,1051.35,1051.35,SKIPPED,SKIPPED,4296.01,4296.01,8492.12
3630325,975,25545,,,,,,,TRT FX OF ULNA,1567.27,626.91,0,1567.27,1332.18,SKIPPED,1567.27,1567.27,1332.18,1332.18,1332.18,685.04,767.96,767.96,SKIPPED,SKIPPED,699.02,699.02,0
3630326,360,27825,,,,,,,TRT LOWER LEG FX,2779.75,1111.9,510.13,2779.75,2362.79,SKIPPED,2779.75,2779.75,2362.79,2362.79,2362.79,1171.38,510.13,510.13,SKIPPED,SKIPPED,1195.29,1195.29,2362.79
3630327,975,27825,,,,,,,TRT LOWER LEG FX,1249.49,499.8,0,1249.49,1062.07,SKIPPED,1249.49,1249.49,1062.07,1062.07,1062.07,539.27,612.25,612.25,SKIPPED,SKIPPED,550.28,550.28,0
3630328,360,24340,,,,,,,RPR BICEPS TENDON,8230.74,3292.3,1051.35,8230.74,6996.13,SKIPPED,8230.74,8230.74,6996.13,6996.13,6996.13,3468.44,1051.35,1051.35,SKIPPED,SKIPPED,3539.22,3539.22,6996.13
3630329,975,24340,,,,,,,RPR BICEPS TENDON,1544.31,617.72,0,1544.31,1312.66,SKIPPED,1544.31,1544.31,1312.66,1312.66,1312.66,677.64,756.71,756.71,SKIPPED,SKIPPED,691.47,691.47,0
3630330,360,27244,,,,,,,TRT THIGH FX,4186.2,1674.48,0,4186.2,3558.27,SKIPPED,4186.2,4186.2,3558.27,3558.27,3558.27,1764.07,0,0,0,1255.86,1800.07,1800.07,3558.27
3630331,975,27244,,,,,,,TRT THIGH FX,2943.03,1177.21,0,2943.03,2501.58,SKIPPED,2943.03,2943.03,2501.58,2501.58,2501.58,1332.95,1442.08,1442.08,0,882.91,1360.15,1360.15,0
3630332,975,27310,,,,,,,EXP KNEE JOINT,1844.23,737.69,0,1844.23,1567.6,SKIPPED,1844.23,1844.23,1567.6,1567.6,1567.6,800.15,903.67,903.67,SKIPPED,SKIPPED,816.48,816.48,0
3630333,360,27240,,,,,,,TRT THIGH FX,4211.73,1684.69,0,4211.73,3579.97,SKIPPED,4211.73,4211.73,3579.97,3579.97,3579.97,1774.82,0,0,0,1263.52,1811.04,1811.04,3579.97
3630334,975,27240,,,,,,,TRT THIGH FX,2423.66,969.46,0,2423.66,2060.11,SKIPPED,2423.66,2423.66,2060.11,2060.11,2060.11,1044.81,1187.59,1187.59,0,727.1,1066.13,1066.13,0
3630335,360,,,,,,,,SURGICAL FIRST ASSIST,165.93,66.37,0,141.04,141.04,SKIPPED,126.11,126.11,141.04,141.04,141.04,69.92,0,0,0,49.78,71.35,71.35,141.04
3630336,360,27769,,,,,,,OPTX POST ANKLE FX,9957.56,3983.02,1051.35,9957.56,8463.93,SKIPPED,9957.56,9957.56,8463.93,8463.93,8463.93,4196.12,1051.35,1051.35,SKIPPED,SKIPPED,4281.75,4281.75,8463.93
3630337,975,27769,,,,,,,OPTX POST ANKLE FX,1846.78,738.71,0,1846.78,1569.76,SKIPPED,1846.78,1846.78,1569.76,1569.76,1569.76,796.5,904.92,904.92,SKIPPED,SKIPPED,812.75,812.75,0
3630338,360,27829,,,,,,,TRT LOWER LEG JOINT,6040.64,2416.26,1051.35,6040.64,5134.54,SKIPPED,6040.64,6040.64,5134.54,5134.54,5134.54,2545.53,1051.35,1051.35,SKIPPED,SKIPPED,2597.48,2597.48,5134.54
3630339,975,27829,,,,,,,TRT LOWER LEG JOINT,1752.33,700.93,0,1752.33,1489.48,SKIPPED,1752.33,1752.33,1489.48,1489.48,1489.48,779.71,858.64,858.64,SKIPPED,SKIPPED,795.62,795.62,0
3630340,360,27698,,,,,,,RPR ANKLE LIGAMENT,6123.6,2449.44,1051.35,6123.6,5205.06,SKIPPED,6123.6,6123.6,5205.06,5205.06,5205.06,2580.49,1051.35,1051.35,SKIPPED,SKIPPED,2633.15,2633.15,5205.06
3630341,975,27698,,,,,,,RPR ANKLE LIGAMENT,1625.99,650.4,0,1625.99,1382.09,SKIPPED,1625.99,1625.99,1382.09,1382.09,1382.09,698.89,796.74,796.74,SKIPPED,SKIPPED,713.15,713.15,0
3630342,360,24366,,,,,,,RECONSTRUCT HEAD OF RADIUS,11540.14,4616.06,1051.35,11540.14,9809.12,SKIPPED,11540.14,11540.14,9809.12,9809.12,9809.12,4863.01,1051.35,1051.35,SKIPPED,SKIPPED,4962.26,4962.26,9809.12
3630343,975,24366,,,,,,,RECONSTRUCT HEAD OF RADIUS,1716.59,686.64,0,1716.59,1459.1,SKIPPED,1716.59,1716.59,1459.1,1459.1,1459.1,746.19,841.13,841.13,SKIPPED,SKIPPED,761.42,761.42,0
3630344,360,27822,,,,,,,TRT ANKLE FX,12411.84,4964.74,1051.35,12411.84,10550.06,SKIPPED,12411.84,12411.84,10550.06,10550.06,10550.06,5230.35,1051.35,1051.35,SKIPPED,SKIPPED,5337.09,5337.09,10550.06
3630345,975,27822,,,,,,,TRT ANKLE FX,2164.58,865.83,0,2164.58,1839.89,SKIPPED,2164.58,2164.58,1839.89,1839.89,1839.89,963.01,1060.64,1060.64,SKIPPED,SKIPPED,982.66,982.66,0
3630346,360,24359,,,,,,,RPR ELBOW DED/ATTCH-OPEN,6856.19,2742.48,867.38,6856.19,5827.76,SKIPPED,6856.19,6856.19,5827.76,5827.76,5827.76,2889.2,867.38,867.38,SKIPPED,SKIPPED,2948.16,2948.16,5827.76
3630347,975,24359,,,,,,,RPR ELBOW DED/ATTCH-OPEN,1665.55,666.22,0,1665.55,1415.72,SKIPPED,1665.55,1665.55,1415.72,1415.72,1415.72,725.74,816.12,816.12,SKIPPED,SKIPPED,740.55,740.55,0
3630348,975,29843,,,,,,,WRIST ARTHROSCOPY,1222.61,489.04,0,1222.61,1039.22,SKIPPED,1222.61,1222.61,1039.22,1039.22,1039.22,532.48,599.08,599.08,SKIPPED,SKIPPED,543.35,543.35,0
3630349,975,27220,,,,,,,TRT HIP SOCKET FX,1323.82,529.53,0,1125.25,1125.25,SKIPPED,1020.78,1020.78,1125.25,1125.25,1125.25,452.47,648.67,648.67,SKIPPED,SKIPPED,461.7,461.7,0
3630350,360,23931,,,,,,,DRAIN ARM BURSA,2602.98,1041.19,414.14,2602.98,2212.53,SKIPPED,2602.98,2602.98,2212.53,2212.53,2212.53,1096.89,414.14,414.14,SKIPPED,SKIPPED,1119.28,1119.28,2212.53
3630351,975,23931,,,,,,,DRAIN ARM BURSA,401.93,160.77,0,401.93,341.64,SKIPPED,401.93,401.93,341.64,341.64,341.64,175.6,196.95,196.95,SKIPPED,SKIPPED,179.18,179.18,0
3630352,360,23515,,,,,,,TRT CLAVICAL FX,14421.98,5768.79,1051.35,14421.98,12258.68,SKIPPED,14421.98,14421.98,12258.68,12258.68,12258.68,6077.42,1051.35,1051.35,SKIPPED,SKIPPED,6201.45,6201.45,12258.68
3630353,975,23515,,,,,,,TRT CLAVICAL FX,1815.02,726.01,0,1815.02,1542.77,SKIPPED,1815.02,1815.02,1542.77,1542.77,1542.77,787.12,889.36,889.36,SKIPPED,SKIPPED,803.18,803.18,0
3630354,975,27888,,,,,,,AMPT FOOT AT ANKLE,1713.03,685.21,0,1713.03,1456.08,SKIPPED,1713.03,1713.03,1456.08,1456.08,1456.08,707.48,839.38,839.38,0,513.91,721.92,721.92,0
3630355,975,27592,,,,,,,AMPT LEG AT THIGH,1724.7,689.88,0,1724.7,1466,SKIPPED,1724.7,1724.7,1466,1466,1466,722.94,845.1,845.1,0,517.41,737.69,737.69,0
3630356,360,29828,,,,,,,ARTHROSCOPY BICEPS TENODESIS,4815.85,1926.34,1051.35,4815.85,4093.47,SKIPPED,4815.85,4815.85,4093.47,4093.47,4093.47,2029.4,1051.35,1051.35,SKIPPED,SKIPPED,2070.82,2070.82,4093.47
3630357,975,29828,,,,,,,ARTHROSCOPY BICEPS TENODESIS,2174.66,869.86,0,2174.66,1848.46,SKIPPED,2174.66,2174.66,1848.46,1848.46,1848.46,999.18,1065.58,1065.58,SKIPPED,SKIPPED,1019.57,1019.57,0
3630358,360,26111,,,,,,,EXC HAND LESION SC 1.5CM>,4897.27,1958.91,414.14,4897.27,4162.68,SKIPPED,4897.27,4897.27,4162.68,4162.68,4162.68,2063.71,414.14,414.14,SKIPPED,SKIPPED,2105.83,2105.83,4162.68
3630359,975,26111,,,,,,,EXC HAND LESION SC 1.5CM>,995.4,398.16,0,995.4,846.09,SKIPPED,995.4,995.4,846.09,846.09,846.09,454.75,487.75,487.75,SKIPPED,SKIPPED,464.03,464.03,0
3630360,360,24545,,,,,,,TRT HUMERUS FX,17485.05,6994.02,1051.35,17485.05,14862.29,SKIPPED,17485.05,17485.05,14862.29,14862.29,14862.29,7368.2,1051.35,1051.35,SKIPPED,SKIPPED,7518.57,7518.57,14862.29
3630361,975,24545,,,,,,,TRT HUMERUS FX,2217.73,887.09,0,2217.73,1885.07,SKIPPED,2217.73,2217.73,1885.07,1885.07,1885.07,1011.84,1086.69,1086.69,SKIPPED,SKIPPED,1032.49,1032.49,0
3630362,360,29848,,,,,,,WRIST ENDOSCOPY,5522.04,2208.82,510.13,5522.04,4693.73,SKIPPED,5522.04,5522.04,4693.73,4693.73,4693.73,2326.99,510.13,510.13,SKIPPED,SKIPPED,2374.48,2374.48,4693.73
3630363,975,29848,,,,,,,WRIST ENDOSCOPY,1218.62,487.45,0,1218.62,1035.83,SKIPPED,1218.62,1218.62,1035.83,1035.83,1035.83,559.99,597.12,597.12,SKIPPED,SKIPPED,571.42,571.42,0
3630364,360,26160,,,,,,,RMV TENDON SHEATH LESION,4264,1705.6,510.13,4264,3624.4,SKIPPED,4264,4264,3624.4,3624.4,3624.4,1796.85,510.13,510.13,SKIPPED,SKIPPED,1833.52,1833.52,3624.4
3630365,975,26160,,,,,,,RMV TENDON SHEATH LESION,791.18,316.47,0,791.18,672.5,SKIPPED,791.18,791.18,672.5,672.5,672.5,347.2,387.68,387.68,SKIPPED,SKIPPED,354.29,354.29,0
3630366,360,27422,,,,,,,REVISION OF UNSTABLE KNEECAP,9446.91,3778.76,1051.35,9446.91,8029.87,SKIPPED,9446.91,9446.91,8029.87,8029.87,8029.87,3980.93,1051.35,1051.35,SKIPPED,SKIPPED,4062.17,4062.17,8029.87
3630367,975,27422,,,,,,,REVISION OF UNSTABLE KNEECAP,1767.93,707.17,0,1767.93,1502.74,SKIPPED,1767.93,1767.93,1502.74,1502.74,1502.74,812.28,866.29,866.29,SKIPPED,SKIPPED,828.86,828.86,0
3630368,360,27279,,,,,,,ARTHRODESIS SACROILIAC JOINT,14656.58,5862.63,0,14656.58,12458.09,SKIPPED,14656.58,14656.58,12458.09,12458.09,12458.09,6176.28,0,0,0,4396.97,6302.33,6302.33,12458.09
3630369,975,27279,,,,,,,ARTHRODESIS SACROILIAC JOINT,1644.67,657.87,0,1644.67,1397.97,SKIPPED,1644.67,1644.67,1397.97,1397.97,1397.97,906.13,805.89,805.89,0,493.4,924.62,924.62,0
3630370,278,,,,,,,,iFUSE Implant System(all sizes),8750,3500,0,7437.5,7437.5,SKIPPED,6650,6650,7437.5,7437.5,7437.5,3687.25,4287.5,4287.5,0,2625,3762.5,3762.5,7437.5
3630371,360,23472,,,,,,,RECONSTRUCT SHOULDER JOINT,18232.6,7293.04,0,15497.71,15497.71,SKIPPED,7161.48,7161.48,15497.71,15497.71,15497.71,7683.22,0,0,0,5469.78,7840.02,7840.02,15497.71
3630372,975,23472,,,,,,,RECONSTRUCT SHOULDER JOINT,3484.32,1393.73,0,3484.32,2961.67,SKIPPED,3484.32,3484.32,2961.67,2961.67,2961.67,1570.58,1707.32,1707.32,0,1045.3,1602.63,1602.63,0
3630373,360,29823,,,,,,,SHOULDER ARTHROSCOPY,6419.09,2567.64,867.38,6419.09,5456.23,SKIPPED,6419.09,6419.09,5456.23,5456.23,5456.23,2705.01,867.38,867.38,SKIPPED,SKIPPED,2760.21,2760.21,5456.23
3630374,975,29823,,,,,,,SHOULDER ARTHROSCOPY,1475.79,590.32,0,1475.79,1254.42,SKIPPED,1475.79,1475.79,1254.42,1254.42,1254.42,648.31,723.14,723.14,SKIPPED,SKIPPED,661.54,661.54,0
3630375,975,26115,,,,,,,EXC HAND LESION SC<1.5CM,790.78,316.31,0,790.78,672.16,SKIPPED,790.78,790.78,672.16,672.16,672.16,363.27,387.48,387.48,SKIPPED,SKIPPED,370.68,370.68,0
3630376,360,27385,,,,,,,RPR THIGH MUSCLE,10003.62,4001.45,1051.35,10003.62,8503.08,SKIPPED,10003.62,10003.62,8503.08,8503.08,8503.08,4215.53,1051.35,1051.35,SKIPPED,SKIPPED,4301.56,4301.56,8503.08
3630377,975,27385,,,,,,,RPR THIGH MUSCLE,1362.83,545.13,0,1362.83,1158.41,SKIPPED,1362.83,1362.83,1158.41,1158.41,1158.41,670.31,667.79,667.79,SKIPPED,SKIPPED,683.99,683.99,0
3630378,360,27245,,,,,,,TRT THIGH FX,7967.64,3187.06,0,6772.49,6772.49,SKIPPED,6055.16,6055.16,6772.49,6772.49,6772.49,3357.57,0,0,0,2390.29,3426.09,3426.09,6772.49
3630379,975,27245,,,,,,,TRT THIGH FX,2943.03,1177.21,0,2943.03,2501.58,SKIPPED,2943.03,2943.03,2501.58,2501.58,2501.58,1332.12,1442.08,1442.08,0,882.91,1359.31,1359.31,0
3630380,360,64708,,,,,,,NEUROPLASTY; MAJOR PERIPHERAL NERVE,5757.39,2302.96,510.13,5757.39,4893.78,SKIPPED,5757.39,5757.39,4893.78,4893.78,4893.78,2426.17,510.13,510.13,SKIPPED,SKIPPED,2475.68,2475.68,4893.78
3630381,975,64708,,,,,,,NEUROPLASTY; MAJOR PERIPHERAL NERVE,1186.73,474.69,0,1186.73,1008.72,SKIPPED,1186.73,1186.73,1008.72,1008.72,1008.72,550.46,581.5,581.5,SKIPPED,SKIPPED,561.69,561.69,0
3630382,360,27428,,,,,,,LIGAMENT RECONTRUCTION; INTRA-ARTICULAR,9032.84,3613.14,1051.35,9032.84,7677.91,SKIPPED,9032.84,9032.84,7677.91,7677.91,7677.91,3806.44,1051.35,1051.35,SKIPPED,SKIPPED,3884.12,3884.12,7677.91
3630383,975,27428,,,,,,,LIGAMENT RECONTRUCTION; INTRA-ARTICULAR,2664.72,1065.89,0,2664.72,2265.01,SKIPPED,2664.72,2664.72,2265.01,2265.01,2265.01,1216.06,1305.71,1305.71,SKIPPED,SKIPPED,1240.88,1240.88,0
3630384,278,,,,,,,,FROZEN HUMAN TISSUE GRAFT,5165,2066,0,4390.25,4390.25,SKIPPED,3925.4,3925.4,4390.25,4390.25,4390.25,2176.53,2530.85,2530.85,0,1549.5,2220.95,2220.95,4390.25
3630385,272,,,,,,,,PIN PASSING DRILL TIP,386.25,154.5,0,328.31,328.31,SKIPPED,293.55,293.55,328.31,328.31,328.31,162.77,189.26,189.26,0,115.88,166.09,166.09,328.31
3630386,272,,,,,,,,ENDOSCOPIC DRILL TIP,360.5,144.2,0,306.42,306.42,SKIPPED,273.98,273.98,306.42,306.42,306.42,151.92,176.64,176.64,0,108.15,155.02,155.02,306.42
3630387,272,,,,,,,,DISP FIRST PASS STR,772.5,309,0,656.62,656.62,SKIPPED,587.1,587.1,656.62,656.62,656.62,325.54,378.52,378.52,0,231.75,332.18,332.18,656.62
3630388,278,,,,,,,,HEALICOIL SA,1030,412,0,875.5,875.5,SKIPPED,782.8,782.8,875.5,875.5,875.5,434.04,504.7,504.7,0,309,442.9,442.9,875.5
3630389,272,,,,,,,,TWIST DRILL,772.5,309,0,656.62,656.62,SKIPPED,587.1,587.1,656.62,656.62,656.62,325.54,378.52,378.52,0,231.75,332.18,332.18,656.62
3630390,272,,,,,,,,SUTUREFIX ULTRA,1158.75,463.5,0,984.94,984.94,SKIPPED,880.65,880.65,984.94,984.94,984.94,488.29,567.79,567.79,0,347.62,498.26,498.26,984.94
3630391,272,,,,,,,,ACCU-PASS STR SHUTTLE,463.5,185.4,0,393.98,393.98,SKIPPED,352.26,352.26,393.98,393.98,393.98,195.32,227.12,227.12,0,139.05,199.31,199.31,393.98
3630392,360,27427,,,,,,,LIGAMENT RECONTRUCTION; EXTRA-ARTICULAR,7323.6,2929.44,1051.35,7323.6,6225.06,SKIPPED,7323.6,7323.6,6225.06,6225.06,6225.06,3086.17,1051.35,1051.35,SKIPPED,SKIPPED,3149.15,3149.15,6225.06
3630393,975,27427,,,,,,,LIGAMENT RECONTRUCTION; EXTRA-ARTICULAR,1690.22,676.09,0,1690.22,1436.69,SKIPPED,1690.22,1690.22,1436.69,1436.69,1436.69,777.61,828.21,828.21,SKIPPED,SKIPPED,793.48,793.48,0
3630394,360,24000,,,,,,,ARTHROTOMY ELBOW,5343.99,2137.6,867.38,5343.99,4542.39,SKIPPED,5343.99,5343.99,4542.39,4542.39,4542.39,2251.96,867.38,867.38,SKIPPED,SKIPPED,2297.92,2297.92,4542.39
3630395,975,24000,,,,,,,ARTHROTOMY ELBOW,1132.85,453.14,0,1132.85,962.92,SKIPPED,1132.85,1132.85,962.92,962.92,962.92,519.45,555.1,555.1,SKIPPED,SKIPPED,530.05,530.05,0
3630396,360,27759,,,,,,,TX TIBL SHFT FX IMED IMPLT,13245.5,5298.2,1051.35,13245.5,11258.68,SKIPPED,13245.5,13245.5,11258.68,11258.68,11258.68,5581.66,1051.35,1051.35,SKIPPED,SKIPPED,5695.57,5695.57,11258.68
3630397,975,27759,,,,,,,TX TIBL SHFT FX IMED IMPLT,2384.64,953.86,0,2384.64,2026.94,SKIPPED,2384.64,2384.64,2026.94,2026.94,2026.94,1085.39,1168.47,1168.47,SKIPPED,SKIPPED,1107.54,1107.54,0
3630398,360,27870,,,,,,,ARTHRODESIS ANKLE OPEN,13073.98,5229.59,1051.35,13073.98,11112.88,SKIPPED,13073.98,13073.98,11112.88,11112.88,11112.88,5509.37,1051.35,1051.35,SKIPPED,SKIPPED,5621.81,5621.81,11112.88
3630399,975,27870,,,,,,,ARTHRODESIS ANKLE OPEN,2461.04,984.42,0,2461.04,2091.88,SKIPPED,2461.04,2461.04,2091.88,2091.88,2091.88,1104.47,1205.91,1205.91,SKIPPED,SKIPPED,1127.01,1127.01,0
3630400,278,,,,,,,,ENDOBUTTON,1000,400,0,850,850,SKIPPED,760,760,850,850,850,421.4,490,490,0,300,430,430,850
3630401,975,29888,,,,,,,Surgical Assist- ACL RECONSTRUCTION,435.66,174.26,0,1086.07,370.31,SKIPPED,435.66,435.66,370.31,370.31,370.31,1064.35,213.47,213.47,SKIPPED,SKIPPED,1086.07,1086.07,0
3630402,975,20693,,,,,,,Surgical Assist-ADJ-REVISE EXT FIXATION,169.22,67.69,0,495.11,143.84,SKIPPED,169.22,169.22,143.84,143.84,143.84,485.21,82.92,82.92,SKIPPED,SKIPPED,495.11,495.11,0
3630403,975,29867,,,,,,,Surgical Assist-ALLGRAF IMPLANT KNEE,540.54,216.22,0,1417.41,459.46,SKIPPED,540.54,540.54,459.46,459.46,459.46,1389.06,264.86,264.86,0,162.16,1417.41,1417.41,0
3630404,975,26951,,,,,,,Surgical Assist-AMPUTATION OF FINGER/THU,257.09,102.84,0,798.13,218.53,SKIPPED,257.09,257.09,218.53,218.53,218.53,782.17,125.97,125.97,SKIPPED,SKIPPED,798.13,798.13,0
3630405,975,27880,,,,,,,Surgical Assist-AMPUTATION LOWER LEG,390.84,156.34,0,989.01,332.21,SKIPPED,390.84,390.84,332.21,332.21,332.21,969.23,191.51,191.51,0,117.25,989.01,989.01,0
3630406,975,20690,,,,,,,Surgical Assist-APPLY BONE FIXATE,249.81,99.92,0,662.57,212.34,SKIPPED,249.81,249.81,212.34,212.34,212.34,649.32,122.41,122.41,SKIPPED,SKIPPED,662.57,662.57,0
3630407,975,29824,,,,,,,Surgical Assist-ARTHROSCOPY SHOULDER DIS,309.7,123.88,0,755.63,263.24,SKIPPED,309.7,309.7,263.24,263.24,263.24,740.52,151.75,151.75,SKIPPED,SKIPPED,755.63,755.63,0
3630408,975,27870,,,,,,,Surgical Assist-ARTHRODESIS ANKLE OPEN,393.77,157.51,0,1127.01,334.7,SKIPPED,393.77,393.77,334.7,334.7,334.7,1104.47,192.95,192.95,SKIPPED,SKIPPED,1127.01,1127.01,0
3630409,975,27279,,,,,,,Surgical Assist-ARTHRODESIS SACROILIAC,263.14,105.26,0,924.62,223.67,SKIPPED,263.14,263.14,223.67,223.67,223.67,906.13,128.94,128.94,0,78.94,924.62,924.62,0
3630410,975,27130,,,,,,,Surgical Assist-ARTHROPLASTY TOTAL HIP,626.91,250.76,0,1420.89,532.87,SKIPPED,626.91,626.91,532.87,532.87,532.87,1392.47,307.19,307.19,0,188.07,1420.89,1420.89,0
3630411,975,29881,,,,,,,Surgical Assist-ARTHRO KNEE W/ MENI.,247.74,99.1,0,604.43,210.58,SKIPPED,247.74,247.74,210.58,210.58,210.58,592.34,121.39,121.39,SKIPPED,SKIPPED,604.43,604.43,0
3630412,975,29828,,,,,,,Surgical Assist-ARTHROSCOPY BICEPS TENOD,347.95,139.18,0,1019.57,295.76,SKIPPED,347.95,347.95,295.76,295.76,295.76,999.18,170.5,170.5,SKIPPED,SKIPPED,1019.57,1019.57,0
3630413,975,29880,,,,,,,Surgical Assist-ARTHROSCOPY KNEE,257.67,103.07,0,627.23,219.02,SKIPPED,257.67,257.67,219.02,219.02,219.02,614.69,126.26,126.26,SKIPPED,SKIPPED,627.23,627.23,0
3630414,975,29877,,,,,,,Surgical Assist-ARTHRO KNEE W/ DEBRID,342.75,137.1,0,692.79,291.34,SKIPPED,342.75,342.75,291.34,291.34,291.34,678.93,167.95,167.95,SKIPPED,SKIPPED,692.79,692.79,0
3630415,975,29873,,,,,,,Surgical Assist-ARTHRO KNEE W/ LAT RELEA,238.75,95.5,0,601.29,202.94,SKIPPED,238.75,238.75,202.94,202.94,202.94,589.26,116.99,116.99,SKIPPED,SKIPPED,601.29,601.29,0
3630416,975,29827,,,,,,,Surgical Assist-ARTHRO SHOULDER ROTATOR,494.06,197.62,0,1187.92,419.95,SKIPPED,494.06,494.06,419.95,419.95,419.95,1164.16,242.09,242.09,SKIPPED,SKIPPED,1187.92,1187.92,0
3630417,975,29819,,,,,,,Surgical Assist-ARTHRO SHOULDER REMOVAL,234.83,93.93,0,655.56,199.61,SKIPPED,234.83,234.83,199.61,199.61,199.61,642.45,115.07,115.07,SKIPPED,SKIPPED,655.56,655.56,0
3630418,975,24000,,,,,,,Surgical Assist-ARTHRO ELBOW,181.25,72.5,0,530.05,154.06,SKIPPED,181.25,181.25,154.06,154.06,154.06,519.45,88.81,88.81,SKIPPED,SKIPPED,530.05,530.05,0
3630419,975,29866,,,,,,,Surgical Assist-AUTOGRAFT IMPLN KNEE W/,401.25,160.5,0,1168.62,341.06,SKIPPED,401.25,401.25,341.06,341.06,341.06,1145.25,196.61,196.61,SKIPPED,SKIPPED,1168.62,1168.62,0
3630420,975,20220,,,,,,,Surgical Assist-BONE BX TROCAR/NEEDLE,27.81,11.12,0,97.43,23.64,SKIPPED,27.81,27.81,23.64,23.64,23.64,95.48,13.63,13.63,SKIPPED,SKIPPED,97.43,97.43,0
3630421,975,64721,,,,,,,Surgical Assist-CARPAL TUNNEL PROF,192.68,77.07,0,487.22,163.78,SKIPPED,192.68,192.68,163.78,163.78,163.78,477.48,94.41,94.41,SKIPPED,SKIPPED,487.22,487.22,0
3630422,975,13132,,,,,,,Surgical Assist-CMPLX RPR 2.6CM-7.5CM,145.39,58.16,0,336.48,123.58,SKIPPED,145.39,145.39,123.58,123.58,123.58,329.75,71.24,71.24,SKIPPED,SKIPPED,336.48,336.48,0
3630423,975,13133,,,,,,,Surgical Assist-CMPLX RPR EA ADTL,60.98,24.39,0,138.95,51.83,SKIPPED,0,0,51.83,51.83,51.83,136.17,29.88,29.88,0,18.29,138.95,138.95,0
3630424,975,11044,,,,,,,Surgical Assist-DEB BONE 20 SQ CM/<,108.27,43.31,0,248.58,92.03,SKIPPED,108.27,108.27,92.03,92.03,92.03,243.61,53.05,53.05,SKIPPED,SKIPPED,248.58,248.58,0
3630425,975,11043,,,,,,,Surgical Assist-DEB MUSC/FAS 20 SQ CM/<,103.81,41.52,0,170.19,88.24,SKIPPED,103.81,103.81,88.24,88.24,88.24,166.79,50.87,50.87,SKIPPED,SKIPPED,170.19,170.19,0
3630426,975,11042,,,,,,,Surgical Assist-DEB SUBQ TISSUE 20 SQ CM,53.92,21.57,0,66.93,45.83,SKIPPED,53.92,53.92,45.83,45.83,45.83,65.59,26.42,26.42,SKIPPED,SKIPPED,66.93,66.93,0
3630427,975,11045,,,,,,,Surgical Assist-DEB SUBQ ADD ON,18.92,7.57,0,28.83,16.08,SKIPPED,0,0,16.08,16.08,16.08,28.25,9.27,9.27,0,5.68,28.83,28.83,0
3630428,975,27496,,,,,,,Surgical Assist-DECOMPRESS THIGH/KNEE,250.09,100.04,0,613.63,212.58,SKIPPED,250.09,250.09,212.58,212.58,212.58,601.36,122.54,122.54,SKIPPED,SKIPPED,613.63,613.63,0
3630429,975,20610,,,,,,,Surgical Assist-DRAIN/INJ BURSA,17.76,7.1,0,50.19,15.1,SKIPPED,17.76,17.76,15.1,15.1,15.1,49.19,8.7,8.7,0,5.33,50.19,50.19,0
3630430,975,20600,,,,,,,Surgical Assist-DRAIN/INJ JOINT W/O US,16.56,6.62,0,39.76,14.08,SKIPPED,16.56,16.56,14.08,14.08,14.08,38.96,8.11,8.11,0,4.97,39.76,39.76,0
3630431,975,23931,,,,,,,Surgical Assist-DRAIN ARM BURSA,64.32,25.73,0,179.18,54.67,SKIPPED,64.32,64.32,54.67,54.67,54.67,175.6,31.52,31.52,SKIPPED,SKIPPED,179.18,179.18,0
3630432,975,25112,,,,,,,"Surgical Assist-EX GANG WRIST,RECUR",246.57,98.63,0,438,209.58,SKIPPED,246.57,246.57,209.58,209.58,209.58,429.24,120.82,120.82,SKIPPED,SKIPPED,438,438,0
3630433,975,25071,,,,,,,Surgical Assist-EXC FOREARM LESSION SC,178.4,71.36,0,472.24,151.64,SKIPPED,178.4,178.4,151.64,151.64,151.64,462.8,87.42,87.42,SKIPPED,SKIPPED,472.24,472.24,0
3630434,975,26111,,,,,,,Surgical Assist-EXC HAND LES 1.5CM<,159.26,63.7,0,464.03,135.37,SKIPPED,159.26,159.26,135.37,135.37,135.37,454.75,78.04,78.04,SKIPPED,SKIPPED,464.03,464.03,0
3630435,975,26115,,,,,,,Surgical Assist-EXC HAND LES <1.5CM,126.53,50.61,0,370.68,107.55,SKIPPED,126.53,126.53,107.55,107.55,107.55,363.27,62,62,SKIPPED,SKIPPED,370.68,370.68,0
3630436,975,27618,,,,,,,Surgical Assist-EXC LEG/ANKLE TUM,200.47,80.19,0,341.58,170.4,SKIPPED,200.47,200.47,170.4,170.4,170.4,334.75,98.23,98.23,SKIPPED,SKIPPED,341.58,341.58,0
3630437,975,27337,,,,,,,Surgical Assist-EXC THIGH/KNEE LES 3+CM,193.84,77.54,0,466.2,164.76,SKIPPED,193.84,193.84,164.76,164.76,164.76,456.88,94.98,94.98,SKIPPED,SKIPPED,466.2,466.2,0
3630438,975,25118,,,,,,,Surgical Assist-EXC WRIST TENDON,166.6,66.64,0,430.09,141.61,SKIPPED,166.6,166.6,141.61,141.61,141.61,421.49,81.63,81.63,SKIPPED,SKIPPED,430.09,430.09,0
3630439,975,27310,,,,,,,Surgical Assist-EXP KNEE JOINT,295.08,118.03,0,816.48,250.82,SKIPPED,295.08,295.08,250.82,250.82,250.82,800.15,144.59,144.59,SKIPPED,SKIPPED,816.48,816.48,0
3630440,975,35860,,,,,,,Surgical Assist-EXPLORE LIMB VESSELS,361.71,144.68,0,909.71,307.45,SKIPPED,361.71,361.71,307.45,307.45,307.45,891.52,177.24,177.24,0,108.51,909.71,909.71,0
3630441,975,27620,,,,,,,Surgical Assist-EXPLORE/TREAT ANKLE JNT,191.47,76.59,0,505.07,162.75,SKIPPED,191.47,191.47,162.75,162.75,162.75,494.97,93.82,93.82,SKIPPED,SKIPPED,505.07,505.07,0
3630442,975,27860,,,,,,,Surgical Assist-FIXATION OF ANKLE,76.55,30.62,0,185.73,65.07,SKIPPED,76.55,76.55,65.07,65.07,65.07,182.02,37.51,37.51,SKIPPED,SKIPPED,185.73,185.73,0
3630443,975,27570,,,,,,,Surgical Assist-FIXATION OF KNEE,68.33,27.33,0,170.29,58.08,SKIPPED,68.33,68.33,58.08,58.08,58.08,166.88,33.48,33.48,SKIPPED,SKIPPED,170.29,170.29,0
3630444,975,23700,,,,,,,Surgical Assist-FIXATION OF SHOULDER,89.11,35.64,0,218.65,75.74,SKIPPED,89.11,89.11,75.74,75.74,75.74,214.28,43.66,43.66,SKIPPED,SKIPPED,218.65,218.65,0
3630445,975,26055,,,,,,,Surgical Assist-INCISE FINGER TENDON,117.36,46.94,0,326.98,99.76,SKIPPED,117.36,117.36,99.76,99.76,99.76,320.44,57.51,57.51,SKIPPED,SKIPPED,326.98,326.98,0
3630446,975,25000,,,,,,,Surgical Assist-INCISION TENDON SHEATH,140.02,56.01,0,388.08,119.02,SKIPPED,140.02,140.02,119.02,119.02,119.02,380.32,68.61,68.61,SKIPPED,SKIPPED,388.08,388.08,0
3630447,975,36556,,,,,,,Surgical Assist-INSERT NON TUNNEL CV CAT,37.82,15.13,0,93.76,32.15,SKIPPED,37.82,37.82,32.15,32.15,32.15,91.88,18.53,18.53,SKIPPED,SKIPPED,93.76,93.76,0
3630448,975,29800,,,,,,,Surgical Assist-JAW ARTHROSCOPY,224.68,89.87,0,591.7,190.98,SKIPPED,224.68,224.68,190.98,190.98,190.98,579.87,110.09,110.09,SKIPPED,SKIPPED,591.7,591.7,0
3630449,975,29851,,,,,,,Surgical Assist-KNEE ARTHROSCOPY,391.29,156.52,0,1031.8,332.6,SKIPPED,391.29,391.29,332.6,332.6,332.6,1011.16,191.73,191.73,SKIPPED,SKIPPED,1031.8,1031.8,0
3630450,975,29876,,,,,,,Surgical Assist-KNEE ARTHRO MEDIAL/LATER,300.7,120.28,0,728.07,255.6,SKIPPED,300.7,300.7,255.6,255.6,255.6,713.51,147.34,147.34,SKIPPED,SKIPPED,728.07,728.07,0
3630451,975,29870,,,,,,,Surgical Assist-DX KNEE ARTHRO,253.06,101.22,0,455.31,215.1,SKIPPED,253.06,253.06,215.1,215.1,215.1,446.2,124,124,SKIPPED,SKIPPED,455.31,455.31,0
3630452,975,29875,,,,,,,Surgical Assist-KNEE ARTHRO,228.35,91.34,0,554.24,194.1,SKIPPED,228.35,228.35,194.1,194.1,194.1,543.16,111.89,111.89,SKIPPED,SKIPPED,554.24,554.24,0
3630453,975,29882,,,,,,,Surgical Assist-KNEE ARTHRO W/ MEN RPR,320.8,128.32,0,767.57,272.68,SKIPPED,320.8,320.8,272.68,272.68,272.68,752.22,157.19,157.19,SKIPPED,SKIPPED,767.57,767.57,0
3630454,975,29874,,,,,,,Surgical Assist-KNEE ARTHRO REMOVE LOOSE,248.21,99.28,0,598.49,210.98,SKIPPED,248.21,248.21,210.98,210.98,210.98,586.52,121.62,121.62,SKIPPED,SKIPPED,598.49,598.49,0
3630455,975,29879,,,,,,,Surgical Assist-KNEE ARTHRO MULTI DRILLI,293.36,117.34,0,736.82,249.36,SKIPPED,293.36,293.36,249.36,249.36,249.36,722.08,143.75,143.75,SKIPPED,SKIPPED,736.82,736.82,0
3630456,975,27427,,,,,,,Surgical Assist-LIG RECONSTRUCTION,270.43,108.17,0,793.48,229.87,SKIPPED,270.43,270.43,229.87,229.87,229.87,777.61,132.51,132.51,SKIPPED,SKIPPED,793.48,793.48,0
3630457,975,27428,,,,,,,Surgical Assist-LIGAMENT RECONSTRUCTION,426.36,170.54,0,1240.88,362.41,SKIPPED,426.36,426.36,362.41,362.41,362.41,1216.06,208.92,208.92,SKIPPED,SKIPPED,1240.88,1240.88,0
3630458,975,97605,,,,,,,Surgical Assist-NEG PRESS WND TX>/=50CM,13.29,5.32,0,28.44,11.3,SKIPPED,13.29,13.29,11.3,11.3,11.3,27.87,6.51,6.51,0,3.99,28.44,28.44,0
3630460,975,27814,,,,,,,Surgical Assist-OPEN TRT BIMALLEOLAR,324.81,129.92,0,853.01,276.09,SKIPPED,324.81,324.81,276.09,276.09,276.09,835.95,159.16,159.16,SKIPPED,SKIPPED,853.01,853.01,0
3630461,975,27766,,,,,,,Surgical Assist-OPEN TX MEDICAL ANKLE FX,281.79,112.72,0,676.63,239.52,SKIPPED,281.79,281.79,239.52,239.52,239.52,663.1,138.08,138.08,SKIPPED,SKIPPED,676.63,676.63,0
3630462,975,27769,,,,,,,Surgical Assist-OPTX POST ANKLE FX,295.49,118.2,0,812.75,251.17,SKIPPED,295.49,295.49,251.17,251.17,251.17,796.5,144.79,144.79,SKIPPED,SKIPPED,812.75,812.75,0
3630463,975,27125,,,,,,,Surgical Assist-PART HIP REPLACEMENT,457.01,182.8,0,1254.18,388.46,SKIPPED,457.01,457.01,388.46,388.46,388.46,1229.1,223.93,223.93,0,137.1,1254.18,1254.18,0
3630464,975,23120,,,,,,,Surgical Assist-PART REMOVAL COLLAR BONE,269.01,107.6,0,656.72,228.66,SKIPPED,269.01,269.01,228.66,228.66,228.66,643.59,131.81,131.81,SKIPPED,SKIPPED,656.72,656.72,0
3630465,975,28476,,,,,,,Surgical Assist-SKELETAL FIXATION,153.98,61.59,0,439.67,130.88,SKIPPED,153.98,153.98,130.88,130.88,130.88,430.88,75.45,75.45,SKIPPED,SKIPPED,439.67,439.67,0
3630466,975,26756,,,,,,,Surgical Assist-PIN FINGER FX,172.61,69.04,0,479.18,146.72,SKIPPED,172.61,172.61,146.72,146.72,146.72,469.6,84.58,84.58,SKIPPED,SKIPPED,479.18,479.18,0
3630467,975,24366,,,,,,,Surgical Assist-RECONSTRUCT RADIUS HEAD,274.66,109.86,0,761.42,233.46,SKIPPED,274.66,274.66,233.46,233.46,233.46,746.19,134.58,134.58,SKIPPED,SKIPPED,761.42,761.42,0
3630468,975,23470,,,,,,,Surgical Assist-RECONSTRUCT SHOULDER JNT,507.95,203.18,0,1330.75,431.76,SKIPPED,507.95,507.95,431.76,431.76,431.76,1304.14,248.9,248.9,0,152.38,1330.75,1330.75,0
3630469,975,23472,,,,,,,Surgical Assist-RECON SHOULDER JOINT,557.49,223,0,1602.63,473.87,SKIPPED,557.49,557.49,473.87,473.87,473.87,1570.58,273.17,273.17,0,167.25,1602.63,1602.63,0
3630470,975,23415,,,,,,,Surgical Assist-RELEASE SHOULDER LIGAMEN,291.19,116.48,0,779.77,247.51,SKIPPED,291.19,291.19,247.51,247.51,247.51,764.17,142.68,142.68,SKIPPED,SKIPPED,779.77,779.77,0
3630471,975,25295,,,,,,,Surgical Assist-RELEASE WRIST/FOREARM TE,209.31,83.72,0,591.04,177.91,SKIPPED,209.31,209.31,177.91,177.91,177.91,579.22,102.56,102.56,SKIPPED,SKIPPED,591.04,591.04,0
3630472,975,20670,,,,,,,Surgical Assist-RMV SUPERFICIAL IMPLANT,55.8,22.32,0,160.75,47.43,SKIPPED,55.8,55.8,47.43,47.43,47.43,157.54,27.34,27.34,SKIPPED,SKIPPED,160.75,160.75,0
3630473,975,20900,,,,,,,Surgical Assist-RMV BONE FOR GRAFT,88.41,35.36,0,201.03,75.15,SKIPPED,88.41,88.41,75.15,75.15,75.15,197.01,43.32,43.32,SKIPPED,SKIPPED,201.03,201.03,0
3630474,975,28118,,,,,,,Surgical Assist-RMV HEEL BONE,183.05,73.22,0,470.76,155.59,SKIPPED,183.05,183.05,155.59,155.59,155.59,461.34,89.69,89.69,SKIPPED,SKIPPED,470.76,470.76,0
3630475,975,20680,,,,,,,Surgical Assist-RMV SUPPORT IMPLANT,225.63,90.25,0,466.22,191.79,SKIPPED,225.63,225.63,191.79,191.79,191.79,456.9,110.56,110.56,SKIPPED,SKIPPED,466.22,466.22,0
3630476,975,27630,,,,,,,Surgical Assist-RMV TENDON LESION,161.2,64.48,0,402.45,137.02,SKIPPED,161.2,161.2,137.02,137.02,137.02,394.4,78.99,78.99,SKIPPED,SKIPPED,402.45,402.45,0
3630477,975,27340,,,,,,,Surgical Assist-REMOVE KNEE CAP BURSA,163.22,65.29,0,420.65,138.74,SKIPPED,163.22,163.22,138.74,138.74,138.74,412.24,79.98,79.98,SKIPPED,SKIPPED,420.65,420.65,0
3630478,975,27347,,,,,,,Surgical Assist-REMOVE KNEE CYST,232.81,93.12,0,588.52,197.89,SKIPPED,232.81,232.81,197.89,197.89,197.89,576.75,114.08,114.08,SKIPPED,SKIPPED,588.52,588.52,0
3630479,975,27635,,,,,,,Surgical Assist-RMV LOWER LEG BONE LES.,258.45,103.38,0,648.03,219.68,SKIPPED,258.45,258.45,219.68,219.68,219.68,635.07,126.64,126.64,SKIPPED,SKIPPED,648.03,648.03,0
3630480,975,25111,,,,,,,Surgical Assist-RMV WRIST TENDON,146.09,58.44,0,364.48,124.18,SKIPPED,146.09,146.09,124.18,124.18,124.18,357.19,71.58,71.58,SKIPPED,SKIPPED,364.48,364.48,0
3630481,975,27380,,,,,,,Surgical Assist-RPR KNEE CAP TENDON,261.16,104.46,0,701.53,221.99,SKIPPED,261.16,261.16,221.99,221.99,221.99,687.5,127.97,127.97,SKIPPED,SKIPPED,701.53,701.53,0
3630482,975,28200,,,,,,,Surgical Assist-RPR FOOT TENDON,204.83,81.93,0,366.98,174.11,SKIPPED,204.83,204.83,174.11,174.11,174.11,359.64,100.37,100.37,SKIPPED,SKIPPED,366.98,366.98,0
3630483,975,28322,,,,,,,Surgical Assist-RPR METATARSAL,286.38,114.55,0,643.86,243.42,SKIPPED,286.38,286.38,243.42,243.42,243.42,630.98,140.33,140.33,SKIPPED,SKIPPED,643.86,643.86,0
3630484,975,23455,,,,,,,Surgical Assist-RPR SHOULDER CAPSULE,463.8,185.52,0,1103.67,394.23,SKIPPED,463.8,463.8,394.23,394.23,394.23,1081.6,227.26,227.26,SKIPPED,SKIPPED,1103.67,1103.67,0
3630485,975,27170,,,,,,,Surgical Assist-RPR/GRAFT FEMUR HEAD NEC,519.84,207.94,0,1291.88,441.86,SKIPPED,519.84,519.84,441.86,441.86,441.86,1266.04,254.72,254.72,0,155.95,1291.88,1291.88,0
3630486,975,27438,,,,,,,Surgical Assist-REVISE KNEECAP W/ IMPLAN,353.78,141.51,0,935.4,300.71,SKIPPED,353.78,353.78,300.71,300.71,300.71,916.69,173.35,173.35,SKIPPED,SKIPPED,935.4,935.4,0
3630487,975,64718,,,,,,,Surgical Assist-REVISE ULNAR NERVE-ELBOW,260.04,104.02,0,670.53,221.03,SKIPPED,260.04,260.04,221.03,221.03,221.03,657.12,127.42,127.42,SKIPPED,SKIPPED,670.53,670.53,0
3630488,975,27440,,,,,,,Surgical Assist-REVISE KNEE JNT(TOTAL),368.77,147.51,0,888.47,313.45,SKIPPED,368.77,368.77,313.45,313.45,313.45,870.7,180.7,180.7,SKIPPED,SKIPPED,888.47,888.47,0
3630489,975,27422,,,,,,,Surgical Assist-REVISE UNSTABLE KNEE,282.87,113.15,0,828.86,240.44,SKIPPED,282.87,282.87,240.44,240.44,240.44,812.28,138.61,138.61,SKIPPED,SKIPPED,828.86,828.86,0
3630490,975,24342,,,,,,,Surgical Assist-RINSJ RPTD BICEPS/TRI TN,310.81,124.32,0,864.8,264.19,SKIPPED,310.81,310.81,264.19,264.19,264.19,847.5,152.3,152.3,SKIPPED,SKIPPED,864.8,864.8,0
3630491,975,26320,,,,,,,Surgical Assist-RMV IMPLANT HAND,144.08,57.63,0,393.67,122.47,SKIPPED,144.08,144.08,122.47,122.47,122.47,385.8,70.6,70.6,SKIPPED,SKIPPED,393.67,393.67,0
3630492,975,23130,,,,,,,Surgical Assist-RMV PART SHOULDER BONE,268.6,107.44,0,692.65,228.31,SKIPPED,268.6,268.6,228.31,228.31,228.31,678.8,131.61,131.61,SKIPPED,SKIPPED,692.65,692.65,0
3630493,975,26160,,,,,,,Surgical Assist-RMV TENDON SHEATH,126.59,50.64,0,354.29,107.6,SKIPPED,126.59,126.59,107.6,107.6,107.6,347.2,62.03,62.03,SKIPPED,SKIPPED,354.29,354.29,0
3630494,975,25110,,,,,,,Surgical Assist-RMV WRIST TENDO LESION,149.28,59.71,0,389.99,126.89,SKIPPED,149.28,149.28,126.89,126.89,126.89,382.19,73.15,73.15,SKIPPED,SKIPPED,389.99,389.99,0
3630495,975,20694,,,,,,,Surgical Assist-RMV DON FIX UNDER ANES,157.14,62.86,0,379.02,133.57,SKIPPED,157.14,157.14,133.57,133.57,133.57,371.44,77,77,SKIPPED,SKIPPED,379.02,379.02,0
3630496,975,24201,,,,,,,Surgical Assist-RMV FOEIGN BODY ARM,138.12,55.25,0,408.39,117.4,SKIPPED,138.12,138.12,117.4,117.4,117.4,400.22,67.68,67.68,SKIPPED,SKIPPED,408.39,408.39,0
3630497,975,27698,,,,,,,Surgical Assist-RPR ANKLE LIGAMENT,260.16,104.06,0,713.15,221.14,SKIPPED,260.16,260.16,221.14,221.14,221.14,698.89,127.48,127.48,SKIPPED,SKIPPED,713.15,713.15,0
3630498,975,24341,,,,,,,Surgical Assist-RPR ARM TENDON,343.02,137.21,0,831.67,291.57,SKIPPED,343.02,343.02,291.57,291.57,291.57,815.04,168.08,168.08,SKIPPED,SKIPPED,831.67,831.67,0
3630499,975,24340,,,,,,,Surgical Assist-RPR BICEPS TENDON,247.09,98.84,0,691.47,210.03,SKIPPED,247.09,247.09,210.03,210.03,210.03,677.64,121.07,121.07,SKIPPED,SKIPPED,691.47,691.47,0
3630500,975,23430,,,,,,,Surgical Assist-RPR BICEP TENDON,329.85,131.94,0,830.76,280.37,SKIPPED,329.85,329.85,280.37,280.37,280.37,814.14,161.63,161.63,SKIPPED,SKIPPED,830.76,830.76,0
3630501,975,23412,,,,,,,Surgical Assist-RPR ROTATOR CUFF,375.08,150.03,0,948.62,318.82,SKIPPED,375.08,375.08,318.82,318.82,318.82,929.65,183.79,183.79,SKIPPED,SKIPPED,948.62,948.62,0
3630502,975,24359,,,,,,,Surgical Assist-RPR ELBOW DED/ATTCH-OPEN,266.49,106.6,0,740.55,226.52,SKIPPED,266.49,266.49,226.52,226.52,226.52,725.74,130.58,130.58,SKIPPED,SKIPPED,740.55,740.55,0
3630503,975,28289,,,,,,,Surgical Assist-RPR HALLUX RIDGUS,254.86,101.94,0,513.39,216.63,SKIPPED,254.86,254.86,216.63,216.63,216.63,503.12,124.88,124.88,SKIPPED,SKIPPED,513.39,513.39,0
3630504,975,25400,,,,,,,Surgical Assist-RPR RADIUS OF ULNA,336.42,134.57,0,894.99,285.96,SKIPPED,336.42,336.42,285.96,285.96,285.96,877.09,164.85,164.85,SKIPPED,SKIPPED,894.99,894.99,0
3630505,975,23410,,,,,,,Surgical Assist-RPR ROTATOR CUFF,363.62,145.45,0,913.18,309.08,SKIPPED,363.62,363.62,309.08,309.08,309.08,894.92,178.17,178.17,SKIPPED,SKIPPED,913.18,913.18,0
3630506,975,27385,,,,,,,Surgical Assist-RPR THIGH MUSCLE,218.05,87.22,0,683.99,185.34,SKIPPED,218.05,218.05,185.34,185.34,185.34,670.31,106.84,106.84,SKIPPED,SKIPPED,683.99,683.99,0
3630507,975,29823,,,,,,,Surgical Assist-SHOULDER ARTHRO,236.12,94.45,0,661.54,200.7,SKIPPED,236.12,236.12,200.7,200.7,200.7,648.31,115.7,115.7,SKIPPED,SKIPPED,661.54,661.54,0
3630508,975,29822,,,,,,,Surgical Assist-SHOULDER ARTHRO DEBRID,260.99,104.4,0,604.58,221.84,SKIPPED,260.99,260.99,221.84,221.84,221.84,592.49,127.89,127.89,SKIPPED,SKIPPED,604.58,604.58,0
3630509,975,29805,,,,,,,Surgical Assist-SHOULDER ARTHRO DX,208.28,83.31,0,523.94,177.04,SKIPPED,208.28,208.28,177.04,177.04,177.04,513.46,102.06,102.06,SKIPPED,SKIPPED,523.94,523.94,0
3630510,975,29806,,,,,,,Surgical Assist-SHOULDER ARTHRO PROF,487.23,194.89,0,1177.44,414.15,SKIPPED,487.23,487.23,414.15,414.15,414.15,1153.89,238.74,238.74,SKIPPED,SKIPPED,1177.44,1177.44,0
3630511,975,29807,,,,,,,Surgical Assist-SHOULDER ARTHRO,474.66,189.86,0,1148.82,403.46,SKIPPED,474.66,474.66,403.46,403.46,403.46,1125.84,232.58,232.58,SKIPPED,SKIPPED,1148.82,1148.82,0
3630512,975,29826,,,,,,,Surgical Assist-SHOULDER BONE SHAVING,81.81,32.72,0,190.35,69.54,SKIPPED,0,0,69.54,69.54,69.54,186.54,40.09,40.09,0,24.54,190.35,190.35,0
3630513,975,27447,,,,,,,Surgical Assist-TOTAL KNEE ARTHROPLASTY,626.44,250.58,0,1419.53,532.47,SKIPPED,626.44,626.44,532.47,532.47,532.47,1391.14,306.96,306.96,0,187.93,1419.53,1419.53,0
3630514,975,28495,,,,,,,Surgical Assist-TRT BIG TOE FX,74.61,29.84,0,167.66,63.42,SKIPPED,74.61,74.61,63.42,63.42,63.42,164.31,36.56,36.56,SKIPPED,SKIPPED,167.66,167.66,0
3630515,975,25600,,,,,,,Surgical Assist-TRT FX RADIUS/ULNA,135.08,54.03,0,367.41,114.82,SKIPPED,135.08,135.08,114.82,114.82,114.82,360.06,66.19,66.19,SKIPPED,SKIPPED,367.41,367.41,0
3630516,975,25605,,,,,,,Surgical Assist-TRT FX RADIUS/ULNA,233.8,93.52,0,575.46,198.73,SKIPPED,233.8,233.8,198.73,198.73,198.73,563.95,114.56,114.56,SKIPPED,SKIPPED,575.46,575.46,0
3630517,975,25607,,,,,,,Surgical Assist-TRT FX EXTRA ARTICULA,334.73,133.89,0,825.18,284.52,SKIPPED,334.73,334.73,284.52,284.52,284.52,808.68,164.02,164.02,SKIPPED,SKIPPED,825.18,825.18,0
3630518,975,25609,,,,,,,Surgical Assist-TRT FX RADIAL 3+ FRAG,483.45,193.38,0,1171.26,410.93,SKIPPED,483.45,483.45,410.93,410.93,410.93,1147.83,236.89,236.89,SKIPPED,SKIPPED,1171.26,1171.26,0
3630519,975,25575,,,,,,,Surgical Assist-TRT FX RADIUS/ULNA,411.35,164.54,0,1007.15,349.65,SKIPPED,411.35,411.35,349.65,349.65,349.65,987.01,201.56,201.56,SKIPPED,SKIPPED,1007.15,1007.15,0
3630520,975,26605,,,,,,,Surgical Assist-TRT METACARPAL,138.69,55.48,0,337.86,117.89,SKIPPED,138.69,138.69,117.89,117.89,117.89,331.1,67.96,67.96,SKIPPED,SKIPPED,337.86,337.86,0
3630521,975,27248,,,,,,,Surgical Assist-TRT THIGH FX,327.59,131.04,0,830.56,278.45,SKIPPED,327.59,327.59,278.45,278.45,278.45,813.95,160.52,160.52,0,98.28,830.56,830.56,0
3630522,975,27814,,,,,,,Surgical Assist-TRT ANKLE FX,354.38,141.75,0,853.01,301.22,SKIPPED,354.38,354.38,301.22,301.22,301.22,835.95,173.65,173.65,SKIPPED,SKIPPED,853.01,853.01,0
3630523,975,27552,,,,,,,Surgical Assist-TRT KNEE DISLOCATION,285.34,114.14,0,709.6,242.54,SKIPPED,285.34,285.34,242.54,242.54,242.54,695.41,139.82,139.82,SKIPPED,SKIPPED,709.6,709.6,0
3630524,975,26615,,,,,,,Surgical Assist-TRT METACARPAL FX,260.84,104.34,0,644.83,221.71,SKIPPED,260.84,260.84,221.71,221.71,221.71,631.93,127.81,127.81,SKIPPED,SKIPPED,644.83,644.83,0
3630525,975,27810,,,,,,,Surgical Assist-TRT ANKLE FX,194.04,77.62,0,479.22,164.93,SKIPPED,194.04,194.04,164.93,164.93,164.93,469.64,95.08,95.08,SKIPPED,SKIPPED,479.22,479.22,0
3630526,975,27818,,,,,,,Surgical Assist-TRT ANKLE FX,191.87,76.75,0,491.91,163.09,SKIPPED,191.87,191.87,163.09,163.09,163.09,482.07,94.02,94.02,SKIPPED,SKIPPED,491.91,491.91,0
3630527,975,27822,,,,,,,Surgical Assist-TRT ANKLE FX,346.34,138.54,0,982.66,294.39,SKIPPED,346.34,346.34,294.39,294.39,294.39,963.01,169.71,169.71,SKIPPED,SKIPPED,982.66,982.66,0
3630528,975,27792,,,,,,,Surgical Assist-TRT ANKLE FX,299.26,119.7,0,721.71,254.37,SKIPPED,299.26,299.26,254.37,254.37,254.37,707.28,146.64,146.64,SKIPPED,SKIPPED,721.71,721.71,0
3630529,975,28496,,,,,,,Surgical Assist-TRT BIG TOE FX,92.45,36.98,0,274.08,78.58,SKIPPED,92.45,92.45,78.58,78.58,78.58,268.6,45.3,45.3,SKIPPED,SKIPPED,274.08,274.08,0
3630530,975,28505,,,,,,,Surgical Assist-TRT BIG TOE FX,279.38,111.75,0,558.9,237.47,SKIPPED,279.38,279.38,237.47,237.47,237.47,547.72,136.9,136.9,SKIPPED,SKIPPED,558.9,558.9,0
3630531,975,23515,,,,,,,Surgical Assist-TRT CLAVICAL FX,290.41,116.16,0,803.18,246.85,SKIPPED,290.41,290.41,246.85,246.85,246.85,787.12,142.3,142.3,SKIPPED,SKIPPED,803.18,803.18,0
3630532,975,24605,,,,,,,Surgical Assist-TRT ELBOW DISLOACTION,195.99,78.4,0,538.19,166.59,SKIPPED,195.99,195.99,166.59,166.59,166.59,527.43,96.04,96.04,SKIPPED,SKIPPED,538.19,538.19,0
3630533,975,27236,,,,,,,Surgical Assist-TRT FEMORAL FX,550.8,220.32,0,1322.66,468.18,SKIPPED,550.8,550.8,468.18,468.18,468.18,1296.21,269.89,269.89,0,165.24,1322.66,1322.66,0
3630534,975,26755,,,,,,,Surgical Assist-RT FINGER FX,128.87,51.55,0,310.65,109.54,SKIPPED,128.87,128.87,109.54,109.54,109.54,304.44,63.15,63.15,SKIPPED,SKIPPED,310.65,310.65,0
3630535,975,26725,,,,,,,Surgical Assist-TRT FINGER FX,131.93,52.77,0,344.48,112.14,SKIPPED,131.93,131.93,112.14,112.14,112.14,337.59,64.65,64.65,SKIPPED,SKIPPED,344.48,344.48,0
3630536,975,26727,,,,,,,Surgical Assist-TRT FINGER FX,214.06,85.62,0,534.11,181.95,SKIPPED,214.06,214.06,181.95,181.95,181.95,523.43,104.89,104.89,SKIPPED,SKIPPED,534.11,534.11,0
3630537,975,25606,,,,,,,Surgical Assist-TRT DISTAL RADIUS FX,276.16,110.46,0,746.79,234.74,SKIPPED,276.16,276.16,234.74,234.74,234.74,731.85,135.32,135.32,SKIPPED,SKIPPED,746.79,746.79,0
3630538,975,25545,,,,,,,Surgical Assist-TRT FX OF ULNA,250.76,100.3,0,699.02,213.15,SKIPPED,250.76,250.76,213.15,213.15,213.15,685.04,122.87,122.87,SKIPPED,SKIPPED,699.02,699.02,0
3630539,975,25607,,,,,,,Surgical Assist-TRT RAD EXTRA-ARTICUL,308.45,123.38,0,825.18,262.18,SKIPPED,308.45,308.45,262.18,262.18,262.18,808.68,151.14,151.14,SKIPPED,SKIPPED,825.18,825.18,0
3630540,975,25608,,,,,,,Surgical Assist-TRT FX RAD INTRA-ARTICUL,346.28,138.51,0,922.74,294.34,SKIPPED,346.28,346.28,294.34,294.34,294.34,904.29,169.68,169.68,SKIPPED,SKIPPED,922.74,922.74,0
3630541,975,25560,,,,,,,Surgical Assist-TRT FX RADIUS/ULNA,114.92,45.97,0,293.18,97.68,SKIPPED,114.92,114.92,97.68,97.68,97.68,287.32,56.31,56.31,SKIPPED,SKIPPED,293.18,293.18,0
3630542,975,25565,,,,,,,Surgical Assist-TRT FX RADIUS/ULNA,225.36,90.14,0,524.47,191.56,SKIPPED,225.36,225.36,191.56,191.56,191.56,513.98,110.43,110.43,SKIPPED,SKIPPED,524.47,524.47,0
3630543,975,27220,,,,,,,Surgical Assist-TRT HIP SOCKET FX,211.82,84.73,0,461.7,180.05,SKIPPED,211.82,211.82,180.05,180.05,180.05,452.47,103.79,103.79,SKIPPED,SKIPPED,461.7,461.7,0
3630544,975,24545,,,,,,,Surgical Assist-TRT HUMERUS FX,354.84,141.94,0,1032.49,301.61,SKIPPED,354.84,354.84,301.61,301.61,301.61,1011.84,173.87,173.87,SKIPPED,SKIPPED,1032.49,1032.49,0
3630545,975,23605,,,,,,,Surgical Assist-TRT HUMERUS FX(CLOSED),192.89,77.16,0,481.24,163.96,SKIPPED,192.89,192.89,163.96,163.96,163.96,471.62,94.52,94.52,SKIPPED,SKIPPED,481.24,481.24,0
3630546,975,23615,,,,,,,Surgical Assist-TRT HUMERUS FX(OPEN),405.18,162.07,0,983.31,344.4,SKIPPED,405.18,405.18,344.4,344.4,344.4,963.64,198.54,198.54,SKIPPED,SKIPPED,983.31,983.31,0
3630547,975,27524,,,,,,,Surgical Assist-TRT KNEE CAP FX,348.02,139.21,0,839.9,295.82,SKIPPED,348.02,348.02,295.82,295.82,295.82,823.1,170.53,170.53,SKIPPED,SKIPPED,839.9,839.9,0
3630548,975,27535,,,,,,,Surgical Assist-TRT KNEE FX,396.69,158.68,0,995.96,337.19,SKIPPED,396.69,396.69,337.19,337.19,337.19,976.04,194.38,194.38,0,119.01,995.96,995.96,0
3630549,975,27825,,,,,,,Surgical Assist-TRT LOWER LEG FX,199.91,79.96,0,550.28,169.92,SKIPPED,199.91,199.91,169.92,169.92,169.92,539.27,97.96,97.96,SKIPPED,SKIPPED,550.28,550.28,0
3630550,975,27829,,,,,,,Surgical Assist-TRT LOWER LEG JOINT,280.37,112.15,0,795.62,238.31,SKIPPED,280.37,280.37,238.31,238.31,238.31,779.71,137.38,137.38,SKIPPED,SKIPPED,795.62,795.62,0
3630551,975,26608,,,,,,,Surgical Assist-TR METACARPAL FX,207.57,83.03,0,542.49,176.43,SKIPPED,207.57,207.57,176.43,176.43,176.43,531.64,101.71,101.71,SKIPPED,SKIPPED,542.49,542.49,0
3630552,975,26600,,,,,,,Surgical Assist-TRT METACARPAL FX,126.51,50.6,0,324.89,107.53,SKIPPED,126.51,126.51,107.53,107.53,107.53,318.39,61.99,61.99,SKIPPED,SKIPPED,324.89,324.89,0
3630553,975,27240,,,,,,,Surgical Assist-TRT THIGH FX,387.79,155.12,0,1066.13,329.62,SKIPPED,387.79,387.79,329.62,329.62,329.62,1044.81,190.02,190.02,0,116.34,1066.13,1066.13,0
3630554,975,27244,,,,,,,Surgical Assist-TRT THIGH FX,470.89,188.36,0,1360.15,400.26,SKIPPED,470.89,470.89,400.26,400.26,400.26,1332.95,230.74,230.74,0,141.27,1360.15,1360.15,0
3630555,975,27245,,,,,,,Surgical Assist-TRT THIGH FX,470.89,188.36,0,1359.31,400.26,SKIPPED,470.89,470.89,400.26,400.26,400.26,1332.12,230.74,230.74,0,141.27,1359.31,1359.31,0
3630556,975,27758,,,,,,,Surgical Assist-TRT TIBIA FX,407.33,162.93,0,997.67,346.23,SKIPPED,407.33,407.33,346.23,346.23,346.23,977.72,199.59,199.59,SKIPPED,SKIPPED,997.67,997.67,0
3630557,975,28515,,,,,,,Surgical Assist-TRT TOE FX,70.48,28.19,0,160.52,59.91,SKIPPED,70.48,70.48,59.91,59.91,59.91,157.31,34.54,34.54,SKIPPED,SKIPPED,160.52,160.52,0
3630558,975,27759,,,,,,,Surgical Assist-TRT TOBL SHFT FX IMED IM,381.54,152.62,0,1107.54,324.31,SKIPPED,381.54,381.54,324.31,324.31,324.31,1085.39,186.95,186.95,SKIPPED,SKIPPED,1107.54,1107.54,0
3630559,975,24999,,,,,,,Surgical Assist-UPPER ARM/ELBOW SURG UNS,88.66,35.46,0,88.66,75.36,SKIPPED,88.66,88.66,75.36,75.36,75.36,0,43.44,43.44,0,26.6,0,0,0
3630560,975,29843,,,,,,,Surgical Assist-WRIST ARTHROCOPY,195.62,78.25,0,543.35,166.28,SKIPPED,195.62,195.62,166.28,166.28,166.28,532.48,95.85,95.85,SKIPPED,SKIPPED,543.35,543.35,0
3630561,975,29848,,,,,,,Surgical Assist-WRIST ENDOSCOPY,194.97,77.99,0,571.42,165.72,SKIPPED,194.97,194.97,165.72,165.72,165.72,559.99,95.54,95.54,SKIPPED,SKIPPED,571.42,571.42,0
3630562,975,77071,,,,,,,Surgical Assist-XRAY STRESS FX VIEW,22.83,9.13,0,62.26,19.41,SKIPPED,22.83,22.83,19.41,19.41,19.41,61.01,22.83,22.83,0,22.83,62.26,62.26,0
3630563,278,,,,,,,,GLENOSPHERE,937.5,375,0,796.88,796.88,SKIPPED,712.5,712.5,796.88,796.88,796.88,395.07,459.38,459.38,0,281.25,403.13,403.13,796.88
3630564,278,,,,,,,,HUMERAL TRAY W/ LOCK RING,1200,480,0,1020,1020,SKIPPED,912,912,1020,1020,1020,505.68,588,588,0,360,516,516,1020
3630565,278,,,,,,,,E1 HUMERAL BEARING,895,358,0,760.75,760.75,SKIPPED,680.2,680.2,760.75,760.75,760.75,377.15,438.55,438.55,0,268.5,384.85,384.85,760.75
3630566,278,,,,,,,,MINI HUMERAL STEM,1155,462,0,981.75,981.75,SKIPPED,877.8,877.8,981.75,981.75,981.75,486.72,565.95,565.95,0,346.5,496.65,496.65,981.75
3630567,278,,,,,,,,PRIMARY SHOULDER STEM,15000,6000,0,12750,12750,SKIPPED,11400,11400,12750,12750,12750,6321,7350,7350,0,4500,6450,6450,12750
3630568,278,,,,,,,,REVERSE SHOULDER -FIXED LOCK SCREW,812.5,325,0,690.62,690.62,SKIPPED,617.5,617.5,690.62,690.62,690.62,342.39,398.12,398.12,0,243.75,349.38,349.38,690.62
3630569,278,,,,,,,,GLENOSPHERE BASE PLATE,1737.5,695,0,1476.88,1476.88,SKIPPED,1320.5,1320.5,1476.88,1476.88,1476.88,732.19,851.38,851.38,0,521.25,747.13,747.13,1476.88
3630570,278,,,,,,,,REVERSE SHOULDER-CENTRAL SCREW,787.5,315,0,669.38,669.38,SKIPPED,598.5,598.5,669.38,669.38,669.38,331.86,385.88,385.88,0,236.25,338.63,338.63,669.38
3630571,360,11981,,,,,,,INSERT DRUG IMPLANT DEVICE,640.57,256.23,269.69,544.48,544.48,SKIPPED,498.94,498.94,544.48,544.48,544.48,269.94,269.69,269.69,SKIPPED,SKIPPED,275.45,275.45,544.48
3630572,975,11981,,,,,,,INSERT DRUG IMPLANT DEVICE,199.99,80,0,199.99,169.99,SKIPPED,199.99,199.99,169.99,169.99,169.99,68.46,98,98,SKIPPED,SKIPPED,69.86,69.86,0
3630573,360,24430,,,,,,,RPR NON/MALUNION HUMERUS W/O GRAFT,16561.58,6624.63,1051.35,16561.58,14077.34,SKIPPED,16561.58,16561.58,14077.34,14077.34,14077.34,6979.05,1051.35,1051.35,SKIPPED,SKIPPED,7121.48,7121.48,14077.34
3630574,975,24430,,,,,,,RPR NON/MALUNION HUMERUS W/O GRAFT,2519.72,1007.89,0,2519.72,2141.76,SKIPPED,2519.72,2519.72,2141.76,2141.76,2141.76,1148.58,1234.66,1234.66,SKIPPED,SKIPPED,1172.02,1172.02,0
3630575,360,25360,,,,,,,OSTEOTOMY ULNA,7098.56,2839.42,1051.35,7098.56,6033.78,SKIPPED,7098.56,7098.56,6033.78,6033.78,6033.78,2991.33,1051.35,1051.35,SKIPPED,SKIPPED,3052.38,3052.38,6033.78
3630576,975,25360,,,,,,,OSTEOTOMY ULNA,1556.23,622.49,0,1556.23,1322.8,SKIPPED,1556.23,1556.23,1322.8,1322.8,1322.8,718.45,762.55,762.55,SKIPPED,SKIPPED,733.11,733.11,0
3630577,360,25405,,,,,,,RPR NONUNION RADIUS/ULNA W/ AUTOGRAFT,13027.93,5211.17,1051.35,13027.93,11073.74,SKIPPED,13027.93,13027.93,11073.74,11073.74,11073.74,5489.97,1051.35,1051.35,SKIPPED,SKIPPED,5602.01,5602.01,11073.74
3630578,975,25405,,,,,,,RPR NONUNION RADIUS/ULNA W/ AUTOGRAFT,2474.05,989.62,0,2474.05,2102.94,SKIPPED,2474.05,2474.05,2102.94,2102.94,2102.94,1132.09,1212.28,1212.28,SKIPPED,SKIPPED,1155.19,1155.19,0
3630579,360,24685,,,,,,,ORIF ULNAR FRACTURE PROX END,12016.5,4806.6,1051.35,12016.5,10214.02,SKIPPED,12016.5,12016.5,10214.02,10214.02,10214.02,5063.76,1051.35,1051.35,SKIPPED,SKIPPED,5167.1,5167.1,10214.02
3630580,975,24685,,,,,,,ORIF ULNAR FRACTURE PROX END,1555.14,622.06,0,1555.14,1321.87,SKIPPED,1555.14,1555.14,1321.87,1321.87,1321.87,716.22,762.02,762.02,SKIPPED,SKIPPED,730.84,730.84,0
3630581,360,29820,,,,,,,ARTHROSCOPY SHLDR SYNOVECTOMY PART,4774.09,1909.64,1051.35,4774.09,4057.98,SKIPPED,4774.09,4774.09,4057.98,4057.98,4057.98,2011.8,1051.35,1051.35,SKIPPED,SKIPPED,2052.86,2052.86,4057.98
3630582,975,29820,,,,,,,ARTHROSCOPY SHLDR SYNOVECTOMY PART,1273.77,509.51,0,1273.77,1082.7,SKIPPED,1273.77,1273.77,1082.7,1082.7,1082.7,587.6,624.15,624.15,SKIPPED,SKIPPED,599.59,599.59,0
3630583,975,29820,,,,,,,Surgical Assist-ARTHROSCOPY SHLDR SYNOVE,203.79,81.52,0,599.59,173.22,SKIPPED,203.79,203.79,173.22,173.22,173.22,587.6,99.86,99.86,SKIPPED,SKIPPED,599.59,599.59,0
3630584,975,11981,,,,,,,Surgical Assist-INSERT DRUG IMPLANT DEVI,31.99,12.8,0,69.86,27.19,SKIPPED,31.99,31.99,27.19,27.19,27.19,68.46,15.68,15.68,SKIPPED,SKIPPED,69.86,69.86,0
3630585,975,24430,,,,,,,Surgical Assist-RPR NON/MALUNION HUMERUS,403.15,161.26,0,1172.02,342.68,SKIPPED,403.15,403.15,342.68,342.68,342.68,1148.58,197.54,197.54,SKIPPED,SKIPPED,1172.02,1172.02,0
3630586,975,25360,,,,,,,Surgical Assist-OSEOTOMY ULNA,249,99.6,0,733.11,211.65,SKIPPED,249,249,211.65,211.65,211.65,718.45,122.01,122.01,SKIPPED,SKIPPED,733.11,733.11,0
3630587,975,25405,,,,,,,Surgical Assist-RPR NONUNION RADIUS/ULNA,395.85,158.34,0,1155.19,336.47,SKIPPED,395.85,395.85,336.47,336.47,336.47,1132.09,193.97,193.97,SKIPPED,SKIPPED,1155.19,1155.19,0
3630588,975,24685,,,,,,,Surgical Assist-ORIF ULNAR FX PROX END,248.82,99.53,0,730.84,211.5,SKIPPED,248.82,248.82,211.5,211.5,211.5,716.22,121.92,121.92,SKIPPED,SKIPPED,730.84,730.84,0
3630589,278,,,,,,,,UNTRAX,375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3630590,278,,,,,,,,ENDOPROSTHESIS HEAD COMPONENT,1462.5,585,0,1243.12,1243.12,SKIPPED,1111.5,1111.5,1243.12,1243.12,1243.12,616.3,716.62,716.62,0,438.75,628.88,628.88,1243.12
3630591,278,,,,,,,,RESTORATION MODULAR HIP SYSTEM 23MM,11590,4636,0,9851.5,9851.5,SKIPPED,8808.4,8808.4,9851.5,9851.5,9851.5,4884.03,5679.1,5679.1,0,3477,4983.7,4983.7,9851.5
3630592,278,,,,,,,,REATORATION MOD HIP SYSTEM 155MM,8988.52,3595.41,0,7640.24,7640.24,SKIPPED,6831.28,6831.28,7640.24,7640.24,7640.24,3787.76,4404.37,4404.37,0,2696.56,3865.06,3865.06,7640.24
3630593,360,23474,,,,,,,REVISE SHOULDER ARTHROPLASTY HUMERAL/GLE,18706.64,7482.66,0,15900.64,15900.64,SKIPPED,8632.65,8632.65,15900.64,15900.64,15900.64,7882.98,0,0,0,5611.99,8043.86,8043.86,15900.64
3630594,975,23474,,,,,,,REVISE SHOULDER ARTHROPLASTY HUMERAL/GLE,4201.81,1680.72,0,4201.81,3571.54,SKIPPED,4201.81,4201.81,3571.54,3571.54,3571.54,1887.42,2058.89,2058.89,0,1260.54,1925.94,1925.94,0
3630595,360,24515,,,,,,,OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WO,14927.63,5971.05,1051.35,14927.63,12688.49,SKIPPED,14927.63,14927.63,12688.49,12688.49,12688.49,6290.5,1051.35,1051.35,SKIPPED,SKIPPED,6418.88,6418.88,12688.49
3630596,975,24515,,,,,,,OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WO,2087.76,835.1,0,2087.76,1774.6,SKIPPED,2087.76,2087.76,1774.6,1774.6,1774.6,962.04,1023,1023,SKIPPED,SKIPPED,981.67,981.67,0
3630597,975,23474,,,,,,,Surgical Assist-REVISE SHOULDER ARTHROPL,672.29,268.92,0,1925.94,571.45,SKIPPED,672.29,672.29,571.45,571.45,571.45,1887.42,329.42,329.42,0,201.69,1925.94,1925.94,0
3630598,975,24515,,,,,,,Surgical Assist-OPTX HUMERAL SHFT FX W/P,334.05,133.62,0,981.67,283.94,SKIPPED,334.05,334.05,283.94,283.94,283.94,962.04,163.68,163.68,SKIPPED,SKIPPED,981.67,981.67,0
3630599,360,24560,,,,,,,"Clsd TRT humeral epicondylar fracture, m",474.05,189.62,87.17,474.05,402.94,SKIPPED,474.05,474.05,402.94,402.94,402.94,199.76,87.17,87.17,SKIPPED,SKIPPED,203.84,203.84,402.94
3630600,975,24560,,,,,,,"Clsd TRT humeral epicondylar fracture, m",678.54,271.42,0,678.54,576.76,SKIPPED,678.54,678.54,576.76,576.76,576.76,327.29,332.48,332.48,SKIPPED,SKIPPED,333.97,333.97,0
3630601,360,24600,,,,,,,Treatment of closed elbow dislocation; w,714.71,285.88,87.17,714.71,607.5,SKIPPED,714.71,714.71,607.5,607.5,607.5,301.18,87.17,87.17,SKIPPED,SKIPPED,307.33,307.33,607.5
3630602,975,24600,,,,,,,Treatment of closed elbow dislocation; w,791.15,316.46,0,791.15,672.48,SKIPPED,791.15,791.15,672.48,672.48,672.48,374.56,387.66,387.66,SKIPPED,SKIPPED,382.2,382.2,0
3630603,278,,,,,,,,JURGISON PIN BALLS,17.5,7,0,14.88,14.88,SKIPPED,13.3,13.3,14.88,14.88,14.88,7.38,8.58,8.58,0,5.25,7.53,7.53,14.88
3630604,278,,,,,,,,OMNIFIT EON 132 CEMENTED HIP SYSTEM,4000,1600,0,3400,3400,SKIPPED,3040,3040,3400,3400,3400,1685.6,1960,1960,0,1200,1720,1720,3400
3630605,278,,,,,,,,OMNIFIT UNIVERSAL DISTAL CEMENT SPACER,280,112,0,238,238,SKIPPED,212.8,212.8,238,238,238,117.99,137.2,137.2,0,84,120.4,120.4,238
3630606,278,,,,,,,,UNITRAX,375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3630607,278,,,,,,,,ARTISAN BONE PLUG CANAL 9-12MM CEMENTED,265,106,0,225.25,225.25,SKIPPED,201.4,201.4,225.25,225.25,225.25,111.67,129.85,129.85,0,79.5,113.95,113.95,225.25
3630608,272,,,,,,,,speedguide drill,987.5,395,0,839.38,839.38,SKIPPED,750.5,750.5,839.38,839.38,839.38,416.14,483.88,483.88,0,296.25,424.63,424.63,839.38
3630609,272,,,,,,,,T8 SPEEDGUIDE,1870,748,0,1589.5,1589.5,SKIPPED,1421.2,1421.2,1589.5,1589.5,1589.5,788.02,916.3,916.3,0,561,804.1,804.1,1589.5
3630610,278,,,,,,,,MTP PLATE,8467.5,3387,0,7197.38,7197.38,SKIPPED,6435.3,6435.3,7197.38,7197.38,7197.38,3568.21,4149.08,4149.08,0,2540.25,3641.03,3641.03,7197.38
3630611,360,27511,,,,,,,ORIF FEMORAL SUPRACONDYLAR FX W/O XTN,3011.62,1204.65,0,3011.62,2559.88,SKIPPED,3011.62,3011.62,2559.88,2559.88,2559.88,1269.1,0,0,0,903.49,1295,1295,2559.88
3630612,975,27511,,,,,,,ORIF FEMORAL SUPRACONDYLAR FX W/O XTN,2383.45,953.38,0,2383.45,2025.93,SKIPPED,2383.45,2383.45,2025.93,2025.93,2025.93,1082.5,1167.89,1167.89,0,715.04,1104.59,1104.59,0
3630613,360,28485,,,,,,,ORIF METATARSAL FRACTURE EACH ASSISTANT,8322.57,3329.03,1051.35,8322.57,7074.18,SKIPPED,8322.57,8322.57,7074.18,7074.18,7074.18,3507.14,1051.35,1051.35,SKIPPED,SKIPPED,3578.71,3578.71,7074.18
3630614,975,28485,,,,,,,ORIF METATARSAL FRACTURE EACH ASSISTANT,1297.78,519.11,0,1297.78,1103.11,SKIPPED,1297.78,1297.78,1103.11,1103.11,1103.11,619.32,635.91,635.91,SKIPPED,SKIPPED,631.96,631.96,0
3630615,360,28645,,,,,,,OPEN TX MTP JOINT DISLOCATION,3706.08,1482.43,867.38,3706.08,3150.17,SKIPPED,3706.08,3706.08,3150.17,3150.17,3150.17,1561.74,867.38,867.38,SKIPPED,SKIPPED,1593.61,1593.61,3150.17
3630616,975,28645,,,,,,,OPEN TX MTP JOINT DISLOCATION,1160.29,464.12,0,1160.29,986.25,SKIPPED,1160.29,1160.29,986.25,986.25,986.25,532.72,568.54,568.54,SKIPPED,SKIPPED,543.59,543.59,0
3630617,975,27511,,,,,,,SurgicalAssist-ORIF FEMORAL SUPRACONDYLA,381.36,152.54,0,1104.59,324.16,SKIPPED,381.36,381.36,324.16,324.16,324.16,1082.5,186.87,186.87,0,114.41,1104.59,1104.59,0
3630618,975,28645,,,,,,,SurgicalAssist-OPEN TX MTP JOINT DISLOC,185.65,74.26,0,543.59,157.8,SKIPPED,185.65,185.65,157.8,157.8,157.8,532.72,90.97,90.97,SKIPPED,SKIPPED,543.59,543.59,0
3630619,272,,,,,,,,5in needle,537.5,215,0,456.88,456.88,SKIPPED,408.5,408.5,456.88,456.88,456.88,226.51,263.38,263.38,0,161.25,231.13,231.13,456.88
3630620,278,,,,,,,,7MM 3 HOLE PLATE,12455,4982,0,10586.75,10586.75,SKIPPED,9465.8,9465.8,10586.75,10586.75,10586.75,5248.54,6102.95,6102.95,0,3736.5,5355.65,5355.65,10586.75
3630621,272,,,,,,,,UNI HEADED SCREW -ALL SIZES,175,70,0,148.75,148.75,SKIPPED,133,133,148.75,148.75,148.75,73.74,85.75,85.75,0,52.5,75.25,75.25,148.75
3630622,272,,,,,,,,HEADLESS TOCAR DRILL,825,330,0,701.25,701.25,SKIPPED,627,627,701.25,701.25,701.25,347.66,404.25,404.25,0,247.5,354.75,354.75,701.25
3630623,272,,,,,,,,FIBERTAK,1050,420,0,892.5,892.5,SKIPPED,798,798,892.5,892.5,892.5,442.47,514.5,514.5,0,315,451.5,451.5,892.5
3630624,272,,,,,,,,FIBERTAK STRAIGHT KIT,437.5,175,0,371.88,371.88,SKIPPED,332.5,332.5,371.88,371.88,371.88,184.37,214.38,214.38,0,131.25,188.13,188.13,371.88
3630625,272,,,,,,,,90 DEGREE TIGHT CUREVE QUICKPASS LASSO,400,160,0,340,340,SKIPPED,304,304,340,340,340,168.56,196,196,0,120,172,172,340
3630626,975,28485,,,,,,,SurgicalAssist-OPEN TRT METATARSAL FX,207.65,83.06,0,631.96,176.5,SKIPPED,207.65,207.65,176.5,176.5,176.5,619.32,101.75,101.75,SKIPPED,SKIPPED,631.96,631.96,0
3630627,360,27372,,,,,,,REMOVAL OREIGN BODY DEEP THIGH/KNEE,6205.53,2482.21,582.36,6205.53,5274.7,SKIPPED,6205.53,6205.53,5274.7,5274.7,5274.7,2615.01,582.36,582.36,SKIPPED,SKIPPED,2668.38,2668.38,5274.7
3630628,975,27372,,,,,,,REMOVAL OREIGN BODY DEEP THIGH/KNEE,946.17,378.47,0,946.17,804.24,SKIPPED,946.17,946.17,804.24,804.24,804.24,439.87,463.62,463.62,SKIPPED,SKIPPED,448.85,448.85,0
3630629,360,28160,,,,,,,HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT,4265.61,1706.24,867.38,4265.61,3625.77,SKIPPED,4265.61,4265.61,3625.77,3625.77,3625.77,1797.53,867.38,867.38,SKIPPED,SKIPPED,1834.21,1834.21,3625.77
3630630,975,28160,,,,,,,HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT,643.86,257.54,0,643.86,547.28,SKIPPED,643.86,643.86,547.28,547.28,547.28,293.92,315.49,315.49,SKIPPED,SKIPPED,299.92,299.92,0
3630631,278,,,,,,,,BIOMET SMOOTH KNEE(ALL SIZES),4338.75,1735.5,0,3687.94,3687.94,SKIPPED,3297.45,3297.45,3687.94,3687.94,3687.94,1828.35,2125.99,2125.99,0,1301.62,1865.66,1865.66,3687.94
3630632,272,,,,,,,,BMT 360 TIB TRAY,8060,3224,0,6851,6851,SKIPPED,6125.6,6125.6,6851,6851,6851,3396.48,3949.4,3949.4,0,2418,3465.8,3465.8,6851
3630633,278,,,,,,,,VAN PS OPEN INTL-FEM,14227.5,5691,0,12093.38,12093.38,SKIPPED,10812.9,10812.9,12093.38,12093.38,12093.38,5995.47,6971.48,6971.48,0,4268.25,6117.83,6117.83,12093.38
3630634,278,,,,,,,,VANGUARD FEM PEG SET 2,812.5,325,0,690.62,690.62,SKIPPED,617.5,617.5,690.62,690.62,690.62,342.39,398.12,398.12,0,243.75,349.38,349.38,690.62
3630635,278,,,,,,,,VNGD PS+TIB RG,4582.5,1833,0,3895.12,3895.12,SKIPPED,3482.7,3482.7,3895.12,3895.12,3895.12,1931.07,2245.42,2245.42,0,1374.75,1970.48,1970.48,3895.12
3630636,272,,,,,,,,VNGD SSK PSC TIB BRG,6760,2704,0,5746,5746,SKIPPED,5137.6,5137.6,5746,5746,5746,2848.66,3312.4,3312.4,0,2028,2906.8,2906.8,5746
3630637,278,,,,,,,,VNGD SSK 360 FEMUR,20653.75,8261.5,0,17555.69,17555.69,SKIPPED,15696.85,15696.85,17555.69,17555.69,17555.69,8703.49,10120.34,10120.34,0,6196.12,8881.11,8881.11,17555.69
3630638,270,,,,,,,,KNIVES,150,60,0,127.5,127.5,SKIPPED,114,114,127.5,127.5,127.5,63.21,73.5,73.5,0,45,64.5,64.5,127.5
3630639,278,,,,,,,,3 HOLE NARROW,3057.5,1223,0,2598.88,2598.88,SKIPPED,2323.7,2323.7,2598.88,2598.88,2598.88,1288.44,1498.18,1498.18,0,917.25,1314.73,1314.73,2598.88
3630640,278,,,,,,,,3.5 CORTICAL(ALL SIZES),91.25,36.5,0,77.56,77.56,SKIPPED,69.35,69.35,77.56,77.56,77.56,38.46,44.71,44.71,0,27.38,39.24,39.24,77.56
3630641,278,,,,,,,,2.4 VAL(ALL SIZES),350,140,0,297.5,297.5,SKIPPED,266,266,297.5,297.5,297.5,147.49,171.5,171.5,0,105,150.5,150.5,297.5
3630642,278,,,,,,,,VOIAR PLATE-NARROR,1987.5,795,0,1689.38,1689.38,SKIPPED,1510.5,1510.5,1689.38,1689.38,1689.38,837.54,973.88,973.88,0,596.25,854.63,854.63,1689.38
36306423,278,C1776,,,,,,,PERSONA KNEE SYSTEM(ALL 4),23580,9432,0,20043,20043,SKIPPED,17920.8,17920.8,20043,20043,20043,9936.61,11554.2,11554.2,0,7074,10139.4,10139.4,20043
3630643,278,C1776,,,,,,,PERSONA KNEE SYSTEM(ALL 4),15000,6000,0,12750,12750,SKIPPED,11400,11400,12750,12750,12750,6321,7350,7350,0,4500,6450,6450,12750
3630644,278,,,,,,,,CHONDRAL DART AR-4005B-18,937.5,375,0,796.88,796.88,SKIPPED,712.5,712.5,796.88,796.88,796.88,395.07,459.38,459.38,0,281.25,403.13,403.13,796.88
3630645,360,28270,,,,,,,CAPSULOTOMY,3091.03,1236.41,867.38,3091.03,2627.38,SKIPPED,3091.03,3091.03,2627.38,2627.38,2627.38,1302.56,867.38,867.38,SKIPPED,SKIPPED,1329.14,1329.14,2627.38
3630646,975,28270,,,,,,,CAPSULOTOMY,804.78,321.91,0,804.78,684.06,SKIPPED,804.78,804.78,684.06,684.06,684.06,366.43,394.34,394.34,SKIPPED,SKIPPED,373.91,373.91,0
3630647,360,29887,,,,,,,ARTHROSCOPIC OSTEOCHOND DISSECANS INT FI,10886.07,4354.43,1051.35,10886.07,9253.16,SKIPPED,10886.07,10886.07,9253.16,9253.16,9253.16,4587.39,1051.35,1051.35,SKIPPED,SKIPPED,4681.01,4681.01,9253.16
3630648,975,29887,,,,,,,ARTHROSCOPIC OSTEOCHOND DISSECANS INT FI,1790.4,716.16,0,1790.4,1521.84,SKIPPED,1790.4,1790.4,1521.84,1521.84,1521.84,821.52,877.3,877.3,SKIPPED,SKIPPED,838.29,838.29,0
3630649,360,26115,,,,,,,EXC HAND LESION SC<1.5CM,4147.31,1658.92,414.14,4147.31,3525.21,SKIPPED,4147.31,4147.31,3525.21,3525.21,3525.21,1747.67,414.14,414.14,SKIPPED,SKIPPED,1783.34,1783.34,3525.21
3630650,278,,,,,,,,"IMPLANT SYSTEM MPFL, BIOCOMPSITE",3717.5,1487,0,3159.88,3159.88,SKIPPED,2825.3,2825.3,3159.88,3159.88,3159.88,1566.56,1821.58,1821.58,0,1115.25,1598.53,1598.53,3159.88
3630651,278,,,,,,,,VAL SCREW TI(ALL SIZES),350,140,0,297.5,297.5,SKIPPED,266,266,297.5,297.5,297.5,147.49,171.5,171.5,0,105,150.5,150.5,297.5
3630652,278,,,,,,,,VOLAR DISTAL RAD PTL TI NARROW LT 3H,1987.5,795,0,1689.38,1689.38,SKIPPED,1510.5,1510.5,1689.38,1689.38,1689.38,837.54,973.88,973.88,0,596.25,854.63,854.63,1689.38
3630653,272,,,,,,,,STERILE KNEE INSTR. PATELLA CUTTER,768.75,307.5,0,653.44,653.44,SKIPPED,584.25,584.25,653.44,653.44,653.44,323.95,376.69,376.69,0,230.62,330.56,330.56,653.44
3630654,278,,,,,,,,COMP REV SHLDR 9 IN STEINMANN,287.5,115,0,244.38,244.38,SKIPPED,218.5,218.5,244.38,244.38,244.38,121.16,140.88,140.88,0,86.25,123.63,123.63,244.38
3630655,278,,,,,,,,STN PN THD TIP (ALL SIZES),487.5,195,0,414.38,414.38,SKIPPED,370.5,370.5,414.38,414.38,414.38,205.44,238.88,238.88,0,146.25,209.63,209.63,414.38
3630656,278,,,,,,,,COMP SHRT ST/RXG GLD/TI VRSDL HD,15000,6000,0,12750,12750,SKIPPED,11400,11400,12750,12750,12750,6321,7350,7350,0,4500,6450,6450,12750
3630657,272,,,,,,,,PSN JIGS PREF & TIB ROT,2850,1140,0,2422.5,2422.5,SKIPPED,2166,2166,2422.5,2422.5,2422.5,1200.99,1396.5,1396.5,0,855,1225.5,1225.5,2422.5
3630658,278,,,,,,,,PSI BONE MODLE,1562.5,625,0,1328.12,1328.12,SKIPPED,1187.5,1187.5,1328.12,1328.12,1328.12,658.44,765.62,765.62,0,468.75,671.88,671.88,1328.12
3630659,360,27132,,,,,,,CONV PREV HIP THA W/WO GRAFT,8402.05,3360.82,0,8244,7141.74,SKIPPED,8244,8244,7141.74,7141.74,7141.74,3540.62,0,0,0,2520.62,3612.88,3612.88,7141.74
3630660,975,,,,,,,,CONV PREV HIP THA W/WO GRAFT,3855.92,1542.37,0,3277.53,3277.53,SKIPPED,2930.5,2930.5,3277.53,3277.53,3277.53,0,1889.4,1889.4,0,1156.78,0,0,0
3630661,360,24530,,,,,,,CLTX SPRCNDYLR/TRANSCNDYLR HUM FX W/WO M,554.12,221.65,87.17,554.12,471,SKIPPED,554.12,554.12,471,471,471,233.5,87.17,87.17,SKIPPED,SKIPPED,238.27,238.27,471
3630662,975,24530,,,,,,,CLTX SPRCNDYLR/TRANSCNDYLR HUM FX W/WO M,813.42,325.37,0,813.42,691.41,SKIPPED,813.42,813.42,691.41,691.41,691.41,389.24,398.58,398.58,SKIPPED,SKIPPED,397.18,397.18,0
3630663,272,,,,,,,,90 DEGREE PROBE BURNER,750,300,0,637.5,637.5,SKIPPED,570,570,637.5,637.5,637.5,316.05,367.5,367.5,0,225,322.5,322.5,637.5
3630664,272,,,,,,,,2.0MM STANDARD DRILL,812.5,325,0,690.62,690.62,SKIPPED,617.5,617.5,690.62,690.62,690.62,342.39,398.12,398.12,0,243.75,349.38,349.38,690.62
3630665,278,,,,,,,,2.7MM ULS DUAL COMP PLT 7 HOLE 84MM,812.5,325,0,690.62,690.62,SKIPPED,617.5,617.5,690.62,690.62,690.62,342.39,398.12,398.12,0,243.75,349.38,349.38,690.62
3630666,360,25515,,,,,,,ORIF RADIAL SHAFT FRACTURE,9448.16,3779.26,1051.35,9448.16,8030.94,SKIPPED,9448.16,9448.16,8030.94,8030.94,8030.94,3981.46,1051.35,1051.35,SKIPPED,SKIPPED,4062.71,4062.71,8030.94
3630667,975,25515,,,,,,,ORIF RADIAL SHAFT FRACTURE,1532.12,612.85,0,1532.12,1302.3,SKIPPED,1532.12,1532.12,1302.3,1302.3,1302.3,733.62,750.74,750.74,SKIPPED,SKIPPED,748.59,748.59,0
3630668,278,,,,,,,,DBLE STRAND ANTERIOR TIBIALIS,4875,1950,0,4143.75,4143.75,SKIPPED,3705,3705,4143.75,4143.75,4143.75,2054.32,2388.75,2388.75,0,1462.5,2096.25,2096.25,4143.75
3630669,278,,,,,,,,"LO-PRO SCREW TM,SS 3.5X12",87.5,35,0,74.38,74.38,SKIPPED,66.5,66.5,74.38,74.38,74.38,36.88,42.88,42.88,0,26.25,37.63,37.63,74.38
3630670,278,,,,,,,,"LO-PRO LOCK SCREW,SS 3.5X12",375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3630671,278,,,,,,,,"LO-PRO LOCK SCREW,SS 3.5X14",375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3630672,278,,,,,,,,"LO-PRO SCREW,SS 4.0X12",87.5,35,0,74.38,74.38,SKIPPED,66.5,66.5,74.38,74.38,74.38,36.88,42.88,42.88,0,26.25,37.63,37.63,74.38
3630673,278,,,,,,,,"LO-PRO SCREW,SS 4.0X14",412.5,165,0,350.62,350.62,SKIPPED,313.5,313.5,350.62,350.62,350.62,173.83,202.12,202.12,0,123.75,177.38,177.38,350.62
3630674,278,,,,,,,,"K-LESS T-ROPE W/DRV,SYN REPR",3737.5,1495,0,3176.88,3176.88,SKIPPED,2840.5,2840.5,3176.88,3176.88,3176.88,1574.99,1831.38,1831.38,0,1121.25,1607.13,1607.13,3176.88
3630675,272,,,,,,,,"2.0MM DRILL BIT,CALIBRATED",237.5,95,0,201.88,201.88,SKIPPED,180.5,180.5,201.88,201.88,201.88,100.09,116.38,116.38,0,71.25,102.13,102.13,201.88
3630676,272,,,,,,,,2.5MM DRILL BIT REF#AR-8943-30,212.5,85,0,180.62,180.62,SKIPPED,161.5,161.5,180.62,180.62,180.62,89.55,104.12,104.12,0,63.75,91.38,91.38,180.62
3630677,272,,,,,,,,"2.5MM DRILL BIT, CALIBRATED",212.5,85,0,180.62,180.62,SKIPPED,161.5,161.5,180.62,180.62,180.62,89.55,104.12,104.12,0,63.75,91.38,91.38,180.62
3630678,278,,,,,,,,"LOCKING THIRD TUBULAR PLATE,SS,7H",637.5,255,0,541.88,541.88,SKIPPED,484.5,484.5,541.88,541.88,541.88,268.65,312.38,312.38,0,191.25,274.13,274.13,541.88
3630679,975,27658,,,,,,,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRA,854.78,341.91,0,854.78,726.56,SKIPPED,854.78,854.78,726.56,726.56,726.56,405.52,418.84,418.84,SKIPPED,SKIPPED,413.8,413.8,0
3630680,360,27886,,,,,,,RE-AMPUTATION LEG THRU TIBIA&FIBULA,7525.72,3010.29,0,6396.86,6396.86,SKIPPED,3235.56,3235.56,6396.86,6396.86,6396.86,3171.34,0,0,0,2257.72,3236.06,3236.06,6396.86
3630681,975,27886,,,,,,,RE-AMPUTATION LEG THRU TIBIA&FIBULA,1503.99,601.6,0,1503.99,1278.39,SKIPPED,1503.99,1503.99,1278.39,1278.39,1278.39,703.46,736.96,736.96,0,451.2,717.82,717.82,0
3630682,278,,,,,,,,BIO-COMP INTERSCREW W/ DIRP SHTH,587.5,235,0,499.38,499.38,SKIPPED,446.5,446.5,499.38,499.38,499.38,247.58,287.88,287.88,0,176.25,252.63,252.63,499.38
3630683,360,27767,,,,,,,CLOSED TRT POSTERIOR MALLELOUS FX,439.9,175.96,87.17,439.9,373.92,SKIPPED,439.9,439.9,373.92,373.92,373.92,185.38,87.17,87.17,SKIPPED,SKIPPED,189.16,189.16,373.92
3630684,975,27767,,,,,,,CLOSED TRT POSTERIOR MALLELOUS FX,640.72,256.29,0,544.61,544.61,SKIPPED,531.76,531.76,544.61,544.61,544.61,321.81,313.95,313.95,SKIPPED,SKIPPED,328.38,328.38,0
3630685,360,26735,,,,,,,OPEN TRT PHALANGEAL SHAFT FX,6393.54,2557.42,867.38,6393.54,5434.51,SKIPPED,6393.54,6393.54,5434.51,5434.51,5434.51,2694.24,867.38,867.38,SKIPPED,SKIPPED,2749.22,2749.22,5434.51
3630686,975,26735,,,,,,,OPEN TRT PHALANGEAL SHAFT FX,1360.63,544.25,0,1360.63,1156.54,SKIPPED,1360.63,1360.63,1156.54,1156.54,1156.54,652.77,666.71,666.71,SKIPPED,SKIPPED,666.09,666.09,0
3630687,360,27536,,,,,,,OPEN TX TIBIAL BICONDYLAR W/WO FIXATION,9029.48,3611.79,0,7675.06,7675.06,SKIPPED,5848.86,5848.86,7675.06,7675.06,7675.06,3805.03,0,0,0,2708.84,3882.68,3882.68,7675.06
3630688,975,27536,,,,,,,OPEN TX TIBIAL BICONDYLAR W/WO FIXATION,2714.8,1085.92,0,2714.8,2307.58,SKIPPED,2714.8,2714.8,2307.58,2307.58,2307.58,1289.34,1330.25,1330.25,0,814.44,1315.65,1315.65,0
3630689,360,27403,,,,,,,ARTHROTOMY W/MENISCUS REPAIR,11228.96,4491.58,1051.35,11228.96,9544.62,SKIPPED,11228.96,11228.96,9544.62,9544.62,9544.62,4731.88,1051.35,1051.35,SKIPPED,SKIPPED,4828.45,4828.45,9544.62
3630690,975,27403,,,,,,,ARTHROTOMY W/MENISCUS REPAIR,1467.62,587.05,0,1467.62,1247.48,SKIPPED,1467.62,1467.62,1247.48,1247.48,1247.48,706.05,719.13,719.13,SKIPPED,SKIPPED,720.46,720.46,0
3630691,272,,,,,,,,REAMER BLADE(ALL SIZES),300,120,0,255,255,SKIPPED,228,228,255,255,255,126.42,147,147,0,90,129,129,255
3630692,272,,,,,,,,FIBERLOOP W/ NEEDLE(ALL SIZES),125,50,0,106.25,106.25,SKIPPED,95,95,106.25,106.25,106.25,52.68,61.25,61.25,0,37.5,53.75,53.75,106.25
3630693,272,,,,,,,,LABRALTAPE,175,70,0,148.75,148.75,SKIPPED,133,133,148.75,148.75,148.75,73.74,85.75,85.75,0,52.5,75.25,75.25,148.75
3630694,272,,,,,,,,H/W INTERBALANCE LGMNT AUGMNT RPR KIT,3737.5,1495,0,3176.88,3176.88,SKIPPED,2840.5,2840.5,3176.88,3176.88,3176.88,1574.99,1831.38,1831.38,0,1121.25,1607.13,1607.13,3176.88
3630695,360,25652,,,,,,,OPEN TREATMENT ULNAR STYLOID FX,5467.46,2186.98,1051.35,5467.46,4647.34,SKIPPED,5467.46,5467.46,4647.34,4647.34,4647.34,2303.99,1051.35,1051.35,SKIPPED,SKIPPED,2351.01,2351.01,4647.34
3630696,975,25652,,,,,,,OPEN TREATMENT ULNAR STYLOID FX,1422.03,568.81,0,1422.03,1208.73,SKIPPED,1422.03,1422.03,1208.73,1208.73,1208.73,683.38,696.79,696.79,SKIPPED,SKIPPED,697.33,697.33,0
3630697,360,26540,,,,,,,RPR HAND JOINT,6605.99,2642.4,867.38,6605.99,5615.09,SKIPPED,6605.99,6605.99,5615.09,5615.09,5615.09,2783.77,867.38,867.38,SKIPPED,SKIPPED,2840.58,2840.58,5615.09
3630698,975,26540,,,,,,,RPR HAND JOINT,1532.42,612.97,0,1532.42,1302.56,SKIPPED,1532.42,1532.42,1302.56,1302.56,1302.56,784.29,750.89,750.89,SKIPPED,SKIPPED,800.3,800.3,0
3630699,270,,,,,,,,ROSA ROBOT,3629.13,1451.65,0,3084.76,3084.76,SKIPPED,2758.14,2758.14,3084.76,3084.76,3084.76,1529.32,1778.27,1778.27,0,1088.74,1560.53,1560.53,3084.76
3630700,270,,,,,,,,ROSA DRAPE,87.5,35,0,74.38,74.38,SKIPPED,66.5,66.5,74.38,74.38,74.38,36.88,42.88,42.88,0,26.25,37.63,37.63,74.38
3630701,270,,,,,,,,ROSA ROBOT SUPPLIES,1575,630,0,1338.75,1338.75,SKIPPED,1197,1197,1338.75,1338.75,1338.75,663.7,771.75,771.75,0,472.5,677.25,677.25,1338.75
3630702,270,,,,,,,,NEURO MICROSCOPE,636.5,254.6,0,541.02,541.02,SKIPPED,483.74,483.74,541.02,541.02,541.02,268.23,311.88,311.88,0,190.95,273.7,273.7,541.02
3630703,360,26685,,,,,,,OPEN TX CARPOMETACARPAL DISLOCATE NOT TH,7816.28,3126.51,867.38,7816.28,6643.84,SKIPPED,7816.28,7816.28,6643.84,6643.84,6643.84,3293.78,867.38,867.38,SKIPPED,SKIPPED,3361,3361,6643.84
3630704,975,26685,,,,,,,OPEN TX CARPOMETACARPAL DISLOCATE NOT TH,1313.39,525.36,0,1313.39,1116.38,SKIPPED,1313.39,1313.39,1116.38,1116.38,1116.38,632.91,643.56,643.56,SKIPPED,SKIPPED,645.83,645.83,0
3630705,278,,,,,,,,VOLAR DISTAL RAD PLATE,1987.5,795,0,1689.38,1689.38,SKIPPED,1510.5,1510.5,1689.38,1689.38,1689.38,837.54,973.88,973.88,0,596.25,854.63,854.63,1689.38
3630706,360,24576,,,,,,,CLOSED TX HEMERAL CONDYLE FX,620.49,248.2,87.17,620.49,527.42,SKIPPED,620.49,620.49,527.42,527.42,527.42,261.47,87.17,87.17,SKIPPED,SKIPPED,266.81,266.81,527.42
3630707,975,24576,,,,,,,CLOSED TX HEMERAL CONDYLE FX,703.75,281.5,0,703.75,598.19,SKIPPED,703.75,703.75,598.19,598.19,598.19,347.92,344.84,344.84,SKIPPED,SKIPPED,355.02,355.02,0
3630708,360,23630,,,,,,,ORIF GRTER HUMERAL TUB FX,16417.44,6566.98,1051.35,16417.44,13954.82,SKIPPED,16417.44,16417.44,13954.82,13954.82,13954.82,6918.31,1051.35,1051.35,SKIPPED,SKIPPED,7059.5,7059.5,13954.82
3630709,975,23630,,,,,,,ORIF GRTER HUMERAL TUB FX,1783.02,713.21,0,1783.02,1515.57,SKIPPED,1783.02,1783.02,1515.57,1515.57,1515.57,850.93,873.68,873.68,SKIPPED,SKIPPED,868.3,868.3,0
3630710,360,25671,,,,,,,PERQ PIN DISTAL RADIOULNAR DISLOC,15697.4,6278.96,867.38,13342.79,13342.79,SKIPPED,12564.84,12564.84,13342.79,13342.79,13342.79,6614.88,867.38,867.38,SKIPPED,SKIPPED,6749.88,6749.88,13342.79
3630711,975,25671,,,,,,,PERQ PIN DISTAL RADIOULNAR DISLOC,1212.65,485.06,0,1212.65,1030.75,SKIPPED,1212.65,1212.65,1030.75,1030.75,1030.75,582.42,594.2,594.2,SKIPPED,SKIPPED,594.31,594.31,0
3630712,360,25675,,,,,,,CLOSED TX RADIOULNAR DISLOC W/MAN,799.92,319.97,87.17,799.92,679.93,SKIPPED,799.92,799.92,679.93,679.93,679.93,337.09,87.17,87.17,SKIPPED,SKIPPED,343.97,343.97,679.93
3630713,975,25675,,,,,,,CLOSED TX RADIOULNAR DISLOC W/MAN,914.38,365.75,0,914.38,777.22,SKIPPED,914.38,914.38,777.22,777.22,777.22,449.03,448.05,448.05,SKIPPED,SKIPPED,458.19,458.19,0
3630714,360,24346,,,,,,,REPAIR MCL ELBOW W/TDN GRAFT,19208.32,7683.33,1051.35,19208.32,16327.07,SKIPPED,19208.32,19208.32,16327.07,16327.07,16327.07,8094.39,1051.35,1051.35,SKIPPED,SKIPPED,8259.58,8259.58,16327.07
3630715,975,24346,,,,,,,REPAIR MCL ELBOW W/TDN GRAFT,2516.4,1006.56,0,2516.4,2138.94,SKIPPED,2516.4,2516.4,2138.94,2138.94,2138.94,1202.7,1233.04,1233.04,SKIPPED,SKIPPED,1227.25,1227.25,0
3630716,360,64418,,,,,,,INJ AA&/STRD SUPRASCAPULAR NERVE,1447.04,578.82,0,1229.98,1229.98,SKIPPED,362.52,362.52,1229.98,1229.98,1229.98,609.79,34.65,34.65,0,434.11,622.23,622.23,1229.98
3630717,975,64418,,,,,,,INJ AA&/STRD SUPRASCAPULAR NERVE,132.06,52.82,0,132.06,112.25,SKIPPED,132.06,132.06,112.25,112.25,112.25,61.65,64.71,64.71,0,39.62,62.91,62.91,0
3630718,360,24579,,,,,,,ORIF HUMERAL CONDYLAR FX,18461.8,7384.72,1051.35,18461.8,15692.53,SKIPPED,18461.8,18461.8,15692.53,15692.53,15692.53,7779.8,1051.35,1051.35,SKIPPED,SKIPPED,7938.57,7938.57,15692.53
3630719,975,24579,,,,,,,ORIF HUMERAL CONDYLAR FX,1812.51,725,0,1812.51,1540.63,SKIPPED,1812.51,1812.51,1540.63,1540.63,1540.63,910.33,888.13,888.13,SKIPPED,SKIPPED,928.91,928.91,0
3630720,360,26020,,,,,,,I&D TENDON SHEATH DIGIT A/O PALM,3418.85,1367.54,867.38,3418.85,2906.02,SKIPPED,3418.85,3418.85,2906.02,2906.02,2906.02,1440.71,867.38,867.38,SKIPPED,SKIPPED,1470.11,1470.11,2906.02
3630721,975,26020,,,,,,,I&D TENDON SHEATH DIGIT A/O PALM,1206.03,482.41,0,1206.03,1025.13,SKIPPED,1206.03,1206.03,1025.13,1025.13,1025.13,611.11,590.95,590.95,SKIPPED,SKIPPED,623.58,623.58,0
3630722,360,25574,,,,,,,OPEN TX RADIAL & ULNAR SHAFT FX,12213.5,4885.4,1051.35,12213.5,10381.48,SKIPPED,12213.5,12213.5,10381.48,10381.48,10381.48,5146.77,1051.35,1051.35,SKIPPED,SKIPPED,5251.81,5251.81,10381.48
3630723,975,25574,,,,,,,OPEN TX RADIAL & ULNAR SHAFT FX,1466.04,586.42,0,1466.04,1246.13,SKIPPED,1466.04,1466.04,1246.13,1246.13,1246.13,738.77,718.36,718.36,SKIPPED,SKIPPED,753.85,753.85,0
3630724,360,25651,,,,,,,PRQ SKELETAL FIXATION ULNAR FX,4187.66,1675.06,867.38,4187.66,3559.51,SKIPPED,4187.66,4187.66,3559.51,3559.51,3559.51,1764.68,867.38,867.38,SKIPPED,SKIPPED,1800.69,1800.69,3559.51
3630725,975,25651,,,,,,,PRQ SKELETAL FIXATION ULNAR FX,1061.07,424.43,0,1061.07,901.91,SKIPPED,1061.07,1061.07,901.91,901.91,901.91,537.95,519.92,519.92,SKIPPED,SKIPPED,548.93,548.93,0
3630726,278,,,,,,,,BIOMET DBM PUTTY 2CC #92-2002,725,290,0,616.25,616.25,SKIPPED,551,551,616.25,616.25,616.25,305.52,355.25,355.25,0,217.5,311.75,311.75,616.25
3630727,278,,,,,,,,BIOMET DBM PUTTY 5CC #92-2003,1487.5,595,0,1264.38,1264.38,SKIPPED,1130.5,1130.5,1264.38,1264.38,1264.38,626.84,728.88,728.88,0,446.25,639.63,639.63,1264.38
3630728,360,24575,,,,,,,ORIF HUMERAL EPICONDYLAR FX,9246.01,3698.4,1051.35,9246.01,7859.11,SKIPPED,9246.01,9246.01,7859.11,7859.11,7859.11,3896.26,1051.35,1051.35,SKIPPED,SKIPPED,3975.78,3975.78,7859.11
3630730,360,24343,,,,,,,RPR LCL ELBOW,7274.85,2909.94,867.38,7274.85,6183.62,SKIPPED,7274.85,7274.85,6183.62,6183.62,6183.62,3065.63,867.38,867.38,SKIPPED,SKIPPED,3128.19,3128.19,6183.62
3630731,975,24343,,,,,,,RPR LCL ELBOW,1542.92,617.17,0,1542.92,1311.48,SKIPPED,1542.92,1542.92,1311.48,1311.48,1311.48,782.54,756.03,756.03,SKIPPED,SKIPPED,798.51,798.51,0
3630732,360,24666,,,,,,,ORIF RADIAL HEAD/NECK FX W/PROSTHETIC,10333.76,4133.5,1051.35,10333.76,8783.7,SKIPPED,10333.76,10333.76,8783.7,8783.7,8783.7,4354.65,1051.35,1051.35,SKIPPED,SKIPPED,4443.52,4443.52,8783.7
3630733,975,24666,,,,,,,ORIF RADIAL HEAD/NECK FX W/PROSTHETIC,1597,638.8,0,1597,1357.45,SKIPPED,1597,1597,1357.45,1357.45,1357.45,800.83,782.53,782.53,SKIPPED,SKIPPED,817.17,817.17,0
3630734,360,26418,,,,,,,RPR EXT TENDON FINGER W/O GRAFT,4479.84,1791.94,510.13,4479.84,3807.86,SKIPPED,4479.84,4479.84,3807.86,3807.86,3807.86,1887.8,510.13,510.13,SKIPPED,SKIPPED,1926.33,1926.33,3807.86
3630735,975,26418,,,,,,,RPR EXT TENDON FINGER W/O GRAFT,1285.67,514.27,0,1285.67,1092.82,SKIPPED,1285.67,1285.67,1092.82,1092.82,1092.82,702.11,629.98,629.98,SKIPPED,SKIPPED,716.44,716.44,0
3630736,975,24575,,,,,,,ORIF HUMERAL EPICONDYLAR FX,1595.28,638.11,0,1595.28,1355.99,SKIPPED,1595.28,1595.28,1355.99,1355.99,1355.99,800.93,781.69,781.69,SKIPPED,SKIPPED,817.28,817.28,0
3630737,360,27266,,,,,,,CLOSED TRT OF POST HIP ARTHROPLASTY,3295.37,1318.15,510.13,3295.37,2801.06,SKIPPED,3295.37,3295.37,2801.06,2801.06,2801.06,1388.67,510.13,510.13,SKIPPED,SKIPPED,1417.01,1417.01,2801.06
3630738,975,27266,,,,,,,CLOSED TRT OF POST HIP ARTHROPLASTY,1267.99,507.2,0,1267.99,1077.79,SKIPPED,1267.99,1267.99,1077.79,1077.79,1077.79,640.97,621.32,621.32,SKIPPED,SKIPPED,654.05,654.05,0
3630740,975,23552,,,,,,,OPEN TX ACROMCLAV DISCL,1301.23,520.49,0,1301.23,1106.05,SKIPPED,1301.23,1301.23,1106.05,1106.05,1106.05,716.75,637.6,637.6,SKIPPED,SKIPPED,731.38,731.38,0
3630741,360,27501,,,,,,,CLSD TRT SPRCNDYLR/TRANCNDYLR FEM W/O MA,4244.63,1697.85,87.17,3607.94,3607.94,SKIPPED,1020.78,1020.78,3607.94,3607.94,3607.94,1788.69,87.17,87.17,SKIPPED,SKIPPED,1825.19,1825.19,3607.94
3630742,975,27501,,,,,,,CLSD TRT SPRCNDYLR/TRANCNDYLR FEM W/O MA,1068.68,427.47,0,1020.78,908.38,SKIPPED,1020.78,1020.78,908.38,908.38,908.38,546.45,523.65,523.65,SKIPPED,SKIPPED,557.6,557.6,0
3630743,360,27520,,,,,,,CLSD TRT OF PATELLAR FX W/O MANI,553.46,221.38,87.17,553.46,470.44,SKIPPED,553.46,553.46,470.44,470.44,470.44,233.23,87.17,87.17,SKIPPED,SKIPPED,237.99,237.99,470.44
3630744,975,27520,,,,,,,CLSD TRT OF PATELLAR FX W/O MANI,648.35,259.34,0,648.35,551.1,SKIPPED,648.35,648.35,551.1,551.1,551.1,334.1,317.69,317.69,SKIPPED,SKIPPED,340.92,340.92,0
3630745,360,27827,,,,,,,ORIT DISTAL TIBIA,10154.03,4061.61,1051.35,10154.03,8630.93,SKIPPED,10154.03,10154.03,8630.93,8630.93,8630.93,4278.91,1051.35,1051.35,SKIPPED,SKIPPED,4366.23,4366.23,8630.93
3630746,975,27827,,,,,,,ORIT DISTAL TIBIA,2401.33,960.53,0,2401.33,2041.13,SKIPPED,2401.33,2401.33,2041.13,2041.13,2041.13,1227.96,1176.65,1176.65,SKIPPED,SKIPPED,1253.02,1253.02,0
3630747,360,27227,,,,,,,OPEN TRT ACTBLR FX,8683.29,3473.32,0,8174.08,7380.8,SKIPPED,8174.08,8174.08,7380.8,7380.8,7380.8,3659.13,0,0,0,2604.99,3733.81,3733.81,7380.8
3630748,975,27227,,,,,,,OPEN TRT ACTBLR FX,3520.24,1408.1,0,3520.24,2992.2,SKIPPED,3520.24,3520.24,2992.2,2992.2,2992.2,1788.09,1724.92,1724.92,0,1056.07,1824.58,1824.58,0
3630749,360,23600,,,,,,,closed tx of proximal humeral fx,606.38,242.55,87.17,531.76,515.42,SKIPPED,531.76,531.76,515.42,515.42,515.42,255.53,87.17,87.17,SKIPPED,SKIPPED,260.74,260.74,515.42
3630750,975,23600,,,,,,,closed tx of proximal humeral fx,680.55,272.22,0,578.47,578.47,SKIPPED,531.76,531.76,578.47,578.47,578.47,350.79,333.47,333.47,SKIPPED,SKIPPED,357.95,357.95,0
3630751,360,23550,,,,,,,OPEN TX CLAVICLE DISLOCATION,9823.73,3929.49,1051.35,9823.73,8350.17,SKIPPED,9823.73,9823.73,8350.17,8350.17,8350.17,4139.72,1051.35,1051.35,SKIPPED,SKIPPED,4224.2,4224.2,8350.17
3630752,975,23550,,,,,,,OPEN TX CLAVICLE DISLOCATION,1229.59,491.84,0,1229.59,1045.15,SKIPPED,1229.59,1229.59,1045.15,1045.15,1045.15,627.84,602.5,602.5,SKIPPED,SKIPPED,640.65,640.65,0
3630753,360,27823,,,,,,,ORIF TRIMALLEOLAR W/ FIX PST LIP,12935.63,5174.25,1051.35,12935.63,10995.29,SKIPPED,12935.63,12935.63,10995.29,10995.29,10995.29,5451.07,1051.35,1051.35,SKIPPED,SKIPPED,5562.32,5562.32,10995.29
3630754,975,27823,,,,,,,ORIF TRIMALLEOLAR W/ FIX PST LIP,2116.47,846.59,0,2116.47,1799,SKIPPED,2116.47,2116.47,1799,1799,1799,1081.01,1037.07,1037.07,SKIPPED,SKIPPED,1103.07,1103.07,0
3630755,360,24546,,,,,,,ORIF HUMERAL SUPTACONDYLAR FX W/ XTN,17403.52,6961.41,1051.35,17403.52,14792.99,SKIPPED,17403.52,17403.52,14792.99,14792.99,14792.99,7333.84,1051.35,1051.35,SKIPPED,SKIPPED,7483.51,7483.51,14792.99
3630756,975,24546,,,,,,,ORIF HUMERAL SUPTACONDYLAR FX W/ XTN,27574.01,11029.6,0,27574.01,23437.91,SKIPPED,27574.01,27574.01,23437.91,23437.91,23437.91,1128.82,13511.26,13511.26,SKIPPED,SKIPPED,1151.86,1151.86,0
3630757,360,25530,,,,,,,CLSD TRT ULNAR SHAFT FX W/O MANIPULATION,490.61,196.24,87.17,490.61,417.02,SKIPPED,490.61,490.61,417.02,417.02,417.02,206.74,87.17,87.17,SKIPPED,SKIPPED,210.96,210.96,417.02
3630758,975,25530,,,,,,,CLSD TRT ULNAR SHAFT FX W/O MANIPULATION,524.53,209.81,0,524.53,445.85,SKIPPED,524.53,524.53,445.85,445.85,445.85,269,257.02,257.02,SKIPPED,SKIPPED,274.49,274.49,0
3630759,360,27134,,,,,,,REVISION HIP REPLACEMENT,5349.33,2139.73,0,5349.33,4546.93,SKIPPED,5349.33,5349.33,4546.93,4546.93,4546.93,2254.21,0,0,0,1604.8,2300.21,2300.21,4546.93
3630760,360,24665,,,,,,,ORIF RADIAL HEAD/NECK,7011.9,2804.76,1051.35,7011.9,5960.12,SKIPPED,7011.9,7011.9,5960.12,5960.12,5960.12,2954.82,1051.35,1051.35,SKIPPED,SKIPPED,3015.12,3015.12,5960.12
3630761,975,24665,,,,,,,ORIF RADIAL HEAD/NECK,1414.14,565.66,0,1414.14,1202.02,SKIPPED,1414.14,1414.14,1202.02,1202.02,1202.02,721.34,692.93,692.93,SKIPPED,SKIPPED,736.06,736.06,0
3630762,360,25073,,,,,,,EXC TUMOR SFT TISSUE FOREARM>3CM,5936.96,2374.78,582.36,5936.96,5046.42,SKIPPED,5936.96,5936.96,5046.42,5046.42,5046.42,2501.83,582.36,582.36,SKIPPED,SKIPPED,2552.89,2552.89,5046.42
3630763,975,25073,,,,,,,EXC TUMOR SFT TISSUE FOREARM>3CM,1145.54,458.22,0,1145.54,973.71,SKIPPED,1145.54,1145.54,973.71,973.71,973.71,585.3,561.31,561.31,SKIPPED,SKIPPED,597.24,597.24,0
3630764,360,27626,,,,,,,ARTHROTOMY W/ SYNOVECTOMY ANKLE,4727.16,1890.86,867.38,4727.16,4018.09,SKIPPED,4727.16,4727.16,4018.09,4018.09,4018.09,1992.03,867.38,867.38,SKIPPED,SKIPPED,2032.68,2032.68,4018.09
3630765,975,27626,,,,,,,ARTHROTOMY W/ SYNOVECTOMY ANKLE,1295.96,518.38,0,1295.96,1101.57,SKIPPED,1295.96,1295.96,1101.57,1101.57,1101.57,661.94,635.02,635.02,SKIPPED,SKIPPED,675.45,675.45,0
3630766,360,21932,,,,,,,EXC TUMOR SOFT TISS BACK/FLANK <5CM,4888.49,1955.4,582.36,4888.49,4155.22,SKIPPED,4888.49,4888.49,4155.22,4155.22,4155.22,2060.01,582.36,582.36,SKIPPED,SKIPPED,2102.05,2102.05,4155.22
3630767,975,21932,,,,,,,EXC TUMOR SOFT TISS BACK/FLANK <5CM,1408.53,563.41,0,1408.53,1197.25,SKIPPED,1408.53,1408.53,1197.25,1197.25,1197.25,721.33,690.18,690.18,SKIPPED,SKIPPED,736.05,736.05,0
3630768,360,26480,,,,,,,TRANSPLANT HAND TENDON,3935.93,1574.37,867.38,3935.93,3345.54,SKIPPED,3935.93,3935.93,3345.54,3345.54,3345.54,1658.6,867.38,867.38,SKIPPED,SKIPPED,1692.45,1692.45,3345.54
3630769,975,26480,,,,,,,TRANSPLANT HAND TENDON,1716.68,686.67,0,1716.68,1459.18,SKIPPED,1716.68,1716.68,1459.18,1459.18,1459.18,880.94,841.17,841.17,SKIPPED,SKIPPED,898.92,898.92,0
3630770,278,,,,,,,,"STYLOID PLATE, 5 HOLE",895,358,0,760.75,760.75,SKIPPED,680.2,680.2,760.75,760.75,760.75,377.15,438.55,438.55,0,268.5,384.85,384.85,760.75
3630771,278,,,,,,,,FIBERWIRE STRAND #AR-7201,88,35.2,0,74.8,74.8,SKIPPED,66.88,66.88,74.8,74.8,74.8,37.08,43.12,43.12,0,26.4,37.84,37.84,74.8
3630772,272,,,,,,,,FIBERTAPE LOOP #AR-7275,175,70,0,148.75,148.75,SKIPPED,133,133,148.75,148.75,148.75,73.74,85.75,85.75,0,52.5,75.25,75.25,148.75
3630773,272,,,,,,,,TLGERTAPE LOOP #AR-7275T,175,70,0,148.75,148.75,SKIPPED,133,133,148.75,148.75,148.75,73.74,85.75,85.75,0,52.5,75.25,75.25,148.75
3630774,360,27138,,,,,,,"REVISION THA, FEMORAL COMPONENT ONLY",8384.25,3353.7,0,7534.83,7126.61,SKIPPED,7534.83,7534.83,7126.61,7126.61,7126.61,3533.13,0,0,0,2515.28,3605.23,3605.23,7126.61
3630775,975,27138,,,,,,,"REVISION THA, FEMORAL COMPONENT ONLY",3092.4,1236.96,0,3092.4,2628.54,SKIPPED,3092.4,3092.4,2628.54,2628.54,2628.54,1649.67,1515.28,1515.28,0,927.72,1683.34,1683.34,0
3630776,272,,,,,,,,PARS KIT,3737.5,1495,0,3176.88,3176.88,SKIPPED,2840.5,2840.5,3176.88,3176.88,3176.88,1574.99,1831.38,1831.38,0,1121.25,1607.13,1607.13,3176.88
3630777,360,28470,,,,,,,CLOSED TRT OF METATARSAL FX,498.75,199.5,87.17,498.75,423.94,SKIPPED,498.75,498.75,423.94,423.94,423.94,210.17,87.17,87.17,SKIPPED,SKIPPED,214.46,214.46,423.94
3630778,975,28470,,,,,,,CLOSED TRT OF METATARSAL FX,421.05,168.42,0,421.05,357.89,SKIPPED,421.05,421.05,357.89,357.89,357.89,227.32,206.31,206.31,SKIPPED,SKIPPED,231.96,231.96,0
3630779,360,27786,,,,,,,CLOSED TRT OF DISTAL FIB FX,567.57,227.03,87.17,567.57,482.43,SKIPPED,567.57,567.57,482.43,482.43,482.43,239.18,87.17,87.17,SKIPPED,SKIPPED,244.06,244.06,482.43
3630780,975,27786,,,,,,,CLOSED TRT OF DISTAL FIB FX,593.86,237.54,0,593.86,504.78,SKIPPED,593.86,593.86,504.78,504.78,504.78,320.5,290.99,290.99,SKIPPED,SKIPPED,327.04,327.04,0
3630781,360,27780,,,,,,,CLOSED TRT OF PROXIMAL FIB FX,420,168,87.17,420,357,SKIPPED,420,420,357,357,357,176.99,87.17,87.17,SKIPPED,SKIPPED,180.6,180.6,357
3630782,975,27780,,,,,,,CLOSED TRT OF PROXIMAL FIB FX,585.54,234.22,0,585.54,497.71,SKIPPED,585.54,585.54,497.71,497.71,497.71,316.81,286.91,286.91,SKIPPED,SKIPPED,323.28,323.28,0
3630783,360,25101,,,,,,,"ARTHROTOMY WRIST W/WO EXPL, W/WO BX, RMV",5720.4,2288.16,867.38,5720.4,4862.34,SKIPPED,5720.4,5720.4,4862.34,4862.34,4862.34,2410.57,867.38,867.38,SKIPPED,SKIPPED,2459.77,2459.77,4862.34
3630784,975,25101,,,,,,,"ARTHROTOMY WRIST W/WO EXPL, W/WO BX, RMV",829.79,331.92,0,829.79,705.32,SKIPPED,829.79,829.79,705.32,705.32,705.32,445.93,406.6,406.6,SKIPPED,SKIPPED,455.03,455.03,0
3630785,360,29825,,,,,,,ARTHROSCOPIC ADHESIONS SHOULDER,6469.59,2587.84,867.38,6469.59,5499.15,SKIPPED,6469.59,6469.59,5499.15,5499.15,5499.15,2726.28,867.38,867.38,SKIPPED,SKIPPED,2781.92,2781.92,5499.15
3630786,975,29825,,,,,,,ARTHROSCOPIC ADHESIONS SHOULDER,1201.83,480.73,0,1201.83,1021.56,SKIPPED,1201.83,1201.83,1021.56,1021.56,1021.56,642.6,588.9,588.9,SKIPPED,SKIPPED,655.71,655.71,0
3630787,360,27446,,,,,,,ARTHROPASTY KNEE MEDIAL OR LATERAL,16926,6770.4,1051.35,16926,14387.1,SKIPPED,16926,16926,14387.1,14387.1,14387.1,7132.62,1051.35,1051.35,SKIPPED,SKIPPED,7278.18,7278.18,14387.1
3630788,975,27446,,,,,,,ARTHROPASTY KNEE MEDIAL OR LATERAL,2345.47,938.19,0,2345.47,1993.65,SKIPPED,2345.47,2345.47,1993.65,1993.65,1993.65,1252.1,1149.28,1149.28,SKIPPED,SKIPPED,1277.65,1277.65,0
3630789,278,C1713,,,,,,,SELF TAPPING SCREWS (ALL SIZES),455,182,0,386.75,386.75,SKIPPED,345.8,345.8,386.75,386.75,386.75,191.74,222.95,222.95,0,136.5,195.65,195.65,386.75
3630790,278,C1734,,,,,,,"NCB SHAFT PLATE, STRAIGHT NARROW 10 HOLE",1657.5,663,0,1408.88,1408.88,SKIPPED,1259.7,1259.7,1408.88,1408.88,1408.88,698.48,812.18,812.18,0,497.25,712.73,712.73,1408.88
3630791,272,,,,,,,,IRRISEPT IRRIGATION SOLUTION,325.92,130.37,0,277.03,277.03,SKIPPED,247.7,247.7,277.03,277.03,277.03,137.35,159.7,159.7,0,97.78,140.15,140.15,277.03
3630792,360,24516,,,,,,,TX HUMRAL SHAFT FX W/IMED IMPLANT,14938.29,5975.32,1051.35,14938.29,12697.55,SKIPPED,14938.29,14938.29,12697.55,12697.55,12697.55,6294.99,1051.35,1051.35,SKIPPED,SKIPPED,6423.46,6423.46,12697.55
3630793,975,24516,,,,,,,TX HUMRAL SHAFT FX W/IMED IMPLANT,1746.23,698.49,0,1746.23,1484.3,SKIPPED,1746.23,1746.23,1484.3,1484.3,1484.3,937.14,855.65,855.65,SKIPPED,SKIPPED,956.27,956.27,0
3630794,272,,,,,,,,ACP KIT(MFR# ABS-10011),437.5,175,0,371.88,371.88,SKIPPED,332.5,332.5,371.88,371.88,371.88,184.37,214.38,214.38,0,131.25,188.13,188.13,371.88
3630795,272,,,,,,,,ACP DOUBLE SYRINGE (MFR# ABS-100105),375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3630796,360,27824,,,,,,,CLOSED TRT DISTAL TIBIA W/O MANIPULATION,462,184.8,87.17,462,392.7,SKIPPED,462,462,392.7,392.7,392.7,194.69,87.17,87.17,SKIPPED,SKIPPED,198.66,198.66,392.7
3630797,975,27824,,,,,,,CLOSED TRT DISTAL TIBIA W/O MANIPULATION,629.41,251.76,0,629.41,535,SKIPPED,629.41,629.41,535,535,535,337.79,308.41,308.41,SKIPPED,SKIPPED,344.68,344.68,0
3630798,272,,,,,,,,RECIP SAW BLADE,84.27,33.71,0,71.63,71.63,SKIPPED,64.05,64.05,71.63,71.63,71.63,35.52,41.29,41.29,0,25.28,36.24,36.24,71.63
3630799,272,,,,,,,,OSCILLATING SAW BLADE,202.82,81.13,0,172.4,172.4,SKIPPED,154.14,154.14,172.4,172.4,172.4,85.47,99.38,99.38,0,60.85,87.21,87.21,172.4
3630800,272,,,,,,,,MICRO SAGITTAL BLADE FINE (MED BLADE),63.32,25.33,0,53.82,53.82,SKIPPED,48.12,48.12,53.82,53.82,53.82,26.69,31.03,31.03,0,19,27.23,27.23,53.82
3630801,272,,,,,,,,MICRO SAGITTAL BLADE FINE (LONG THIN),63.32,25.33,0,53.82,53.82,SKIPPED,48.12,48.12,53.82,53.82,53.82,26.69,31.03,31.03,0,19,27.23,27.23,53.82
3630802,272,,,,,,,,MICRO SAGITTAL BLADE FINE,19.2,7.68,0,16.32,16.32,SKIPPED,14.59,14.59,16.32,16.32,16.32,8.09,9.41,9.41,0,5.76,8.26,8.26,16.32
3630803,272,,,,,,,,MICRO SAGITTAL BLADE COURSE,37.05,14.82,0,31.49,31.49,SKIPPED,28.16,28.16,31.49,31.49,31.49,15.61,18.15,18.15,0,11.12,15.93,15.93,31.49
3630804,272,,,,,,,,"4.0 OVAL BUR, MEDIUM",59.7,23.88,0,50.74,50.74,SKIPPED,45.37,45.37,50.74,50.74,50.74,25.16,29.25,29.25,0,17.91,25.67,25.67,50.74
3630805,272,,,,,,,,"2.1 BARREL BUR, MEDIUM",58.75,23.5,0,49.94,49.94,SKIPPED,44.65,44.65,49.94,49.94,49.94,24.75,28.79,28.79,0,17.62,25.26,25.26,49.94
3630806,272,,,,,,,,2.1 MICRO TAPERED FISSURE BUR,16.82,6.73,0,14.3,14.3,SKIPPED,12.78,12.78,14.3,14.3,14.3,7.09,8.24,8.24,0,5.05,7.23,7.23,14.3
3630807,278,C1734,,,,,,,SYNDEMOSIS TIGHTROPE MFR/PART#AR-892555,3737.5,1495,0,3176.88,3176.88,SKIPPED,2840.5,2840.5,3176.88,3176.88,3176.88,1574.99,1831.38,1831.38,0,1121.25,1607.13,1607.13,3176.88
3630808,360,27664,,,,,,,"RPR EXTENSION TENDON, LEG; PRIMARY W/O G",7717.5,3087,1051.35,7717.5,6559.88,SKIPPED,7717.5,7717.5,6559.88,6559.88,6559.88,3252.16,1051.35,1051.35,SKIPPED,SKIPPED,3318.53,3318.53,6559.88
3630809,975,27664,,,,,,,"RPR EXTENSION TENDON, LEG; PRIMARY W/O G",747.03,298.81,0,747.03,634.98,SKIPPED,747.03,747.03,634.98,634.98,634.98,400.91,366.04,366.04,SKIPPED,SKIPPED,409.09,409.09,0
3630810,360,25120,,,,,,,EXCISION/CURETTAGE CYST/TUM RAD/ULNA,6191.24,2476.5,867.38,6191.24,5262.55,SKIPPED,6191.24,6191.24,5262.55,5262.55,5262.55,2608.99,867.38,867.38,SKIPPED,SKIPPED,2662.23,2662.23,5262.55
3630811,975,25120,,,,,,,EXCISION/CURETTAGE CYST/TUM RAD/ULNA,1027.66,411.06,0,1027.66,873.51,SKIPPED,1027.66,1027.66,873.51,873.51,873.51,551.5,503.55,503.55,SKIPPED,SKIPPED,562.76,562.76,0
3630812,272,,,,,,,,Disposable Pad for Leg Holder,93.13,37.25,0,79.16,79.16,SKIPPED,70.78,70.78,79.16,79.16,79.16,39.25,45.63,45.63,0,27.94,40.05,40.05,79.16
3630813,360,27310,,,,,,,ARTHROTOMY KNEE W/ EXPLOR/DRAIN/REMOVAL,8982,3592.8,867.38,8982,7634.7,SKIPPED,8982,8982,7634.7,7634.7,7634.7,3785.01,867.38,867.38,SKIPPED,SKIPPED,3862.26,3862.26,7634.7
36474,975,36474,,,,,,,ENDOVENOUS MCHNCHEM ADD-ON,214.17,85.67,0,182.04,182.04,SKIPPED,0,0,182.04,182.04,182.04,95.36,104.94,104.94,0,64.25,97.31,97.31,0
3650001,272,,,,,,,,STAPLER SUREFORM 60,1325,530,0,1126.25,1126.25,SKIPPED,1007,1007,1126.25,1126.25,1126.25,558.36,649.25,649.25,0,397.5,569.75,569.75,1126.25
3650002,272,,,,,,,,"RELOAD SUREFORM 60, 2.5 WHITE",575,230,0,488.75,488.75,SKIPPED,437,437,488.75,488.75,488.75,242.3,281.75,281.75,0,172.5,247.25,247.25,488.75
3650003,272,,,,,,,,"RELOAD SUREFORM 60, 3.5 BLUE",575,230,0,488.75,488.75,SKIPPED,437,437,488.75,488.75,488.75,242.3,281.75,281.75,0,172.5,247.25,247.25,488.75
3650004,272,,,,,,,,"RELOAD SUREFORM 60, 4.3 GREEN",575,230,0,488.75,488.75,SKIPPED,437,437,488.75,488.75,488.75,242.3,281.75,281.75,0,172.5,247.25,247.25,488.75
3650005,272,,,,,,,,"RELOAD SUREFORM 60, 4.6 BLACK",575,230,0,488.75,488.75,SKIPPED,437,437,488.75,488.75,488.75,242.3,281.75,281.75,0,172.5,247.25,247.25,488.75
3650006,272,,,,,,,,MARYLAND BIPOLAR FORCEPS,587.5,235,0,499.38,499.38,SKIPPED,446.5,446.5,499.38,499.38,499.38,247.58,287.88,287.88,0,176.25,252.63,252.63,499.38
3650007,272,,,,,,,,MONOPOLAR CURVED SCISSORS,800,320,0,680,680,SKIPPED,608,608,680,680,680,337.12,392,392,0,240,344,344,680
3650008,272,,,,,,,,8MM FORCE BIPOLAR,587.5,235,0,499.38,499.38,SKIPPED,446.5,446.5,499.38,499.38,499.38,247.58,287.88,287.88,0,176.25,252.63,252.63,499.38
3650009,272,,,,,,,,CADIERE FORCEPS,375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3650010,272,,,,,,,,PROGRASP FORCEPS,375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3650011,272,,,,,,,,LARGE NEEDLE GRASPER,425,170,0,361.25,361.25,SKIPPED,323,323,361.25,361.25,361.25,179.1,208.25,208.25,0,127.5,182.75,182.75,361.25
3650012,272,,,,,,,,TIE-UP FENESTRATED GRASPER,550,220,0,467.5,467.5,SKIPPED,418,418,467.5,467.5,467.5,231.77,269.5,269.5,0,165,236.5,236.5,467.5
3650013,272,,,,,,,,MEGA NEEDLE DRIVER,550,220,0,467.5,467.5,SKIPPED,418,418,467.5,467.5,467.5,231.77,269.5,269.5,0,165,236.5,236.5,467.5
3650014,272,,,,,,,,PERMANENT CAUTERY HOOK,300,120,0,255,255,SKIPPED,228,228,255,255,255,126.42,147,147,0,90,129,129,255
3650015,272,,,,,,,,MEDIUM-LARGE CLIP APPLIER,200,80,0,170,170,SKIPPED,152,152,170,170,170,84.28,98,98,0,60,86,86,170
3650016,272,,,,,,,,TIP COVER ACCESSORY,50,20,0,42.5,42.5,SKIPPED,38,38,42.5,42.5,42.5,21.07,24.5,24.5,0,15,21.5,21.5,42.5
3650017,272,,,,,,,,5-8MM CANNULA SEAL,45,18,0,38.25,38.25,SKIPPED,34.2,34.2,38.25,38.25,38.25,18.96,22.05,22.05,0,13.5,19.35,19.35,38.25
3650018,272,,,,,,,,8MM BLADELESS OBTURATOR,75,30,0,63.75,63.75,SKIPPED,57,57,63.75,63.75,63.75,31.6,36.75,36.75,0,22.5,32.25,32.25,63.75
3650019,272,,,,,,,,"8MM BLADELESS OBTURATOR, LONG",75,30,0,63.75,63.75,SKIPPED,57,57,63.75,63.75,63.75,31.6,36.75,36.75,0,22.5,32.25,32.25,63.75
3650020,272,,,,,,,,12-8MM REDUCER,62.5,25,0,53.12,53.12,SKIPPED,47.5,47.5,53.12,53.12,53.12,26.34,30.62,30.62,0,18.75,26.88,26.88,53.12
3650021,272,,,,,,,,ASSY HANHELD CAMERA HEAD,200,80,0,170,170,SKIPPED,152,152,170,170,170,84.28,98,98,0,60,86,86,170
3650022,272,,,,,,,,"STAINLESS STEEL REPROCESSING TRAY, 2D CA",1600,640,0,1360,1360,SKIPPED,1216,1216,1360,1360,1360,674.24,784,784,0,480,688,688,1360
3650023,272,,,,,,,,"ASSY, 2D CAMERA LIGHT GUIDE",7.5,3,0,6.38,6.38,SKIPPED,5.7,5.7,6.38,6.38,6.38,3.17,3.68,3.68,0,2.25,3.23,3.23,6.38
3650024,272,,,,,,,,"KIT, ADAPTER,THREADED,2D CAMERA LIGHT GU",50,20,0,42.5,42.5,SKIPPED,38,38,42.5,42.5,42.5,21.07,24.5,24.5,0,15,21.5,21.5,42.5
3650025,272,,,,,,,,"KIT,CABLE,FIBER OPTIC,ST,CIRCULAR-MT M-F",15,6,0,12.75,12.75,SKIPPED,11.4,11.4,12.75,12.75,12.75,6.32,7.35,7.35,0,4.5,6.45,6.45,12.75
3650026,272,,,,,,,,MONOPOLAR CAUTERY CORD,5,2,0,4.25,4.25,SKIPPED,3.8,3.8,4.25,4.25,4.25,2.11,2.45,2.45,0,1.5,2.15,2.15,4.25
3650027,242,,,,,,,,BIPOLAR CAUTERY CORD,5.25,2.1,0,4.46,4.46,SKIPPED,3.99,3.99,4.46,4.46,4.46,2.21,2.57,2.57,0,1.58,2.26,2.26,4.46
3650028,272,,,,,,,,DA VINCI X/XI ENDOWRIST SUCTION IRRIGATO,662.5,265,0,563.12,563.12,SKIPPED,503.5,503.5,563.12,563.12,563.12,279.18,324.62,324.62,0,198.75,284.88,284.88,563.12
3650029,272,,,,,,,,12MM & STAPLER CANNULA SEAL,50,20,0,42.5,42.5,SKIPPED,38,38,42.5,42.5,42.5,21.07,24.5,24.5,0,15,21.5,21.5,42.5
3650030,272,,,,,,,,INSTRUMENT ARM DRAPE,130,52,0,110.5,110.5,SKIPPED,98.8,98.8,110.5,110.5,110.5,54.78,63.7,63.7,0,39,55.9,55.9,110.5
3650031,272,,,,,,,,COLUMN DRAPE,45,18,0,38.25,38.25,SKIPPED,34.2,34.2,38.25,38.25,38.25,18.96,22.05,22.05,0,13.5,19.35,19.35,38.25
3650032,360,43775,,,,,,,LAP SLEEVE GASTRECTOMY,13296.15,5318.46,0,11301.73,11301.73,SKIPPED,5511.33,5511.33,11301.73,11301.73,11301.73,5602.99,0,0,0,3988.84,5717.34,5717.34,11301.73
3650033,975,43775,,,,,,,LAP SLEEVE GASTRECTOMY,2230.14,892.06,0,2230.14,1895.62,SKIPPED,2230.14,2230.14,1895.62,1895.62,1895.62,1192.21,1092.77,1092.77,0,669.04,1216.54,1216.54,0
3650034,360,43644,,,,,,,LAPAROSCPIC GASTRIC BYPASS ROU-EN-Y,19455.03,7782.01,0,16536.78,16536.78,SKIPPED,8549.14,8549.14,16536.78,16536.78,16536.78,8198.35,0,0,0,5836.51,8365.66,8365.66,16536.78
3650035,975,43644,,,,,,,LAPAROSCPIC GASTRIC BYPASS ROU-EN-Y,3494.65,1397.86,0,3494.65,2970.45,SKIPPED,3494.65,3494.65,2970.45,2970.45,2970.45,1874.32,1712.38,1712.38,0,1048.4,1912.57,1912.57,0
3650036,272,,,,,,,,Ensizor Endoscopic Scissors REF#:ES26235,812.5,325,0,690.62,690.62,SKIPPED,617.5,617.5,690.62,690.62,690.62,342.39,398.12,398.12,0,243.75,349.38,349.38,690.62
3650037,360,49587,,,,,,,RPR UMBILICAL HERNIA >5 YR INCARCERATED,8204.7,3281.88,867.38,8204.7,6974,SKIPPED,8204.7,8204.7,6974,6974,6974,3457.46,867.38,867.38,SKIPPED,SKIPPED,3528.02,3528.02,6974
3650038,975,49587,,,,,,,RPR UMBILICAL HERNIA >5 YR INCARCERATED,9674.85,3869.94,0,9674.85,8223.62,SKIPPED,9674.85,9674.85,8223.62,8223.62,8223.62,520.75,4740.68,4740.68,SKIPPED,SKIPPED,531.38,531.38,0
3654110,450,27197,,,,,,,"Closed treatment pelvic ring fx, unil or",521.14,208.46,0,521.14,442.97,SKIPPED,521.14,521.14,442.97,442.97,442.97,219.61,255.36,255.36,0,156.34,224.09,224.09,442.97
3654111,360,38589,,,,,,,UNLISTED LAPAROSCOPY LYMPHATIC,10787.7,4315.08,0,10787.7,9169.54,SKIPPED,10787.7,10787.7,9169.54,9169.54,9169.54,4545.94,0,0,0,3236.31,4638.71,4638.71,9169.54
3654112,975,38589,,,,,,,UNLISTED LAPAROSCOPY LYMPHATIC,2081.78,832.71,0,2081.78,1769.51,SKIPPED,2081.78,2081.78,1769.51,1769.51,1769.51,0,1020.07,1020.07,0,624.53,0,0,0
3660017,710,,,,,,,,PACU 0-30 MIN,381.65,152.66,0,324.4,324.4,SKIPPED,290.05,290.05,324.4,324.4,324.4,160.83,187.01,187.01,0,114.5,164.11,164.11,324.4
3660028,710,,,,,,,,PACU 30-60 MIN,763.32,305.33,0,648.82,648.82,SKIPPED,580.12,580.12,648.82,648.82,648.82,321.67,374.03,374.03,0,229,328.23,328.23,648.82
3660039,710,,,,,,,,PACU EA ADL 30 MIN,381.65,152.66,0,324.4,324.4,SKIPPED,290.05,290.05,324.4,324.4,324.4,160.83,187.01,187.01,0,114.5,164.11,164.11,324.4
3660040,710,,,,,,,,PACU 90-120 MIN,1526.64,610.66,0,1297.64,1297.64,SKIPPED,1160.25,1160.25,1297.64,1297.64,1297.64,643.33,748.05,748.05,0,457.99,656.46,656.46,1297.64
3700012,710,,,,,,,,PACU 60-90 MIN,1144.97,457.99,0,973.22,973.22,SKIPPED,870.18,870.18,973.22,973.22,973.22,482.49,561.04,561.04,0,343.49,492.34,492.34,973.22
3760002,278,C1781,,,,,,,"MESH EX BARD 6""X8""",1982,792.8,0,1684.7,1684.7,SKIPPED,1506.32,1506.32,1684.7,1684.7,1684.7,835.21,971.18,971.18,0,594.6,852.26,852.26,1684.7
3760007,252,,,,,,,,TACKER HERNIA 5MM,1113,445.2,0,946.05,946.05,SKIPPED,845.88,845.88,946.05,946.05,946.05,469.02,545.37,545.37,0,333.9,478.59,478.59,946.05
3760011,271,,,,,,,,BAND SPAND SZ1 EA,15.75,6.3,0,13.39,13.39,SKIPPED,11.97,11.97,13.39,13.39,13.39,6.63,7.72,7.72,0,4.72,6.77,6.77,13.39
3760012,270,,,,,,,,HYTAPE,38.85,15.54,0,33.02,33.02,SKIPPED,29.53,29.53,33.02,33.02,33.02,16.38,19.04,19.04,0,11.66,16.71,16.71,33.02
3760013,271,,,,,,,,BAND SPAND LG EA,25.2,10.08,0,21.42,21.42,SKIPPED,19.15,19.15,21.42,21.42,21.42,10.62,12.35,12.35,0,7.56,10.84,10.84,21.42
3760022,270,,,,,,,,OINT ALOE PROTECT,6.3,2.52,0,5.36,5.36,SKIPPED,4.79,4.79,5.36,5.36,5.36,2.66,3.09,3.09,0,1.89,2.71,2.71,5.36
3760023,270,,,,,,,,OINT ANTIFUNGAL,11.55,4.62,0,9.82,9.82,SKIPPED,8.78,8.78,9.82,9.82,9.82,4.87,5.66,5.66,0,3.46,4.97,4.97,9.82
3760026,270,,,,,,,,DUODERM 6x7,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3760027,270,,,,,,,,DUODERM 3x3 THIN,8.4,3.36,0,7.14,7.14,SKIPPED,6.38,6.38,7.14,7.14,7.14,3.54,4.12,4.12,0,2.52,3.61,3.61,7.14
3760028,270,,,,,,,,DRESSING 2X2 AQUACEL,9.45,3.78,0,8.03,8.03,SKIPPED,7.18,7.18,8.03,8.03,8.03,3.98,4.63,4.63,0,2.84,4.06,4.06,8.03
3760029,270,,,,,,,,DRESSING 4X4 AQUACEL,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3760031,270,,,,,,,,MESH HERNIA PLUG-MED,617.4,246.96,0,524.79,524.79,SKIPPED,469.22,469.22,524.79,524.79,524.79,260.17,302.53,302.53,0,185.22,265.48,265.48,524.79
3760036,270,L4360,,,,,,,FOAM WALKER-XL,195.3,78.12,0,166,166,SKIPPED,148.43,148.43,166,166,166,82.3,95.7,95.7,0,58.59,83.98,83.98,166
3760037,270,L4360,,,,,,,FOAM WALKER-LG,195.3,78.12,0,166,166,SKIPPED,148.43,148.43,166,166,166,82.3,95.7,95.7,0,58.59,83.98,83.98,166
3760038,270,L4360,,,,,,,FOAM WALKER-SMALL,195.3,78.12,0,166,166,SKIPPED,148.43,148.43,166,166,166,82.3,95.7,95.7,0,58.59,83.98,83.98,166
3760039,278,,,,,,,,CORK SCREW ANCHORS 2.0,455,182,0,386.75,386.75,SKIPPED,345.8,345.8,386.75,386.75,386.75,191.74,222.95,222.95,0,136.5,195.65,195.65,386.75
3760041,270,,,,,,,,ABD 8X10,9.45,3.78,0,8.03,8.03,SKIPPED,7.18,7.18,8.03,8.03,8.03,3.98,4.63,4.63,0,2.84,4.06,4.06,8.03
3760043,278,L8641,,,,,,,KMI GRT TOE IMPLT METATAR,5754,2301.6,0,4890.9,4890.9,SKIPPED,4373.04,4373.04,4890.9,4890.9,4890.9,2424.74,2819.46,2819.46,0,1726.2,2474.22,2474.22,4890.9
3760046,270,,,,,,,,BARD MESH 3x6,145.95,58.38,0,124.06,124.06,SKIPPED,110.92,110.92,124.06,124.06,124.06,61.5,71.52,71.52,0,43.78,62.76,62.76,124.06
3760047,272,,,,,,,,ASNIS MICRO 2.0MM SCREW,90.3,36.12,0,76.76,76.76,SKIPPED,68.63,68.63,76.76,76.76,76.76,38.05,44.25,44.25,0,27.09,38.83,38.83,76.76
3760048,272,,,,,,,,ASNIS MICRO 2.0MM WASHER,43.05,17.22,0,36.59,36.59,SKIPPED,32.72,32.72,36.59,36.59,36.59,18.14,21.09,21.09,0,12.92,18.51,18.51,36.59
3760054,272,,,,,,,,MINI TIGHTROPE REPAIR KIT,1087.8,435.12,0,924.63,924.63,SKIPPED,826.73,826.73,924.63,924.63,924.63,458.4,533.02,533.02,0,326.34,467.75,467.75,924.63
3760055,270,,,,,,,,RADIAL JAW HOT,262.5,105,0,223.12,223.12,SKIPPED,199.5,199.5,223.12,223.12,223.12,110.62,128.62,128.62,0,78.75,112.88,112.88,223.12
3760056,270,,,,,,,,EEA COLONIC STAPLE,1233.75,493.5,0,1048.69,1048.69,SKIPPED,937.65,937.65,1048.69,1048.69,1048.69,519.9,604.54,604.54,0,370.12,530.51,530.51,1048.69
3760057,270,,,,,,,,BONE FILLER/PUTTY,575.4,230.16,0,489.09,489.09,SKIPPED,437.3,437.3,489.09,489.09,489.09,242.47,281.95,281.95,0,172.62,247.42,247.42,489.09
3760058,270,,,,,,,,TOTAL TOE,3097.5,1239,0,2632.88,2632.88,SKIPPED,2354.1,2354.1,2632.88,2632.88,2632.88,1305.29,1517.78,1517.78,0,929.25,1331.93,1331.93,2632.88
3760059,270,,,,,,,,GUIDE PIN,111.3,44.52,0,94.6,94.6,SKIPPED,84.59,84.59,94.6,94.6,94.6,46.9,54.54,54.54,0,33.39,47.86,47.86,94.6
3760061,272,,,,,,,,ENDOCUTTER,400.05,160.02,0,340.04,340.04,SKIPPED,304.04,304.04,340.04,340.04,340.04,168.58,196.02,196.02,0,120.02,172.02,172.02,340.04
3760062,272,,,,,,,,ENDOCUTTER RELOAD,151.2,60.48,0,128.52,128.52,SKIPPED,114.91,114.91,128.52,128.52,128.52,63.72,74.09,74.09,0,45.36,65.02,65.02,128.52
3760063,272,,,,,,,,GUIDE WIRE,373.75,149.5,0,317.69,317.69,SKIPPED,284.05,284.05,317.69,317.69,317.69,157.5,183.14,183.14,0,112.12,160.71,160.71,317.69
3760066,270,,,,,,,,GUIDE WIRE,780,312,0,663,663,SKIPPED,592.8,592.8,663,663,663,328.69,382.2,382.2,0,234,335.4,335.4,663
3760068,270,,,,,,,,OPTIFLO,98.7,39.48,0,83.9,83.9,SKIPPED,75.01,75.01,83.9,83.9,83.9,41.59,48.36,48.36,0,29.61,42.44,42.44,83.9
3760075,272,,,,,,,,SURGICEL,266,106.4,0,226.1,226.1,SKIPPED,202.16,202.16,226.1,226.1,226.1,112.09,130.34,130.34,0,79.8,114.38,114.38,226.1
3760077,272,,,,,,,,SYN-2.0 DRILL BIT,800.1,320.04,0,680.08,680.08,SKIPPED,608.08,608.08,680.08,680.08,680.08,337.16,392.05,392.05,0,240.03,344.04,344.04,680.08
3760078,272,,,,,,,,SYN-1.1KWIRE THREAD(623),74.55,29.82,0,63.37,63.37,SKIPPED,56.66,56.66,63.37,63.37,63.37,31.42,36.53,36.53,0,22.36,32.06,32.06,63.37
3760080,272,,,,,,,,JOINT PUTTY2.55(JT-FOUND),729.75,291.9,0,620.29,620.29,SKIPPED,554.61,554.61,620.29,620.29,620.29,307.51,357.58,357.58,0,218.92,313.79,313.79,620.29
3760081,270,,,,,,,,PODIATRY TRAY,40.95,16.38,0,34.81,34.81,SKIPPED,31.12,31.12,34.81,34.81,34.81,17.26,20.07,20.07,0,12.28,17.61,17.61,34.81
3760082,271,,,,,,,,JED MANDIBLE CUPS,40.95,16.38,0,34.81,34.81,SKIPPED,31.12,31.12,34.81,34.81,34.81,17.26,20.07,20.07,0,12.28,17.61,17.61,34.81
3760083,272,,,,,,,,SURGIMESH WN +221510,1446.9,578.76,0,1229.86,1229.86,SKIPPED,1099.64,1099.64,1229.86,1229.86,1229.86,609.73,708.98,708.98,0,434.07,622.17,622.17,1229.86
3760084,272,,,,,,,,SURIGMESH WN +1415,1128.75,451.5,0,959.44,959.44,SKIPPED,857.85,857.85,959.44,959.44,959.44,475.65,553.09,553.09,0,338.62,485.36,485.36,959.44
3760085,272,,,,,,,,CARTER THOMP SYSTEM,207.9,83.16,0,176.72,176.72,SKIPPED,158,158,176.72,176.72,176.72,87.61,101.87,101.87,0,62.37,89.4,89.4,176.72
3760087,272,,,,,,,,J P 10FR RND DRAIN W/TROC,132.3,52.92,0,112.46,112.46,SKIPPED,100.55,100.55,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,112.46
3760088,272,,,,,,,,FIBRILLAR ABS 4X4,507.15,202.86,0,431.08,431.08,SKIPPED,385.43,385.43,431.08,431.08,431.08,213.71,248.5,248.5,0,152.14,218.07,218.07,431.08
3760090,272,,,,,,,,FRAZIER SUCTION TIP 10FR,11.55,4.62,0,9.82,9.82,SKIPPED,8.78,8.78,9.82,9.82,9.82,4.87,5.66,5.66,0,3.46,4.97,4.97,9.82
3760091,278,,,,,,,,6-10MM LORDOTIC CERV SPAC,5000,2000,0,4250,4250,SKIPPED,3800,3800,4250,4250,4250,2107,2450,2450,0,1500,2150,2150,4250
3760092,278,,,,,,,,5-11MM COMPOSITE CER SPAC,3914,1565.6,0,3326.9,3326.9,SKIPPED,2974.64,2974.64,3326.9,3326.9,3326.9,1649.36,1917.86,1917.86,0,1174.2,1683.02,1683.02,3326.9
3760093,278,,,,,,,,ONE LVL 8-20MM PLATE,4738,1895.2,0,4027.3,4027.3,SKIPPED,3600.88,3600.88,4027.3,4027.3,4027.3,1996.59,2321.62,2321.62,0,1421.4,2037.34,2037.34,4027.3
3760094,278,,,,,,,,TWO LVL 20-40MM PLATE,5179,2071.6,0,4402.15,4402.15,SKIPPED,3936.04,3936.04,4402.15,4402.15,4402.15,2182.43,2537.71,2537.71,0,1553.7,2226.97,2226.97,4402.15
3760095,278,,,,,,,,THREE LVL 36-66MM PLATE,5703,2281.2,0,4847.55,4847.55,SKIPPED,4334.28,4334.28,4847.55,4847.55,4847.55,2403.24,2794.47,2794.47,0,1710.9,2452.29,2452.29,4847.55
3760096,278,,,,,,,,FOUR LVL 52-84MM PLATE,7773,3109.2,0,6607.05,6607.05,SKIPPED,5907.48,5907.48,6607.05,6607.05,6607.05,3275.54,3808.77,3808.77,0,2331.9,3342.39,3342.39,6607.05
3760097,278,,,,,,,,FIX SELF-DRILL BONE SCREW,1050,420,0,892.5,892.5,SKIPPED,798,798,892.5,892.5,892.5,442.47,514.5,514.5,0,315,451.5,451.5,892.5
3760098,278,,,,,,,,VARIABLE S-DRILL BONE SCR,3803,1521.2,0,3232.55,3232.55,SKIPPED,2890.28,2890.28,3232.55,3232.55,3232.55,1602.58,1863.47,1863.47,0,1140.9,1635.29,1635.29,3232.55
3760099,272,,,,,,,,DISTRACTION PINS 12-16MM,505.05,202.02,0,429.29,429.29,SKIPPED,383.84,383.84,429.29,429.29,429.29,212.83,247.47,247.47,0,151.52,217.17,217.17,429.29
3760100,272,,,,,,,,STRYKER DIAMOND DRILL,242.55,97.02,0,206.17,206.17,SKIPPED,184.34,184.34,206.17,206.17,206.17,102.21,118.85,118.85,0,72.76,104.3,104.3,206.17
3760101,272,,,,,,,,STRYKER DIAMOND COARSE,242.55,97.02,0,206.17,206.17,SKIPPED,184.34,184.34,206.17,206.17,206.17,102.21,118.85,118.85,0,72.76,104.3,104.3,206.17
3760102,272,,,,,,,,DIAMOND BURR,242.55,97.02,0,206.17,206.17,SKIPPED,184.34,184.34,206.17,206.17,206.17,102.21,118.85,118.85,0,72.76,104.3,104.3,206.17
3760104,270,,,,,,,,PRONE PILLOW-ALL,174.3,69.72,0,148.16,148.16,SKIPPED,132.47,132.47,148.16,148.16,148.16,73.45,85.41,85.41,0,52.29,74.95,74.95,148.16
3760105,272,Q4107,,,,,,,GRAFTON,222.6,89.04,0,189.21,189.21,SKIPPED,106.41,106.41,189.21,189.21,189.21,93.81,109.07,109.07,0,66.78,95.72,95.72,189.21
3760107,272,,,,,,,,OPT THREAD TROCAR 11X150,112.35,44.94,0,95.5,95.5,SKIPPED,85.39,85.39,95.5,95.5,95.5,47.34,55.05,55.05,0,33.7,48.31,48.31,95.5
3760108,272,,,,,,,,KLL ACESS SYSTEM 5X150,98.7,39.48,0,83.9,83.9,SKIPPED,75.01,75.01,83.9,83.9,83.9,41.59,48.36,48.36,0,29.61,42.44,42.44,83.9
3760109,272,,,,,,,,THREAD SLEEVE 5X150,36.75,14.7,0,31.24,31.24,SKIPPED,27.93,27.93,31.24,31.24,31.24,15.48,18.01,18.01,0,11.02,15.8,15.8,31.24
3760110,272,,,,,,,,ADV FIXATION 5X100MM,98.7,39.48,0,83.9,83.9,SKIPPED,75.01,75.01,83.9,83.9,83.9,41.59,48.36,48.36,0,29.61,42.44,42.44,83.9
3760111,272,,,,,,,,ADV FIXATION5X100CANNULA,36.75,14.7,0,31.24,31.24,SKIPPED,27.93,27.93,31.24,31.24,31.24,15.48,18.01,18.01,0,11.02,15.8,15.8,31.24
3760112,272,,,,,,,,ADV FIXATION 12X100,112.35,44.94,0,95.5,95.5,SKIPPED,85.39,85.39,95.5,95.5,95.5,47.34,55.05,55.05,0,33.7,48.31,48.31,95.5
3760113,272,,,,,,,,ADV FIXATION12X100CANNULA,106.05,42.42,0,90.14,90.14,SKIPPED,80.6,80.6,90.14,90.14,90.14,44.69,51.96,51.96,0,31.82,45.6,45.6,90.14
3760114,272,,,,,,,,HASSON GELPORT BALLOON,164.85,65.94,0,140.12,140.12,SKIPPED,125.29,125.29,140.12,140.12,140.12,69.47,80.78,80.78,0,49.46,70.89,70.89,140.12
3760116,270,,,,,,,,TA60/TA90,144.9,57.96,0,123.16,123.16,SKIPPED,110.12,110.12,123.16,123.16,123.16,61.06,71,71,0,43.47,62.31,62.31,123.16
3760118,278,,,,,,,,9 HOLE MEDIAL PLATE,1209.6,483.84,0,1028.16,1028.16,SKIPPED,919.3,919.3,1028.16,1028.16,1028.16,509.73,592.7,592.7,0,362.88,520.13,520.13,1028.16
3760120,272,,,,,,,,DRILL BIT 2.0,248.85,99.54,0,211.52,211.52,SKIPPED,189.13,189.13,211.52,211.52,211.52,104.87,121.94,121.94,0,74.66,107.01,107.01,211.52
3760122,272,,,,,,,,GOLDVAC BOVIE W/PUSH PIN&,75.6,30.24,0,64.26,64.26,SKIPPED,57.46,57.46,64.26,64.26,64.26,31.86,37.04,37.04,0,22.68,32.51,32.51,64.26
3760124,272,,,,,,,,DRILL BIT 4MM,279.3,111.72,0,237.4,237.4,SKIPPED,212.27,212.27,237.4,237.4,237.4,117.7,136.86,136.86,0,83.79,120.1,120.1,237.4
3760128,270,A4461,,,,,,,DLYS CATH,135.45,54.18,0,115.13,115.13,SKIPPED,12.35,12.35,115.13,115.13,115.13,57.08,66.37,66.37,0,40.64,58.24,58.24,115.13
3760130,270,,,,,,,,C-TRACK PROBE COVER,19.95,7.98,0,16.96,16.96,SKIPPED,15.16,15.16,16.96,16.96,16.96,8.41,9.78,9.78,0,5.98,8.58,8.58,16.96
3760131,272,,,,,,,,GOLD SERIES 5MM SINGLE,100.8,40.32,0,85.68,85.68,SKIPPED,76.61,76.61,85.68,85.68,85.68,42.47,49.39,49.39,0,30.24,43.34,43.34,85.68
3760132,272,,,,,,,,GOLD SERIES TROCAR 5MM DB,106.05,42.42,0,90.14,90.14,SKIPPED,80.6,80.6,90.14,90.14,90.14,44.69,51.96,51.96,0,31.82,45.6,45.6,90.14
3760133,272,,,,,,,,THER GUARD&ABC BOVIE PD,48.3,19.32,0,41.06,41.06,SKIPPED,36.71,36.71,41.06,41.06,41.06,20.35,23.67,23.67,0,14.49,20.77,20.77,41.06
3760134,272,,,,,,,,ABC(ARGON BOVIE) HANDPCE,214.2,85.68,0,182.07,182.07,SKIPPED,162.79,162.79,182.07,182.07,182.07,90.27,104.96,104.96,0,64.26,92.11,92.11,182.07
3760135,272,,,,,,,,ABC FLERPROBE(COLONOSCOPY,361.2,144.48,0,307.02,307.02,SKIPPED,274.51,274.51,307.02,307.02,307.02,152.21,176.99,176.99,0,108.36,155.32,155.32,307.02
3760136,272,,,,,,,,EXPOSE FAN EXTRACTOR,100.8,40.32,0,85.68,85.68,SKIPPED,76.61,76.61,85.68,85.68,85.68,42.47,49.39,49.39,0,30.24,43.34,43.34,85.68
3760137,272,,,,,,,,THORACENTESIS TRAY 8FR,102.9,41.16,0,87.46,87.46,SKIPPED,78.2,78.2,87.46,87.46,87.46,43.36,50.42,50.42,0,30.87,44.25,44.25,87.46
3760138,272,,,,,,,,BARD MAX CORE DISP. INS.,87.15,34.86,0,74.08,74.08,SKIPPED,66.23,66.23,74.08,74.08,74.08,36.72,42.7,42.7,0,26.14,37.47,37.47,74.08
3760139,272,,,,,,,,VENTRALEX MESH 1.7X1.7,845.25,338.1,0,718.46,718.46,SKIPPED,642.39,642.39,718.46,718.46,718.46,356.19,414.17,414.17,0,253.58,363.46,363.46,718.46
3760140,272,,,,,,,,VENTRALEX MSH 2.5X2.5MD,723.45,289.38,0,614.93,614.93,SKIPPED,549.82,549.82,614.93,614.93,614.93,304.86,354.49,354.49,0,217.04,311.08,311.08,614.93
3760141,272,,,,,,,,ANKLE STRAP(ARTHROSCOPY),201.6,80.64,0,171.36,171.36,SKIPPED,153.22,153.22,171.36,171.36,171.36,84.96,98.78,98.78,0,60.48,86.69,86.69,171.36
3760142,272,,,,,,,,ENTRADA COLONIC OVERTUBE,274.05,109.62,0,232.94,232.94,SKIPPED,208.28,208.28,232.94,232.94,232.94,115.48,134.28,134.28,0,82.22,117.84,117.84,232.94
3760143,272,,,,,,,,TALON GRSPING FCEPS,237.3,94.92,0,201.7,201.7,SKIPPED,180.35,180.35,201.7,201.7,201.7,100,116.28,116.28,0,71.19,102.04,102.04,201.7
3760144,272,,,,,,,,GUARDUS OVERTUBE ESOPH,275.1,110.04,0,233.84,233.84,SKIPPED,209.08,209.08,233.84,233.84,233.84,115.92,134.8,134.8,0,82.53,118.29,118.29,233.84
3760145,272,,,,,,,,CARR-LOCKE IJECT NEEDLE,75.6,30.24,0,64.26,64.26,SKIPPED,57.46,57.46,64.26,64.26,64.26,31.86,37.04,37.04,0,22.68,32.51,32.51,64.26
3760146,272,,,,,,,,AVG MED BLADE 25MMX9.0MM,106.05,42.42,0,90.14,90.14,SKIPPED,80.6,80.6,90.14,90.14,90.14,44.69,51.96,51.96,0,31.82,45.6,45.6,90.14
3760147,272,,,,,,,,EGG BUR 4.0MM,140.7,56.28,0,119.6,119.6,SKIPPED,106.93,106.93,119.6,119.6,119.6,59.29,68.94,68.94,0,42.21,60.5,60.5,119.6
3760148,272,,,,,,,,HELICO RASP,248.85,99.54,0,211.52,211.52,SKIPPED,189.13,189.13,211.52,211.52,211.52,104.87,121.94,121.94,0,74.66,107.01,107.01,211.52
3760149,272,,,,,,,,SHORT BLADE 18.00MMX5.5MM,106.05,42.42,0,90.14,90.14,SKIPPED,80.6,80.6,90.14,90.14,90.14,44.69,51.96,51.96,0,31.82,45.6,45.6,90.14
3760150,272,,,,,,,,INTERPULSE HANDPIECE SET,106.05,42.42,0,90.14,90.14,SKIPPED,80.6,80.6,90.14,90.14,90.14,44.69,51.96,51.96,0,31.82,45.6,45.6,90.14
3760151,272,,,,,,,,SHANNON BURR 2.1MM,106.05,42.42,0,90.14,90.14,SKIPPED,80.6,80.6,90.14,90.14,90.14,44.69,51.96,51.96,0,31.82,45.6,45.6,90.14
3760152,272,,,,,,,,ROUND CARBIDE BUR 2.3MM,106.05,42.42,0,90.14,90.14,SKIPPED,80.6,80.6,90.14,90.14,90.14,44.69,51.96,51.96,0,31.82,45.6,45.6,90.14
3760155,272,,,,,,,,ENDO STAPLER ETS FLEX45,370.65,148.26,0,315.05,315.05,SKIPPED,281.69,281.69,315.05,315.05,315.05,156.19,181.62,181.62,0,111.2,159.38,159.38,315.05
3760156,272,,,,,,,,RELOADS VASCULAR 6 ROW,207.9,83.16,0,176.72,176.72,SKIPPED,158,158,176.72,176.72,176.72,87.61,101.87,101.87,0,62.37,89.4,89.4,176.72
3760158,272,,,,,,,,SCD COMP(ALL),165,66,0,140.25,140.25,SKIPPED,125.4,125.4,140.25,140.25,140.25,69.53,80.85,80.85,0,49.5,70.95,70.95,140.25
3760160,272,,,,,,,,DISP LAPRO SMOKE EVAC SYS,46.2,18.48,0,39.27,39.27,SKIPPED,35.11,35.11,39.27,39.27,39.27,19.47,22.64,22.64,0,13.86,19.87,19.87,39.27
3760161,272,,,,,,,,GUIDEWIRE .038-150CM,98.7,39.48,0,83.9,83.9,SKIPPED,75.01,75.01,83.9,83.9,83.9,41.59,48.36,48.36,0,29.61,42.44,42.44,83.9
3760162,272,,,,,,,,GUIDE SCOPE,94.5,37.8,0,80.32,80.32,SKIPPED,71.82,71.82,80.32,80.32,80.32,39.83,46.3,46.3,0,28.35,40.64,40.64,80.32
3760163,272,,,,,,,,DISP 3-LEAD SYSTEM,46.2,18.48,0,39.27,39.27,SKIPPED,35.11,35.11,39.27,39.27,39.27,19.47,22.64,22.64,0,13.86,19.87,19.87,39.27
3760164,272,,,,,,,,5FR BILIARY FOGARTY CATH,137.55,55.02,0,116.92,116.92,SKIPPED,104.54,104.54,116.92,116.92,116.92,57.97,67.4,67.4,0,41.26,59.15,59.15,116.92
3760167,272,,,,,,,,SMALL JOINT 2.5MM CUTTER,109.2,43.68,0,92.82,92.82,SKIPPED,82.99,82.99,92.82,92.82,92.82,46.02,53.51,53.51,0,32.76,46.96,46.96,92.82
3760168,272,,,,,,,,SMALL JOINT 3.5 CUTTER,108.15,43.26,0,91.93,91.93,SKIPPED,82.19,82.19,91.93,91.93,91.93,45.57,52.99,52.99,0,32.44,46.5,46.5,91.93
3760169,272,,,,,,,,SM JOINT 3.0MM HOOD BURR,112.35,44.94,0,95.5,95.5,SKIPPED,85.39,85.39,95.5,95.5,95.5,47.34,55.05,55.05,0,33.7,48.31,48.31,95.5
3760170,272,,,,,,,,ARTHROSCOPY PUMP TUBE,86.1,34.44,0,73.18,73.18,SKIPPED,65.44,65.44,73.18,73.18,73.18,36.28,42.19,42.19,0,25.83,37.02,37.02,73.18
3760171,272,,,,,,,,SURGIMESH WN,411.6,164.64,0,349.86,349.86,SKIPPED,312.82,312.82,349.86,349.86,349.86,173.45,201.68,201.68,0,123.48,176.99,176.99,349.86
3760172,272,,,,,,,,SURGIMESH XB,2065.35,826.14,0,1755.55,1755.55,SKIPPED,1569.67,1569.67,1755.55,1755.55,1755.55,870.34,1012.02,1012.02,0,619.6,888.1,888.1,1755.55
3760173,272,,,,,,,,10CC CONTROL SYRINGE,33.6,13.44,0,28.56,28.56,SKIPPED,25.54,25.54,28.56,28.56,28.56,14.16,16.46,16.46,0,10.08,14.45,14.45,28.56
3760174,272,,,,,,,,4.050MM CANNULATED SCREW,393.75,157.5,0,334.69,334.69,SKIPPED,299.25,299.25,334.69,334.69,334.69,165.92,192.94,192.94,0,118.12,169.31,169.31,334.69
3760175,272,,,,,,,,K-WIRE 1.25,69.3,27.72,0,58.9,58.9,SKIPPED,52.67,52.67,58.9,58.9,58.9,29.2,33.96,33.96,0,20.79,29.8,29.8,58.9
3760176,272,,,,,,,,"ORTHOGLASS ROLL 1""-5""",110,44,0,93.5,93.5,SKIPPED,83.6,83.6,93.5,93.5,93.5,46.35,53.9,53.9,0,33,47.3,47.3,93.5
3760177,272,,,,,,,,TRIM IT DRILL PIN 1.5MMX,418.95,167.58,0,356.11,356.11,SKIPPED,318.4,318.4,356.11,356.11,356.11,176.55,205.29,205.29,0,125.68,180.15,180.15,356.11
3760181,272,,,,,,,,1 CC SIMUBLAST GEL-FOOT,509.25,203.7,0,432.86,432.86,SKIPPED,387.03,387.03,432.86,432.86,432.86,214.6,249.53,249.53,0,152.78,218.98,218.98,432.86
3760182,272,,,,,,,,IMPLT SYS MINI SCORPION,2994.6,1197.84,0,2545.41,2545.41,SKIPPED,2275.9,2275.9,2545.41,2545.41,2545.41,1261.93,1467.35,1467.35,0,898.38,1287.68,1287.68,2545.41
3760183,271,A4606,,,,,,,O2 PROBE REPLACEMENT,119.7,47.88,0,101.74,101.74,SKIPPED,90.97,90.97,101.74,101.74,101.74,50.44,58.65,58.65,0,35.91,51.47,51.47,101.74
3760184,278,,,,,,,,ARTHREX-PLATE META OP4MM,3132,1252.8,0,2662.2,2662.2,SKIPPED,2380.32,2380.32,2662.2,2662.2,2662.2,1319.82,1534.68,1534.68,0,939.6,1346.76,1346.76,2662.2
3760186,272,,,,,,,,CALCIUM SULFATE-IMPL MAT,1731.45,692.58,0,1471.73,1471.73,SKIPPED,1315.9,1315.9,1471.73,1471.73,1471.73,729.63,848.41,848.41,0,519.44,744.52,744.52,1471.73
3760187,272,,,,,,,,PARIETEX COMPOSITE MESH,3408.3,1363.32,0,2897.06,2897.06,SKIPPED,2590.31,2590.31,2897.06,2897.06,2897.06,1436.26,1670.07,1670.07,0,1022.49,1465.57,1465.57,2897.06
3760188,272,,,,,,,,AUTOSUTURE-STAPLES,1324.05,529.62,0,1125.44,1125.44,SKIPPED,1006.28,1006.28,1125.44,1125.44,1125.44,557.95,648.78,648.78,0,397.22,569.34,569.34,1125.44
3760189,278,,,,,,,,DURAGEN 1X3,1916,766.4,0,1628.6,1628.6,SKIPPED,1456.16,1456.16,1628.6,1628.6,1628.6,807.4,938.84,938.84,0,574.8,823.88,823.88,1628.6
3760192,270,,,,,,,,FACIAL FOAM PAD,26.25,10.5,0,22.31,22.31,SKIPPED,19.95,19.95,22.31,22.31,22.31,11.06,12.86,12.86,0,7.88,11.29,11.29,22.31
3760201,270,,,,,,,,ABSARBATAC ABS TACK 30X,1230.6,492.24,0,1046.01,1046.01,SKIPPED,935.26,935.26,1046.01,1046.01,1046.01,518.58,602.99,602.99,0,369.18,529.16,529.16,1046.01
3760202,270,,,,,,,,PROTACK 174006,1079.4,431.76,0,917.49,917.49,SKIPPED,820.34,820.34,917.49,917.49,917.49,454.86,528.91,528.91,0,323.82,464.14,464.14,917.49
3760205,270,,,,,,,,ADAPTIC DRESS 3X3,9.45,3.78,0,8.03,8.03,SKIPPED,7.18,7.18,8.03,8.03,8.03,3.98,4.63,4.63,0,2.84,4.06,4.06,8.03
3760210,270,E0176,,,,,,,CODMAN EXTERNAL DRAIN SET,81.9,32.76,0,69.62,69.62,SKIPPED,62.24,62.24,69.62,69.62,69.62,34.52,40.13,40.13,0,24.57,35.22,35.22,69.62
3760217,270,,,,,,,,ADAPTIC DRESS 3X16,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3760270,270,,,,,,,,C ARMOUR,88.2,35.28,0,74.97,74.97,SKIPPED,67.03,67.03,74.97,74.97,74.97,37.17,43.22,43.22,0,26.46,37.93,37.93,74.97
3760290,270,,,,,,,,ABD 5X9,8.4,3.36,0,7.14,7.14,SKIPPED,6.38,6.38,7.14,7.14,7.14,3.54,4.12,4.12,0,2.52,3.61,3.61,7.14
3760293,270,,,,,,,,WAFFLE CUSHION,26.25,10.5,0,22.31,22.31,SKIPPED,19.95,19.95,22.31,22.31,22.31,11.06,12.86,12.86,0,7.88,11.29,11.29,22.31
3760306,270,,,,,,,,ZIPLINE(ALL SIZES),102.9,41.16,0,87.46,87.46,SKIPPED,78.2,78.2,87.46,87.46,87.46,43.36,50.42,50.42,0,30.87,44.25,44.25,87.46
3760320,270,J8499,,,,,,,TONSIL SPONGE,11.55,4.62,0,9.82,9.82,SKIPPED,8.78,8.78,9.82,9.82,9.82,4.87,5.66,5.66,0,3.46,4.97,4.97,9.82
3760324,270,A4618,,,,,,,CIRCUIT W/FILT ANES ADULT,29.4,11.76,0,28.34,24.99,SKIPPED,28.34,28.34,24.99,24.99,24.99,12.39,14.41,14.41,0,8.82,12.64,12.64,24.99
3760326,270,,,,,,,,MYRINGOTOMY BLADE,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3760329,270,,,,,,,,DONALDSON VENT TUBES,25.2,10.08,0,21.42,21.42,SKIPPED,19.15,19.15,21.42,21.42,21.42,10.62,12.35,12.35,0,7.56,10.84,10.84,21.42
3760332,270,,,,,,,,ANKLE BRACE,158.55,63.42,0,134.77,134.77,SKIPPED,120.5,120.5,134.77,134.77,134.77,66.82,77.69,77.69,0,47.56,68.18,68.18,134.77
3760340,270,,,,,,,,V LOC,180.6,72.24,0,153.51,153.51,SKIPPED,137.26,137.26,153.51,153.51,153.51,76.11,88.49,88.49,0,54.18,77.66,77.66,153.51
3760344,270,,,,,,,,KNEE IMMOB,64.05,25.62,0,54.44,54.44,SKIPPED,48.68,48.68,54.44,54.44,54.44,26.99,31.38,31.38,0,19.22,27.54,27.54,54.44
3760356,270,,,,,,,,ANTI EMOBOL STOCK,154,61.6,0,130.9,130.9,SKIPPED,117.04,117.04,130.9,130.9,130.9,64.9,75.46,75.46,0,46.2,66.22,66.22,130.9
3760360,270,,,,,,,,BIO PREP KIT,44.1,17.64,0,37.48,37.48,SKIPPED,33.52,33.52,37.48,37.48,37.48,18.58,21.61,21.61,0,13.23,18.96,18.96,37.48
3760368,270,,,,,,,,TKR BOOTLINER,64.05,25.62,0,54.44,54.44,SKIPPED,48.68,48.68,54.44,54.44,54.44,26.99,31.38,31.38,0,19.22,27.54,27.54,54.44
3760370,270,,,,,,,,3.5MM GATOR MICRO BADE,61.95,24.78,0,52.66,52.66,SKIPPED,47.08,47.08,52.66,52.66,52.66,26.11,30.36,30.36,0,18.58,26.64,26.64,52.66
3760394,270,,,,,,,,ARM CAST LONG AD,206.85,82.74,0,175.82,175.82,SKIPPED,157.21,157.21,175.82,175.82,175.82,87.17,101.36,101.36,0,62.06,88.95,88.95,175.82
3760413,270,,,,,,,,ARM CAST SHORT AD,162.75,65.1,0,138.34,138.34,SKIPPED,123.69,123.69,138.34,138.34,138.34,68.58,79.75,79.75,0,48.82,69.98,69.98,138.34
3760421,270,,,,,,,,500ML WOUND VAC CANNISTER,60.9,24.36,0,51.76,51.76,SKIPPED,46.28,46.28,51.76,51.76,51.76,25.67,29.84,29.84,0,18.27,26.19,26.19,51.76
3760430,270,,,,,,,,6'' ESMARK,12.6,5.04,0,10.71,10.71,SKIPPED,9.58,9.58,10.71,10.71,10.71,5.31,6.17,6.17,0,3.78,5.42,5.42,10.71
3760435,272,,,,,,,,ENDO TUBE 7.5,3.4,1.36,0,2.89,2.89,SKIPPED,2.58,2.58,2.89,2.89,2.89,1.43,1.67,1.67,0,1.02,1.46,1.46,2.89
3760445,270,,,,,,,,ARM IMMOBILIZER,44.1,17.64,0,37.48,37.48,SKIPPED,33.52,33.52,37.48,37.48,37.48,18.58,21.61,21.61,0,13.23,18.96,18.96,37.48
3760457,270,,,,,,,,ARM SLING MEDIUM,34.65,13.86,0,29.45,29.45,SKIPPED,26.33,26.33,29.45,29.45,29.45,14.6,16.98,16.98,0,10.4,14.9,14.9,29.45
3760459,975,64708,,,,,,,Surgical Assist-NEUROPLASTY/MAJOR,189.87,75.95,0,561.69,161.39,SKIPPED,189.87,189.87,161.39,161.39,161.39,550.46,93.04,93.04,SKIPPED,SKIPPED,561.69,561.69,0
3760495,270,,,,,,,,PDS ENDOLOOP,149.1,59.64,0,126.74,126.74,SKIPPED,113.32,113.32,126.74,126.74,126.74,62.83,73.06,73.06,0,44.73,64.11,64.11,126.74
3760510,270,A4322,,,,,,,ASEPTO SYRINGE,13.65,5.46,0,11.6,11.6,SKIPPED,10.56,10.56,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3760522,270,,,,,,,,DEPUY GLOVE LINER,67.2,26.88,0,57.12,57.12,SKIPPED,51.07,51.07,57.12,57.12,57.12,28.32,32.93,32.93,0,20.16,28.9,28.9,57.12
3760540,270,,,,,,,,COVIDIEN ENDO STAPLER,100.8,40.32,0,85.68,85.68,SKIPPED,76.61,76.61,85.68,85.68,85.68,42.47,49.39,49.39,0,30.24,43.34,43.34,85.68
3760542,270,,,,,,,,AUTO SUTURE SURGITIE,49.35,19.74,0,41.95,41.95,SKIPPED,37.51,37.51,41.95,41.95,41.95,20.8,24.18,24.18,0,14.8,21.22,21.22,41.95
3760544,270,,,,,,,,DLYS CATH KIT,4574.85,1829.94,0,3888.62,3888.62,SKIPPED,3476.89,3476.89,3888.62,3888.62,3888.62,1927.85,2241.68,2241.68,0,1372.46,1967.19,1967.19,3888.62
3760548,270,,,,,,,,EPIX GRASPER,445.2,178.08,0,378.42,378.42,SKIPPED,338.35,338.35,378.42,378.42,378.42,187.61,218.15,218.15,0,133.56,191.44,191.44,378.42
3760560,270,,,,,,,,SHAVING CREAM,12.6,5.04,0,10.71,10.71,SKIPPED,9.58,9.58,10.71,10.71,10.71,5.31,6.17,6.17,0,3.78,5.42,5.42,10.71
3760572,270,,,,,,,,BANDAID SM,5.25,2.1,0,4.46,4.46,SKIPPED,3.99,3.99,4.46,4.46,4.46,2.21,2.57,2.57,0,1.58,2.26,2.26,4.46
3760584,270,,,,,,,,BANDAID LG,6.3,2.52,0,5.36,5.36,SKIPPED,4.79,4.79,5.36,5.36,5.36,2.66,3.09,3.09,0,1.89,2.71,2.71,5.36
3760596,270,,,,,,,,RELOAD TA60/TA90,479.85,191.94,0,407.87,407.87,SKIPPED,364.69,364.69,407.87,407.87,407.87,202.21,235.13,235.13,0,143.96,206.34,206.34,407.87
3760599,270,J8499,,,,,,,ANTIFUNGAL 3.25OZ TUBE,44.1,17.64,0,37.48,37.48,SKIPPED,33.52,33.52,37.48,37.48,37.48,18.58,21.61,21.61,0,13.23,18.96,18.96,37.48
3760615,270,J8499,,,,,,,BENZOIN SWAB,9.45,3.78,0,8.03,8.03,SKIPPED,7.18,7.18,8.03,8.03,8.03,3.98,4.63,4.63,0,2.84,4.06,4.06,8.03
3760647,270,,,,,,,,PROCTOSCOPE BULB,26.25,10.5,0,22.31,22.31,SKIPPED,19.95,19.95,22.31,22.31,22.31,11.06,12.86,12.86,0,7.88,11.29,11.29,22.31
3760659,270,,,,,,,,BIOPSY TRAY LIVER,93.45,37.38,0,79.43,79.43,SKIPPED,71.02,71.02,79.43,79.43,79.43,39.38,45.79,45.79,0,28.04,40.18,40.18,79.43
3760778,270,L4360,,,,,,,FOAM WALKER-MED,195.3,78.12,0,166,166,SKIPPED,148.43,148.43,166,166,166,82.3,95.7,95.7,0,58.59,83.98,83.98,166
3760782,270,,,,,,,,GAUZE XFOAM 2X2,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3760801,270,,,,,,,,BONE WAX,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3760802,270,,,,,,,,"MEDIPORE 2""",11.55,4.62,0,9.82,9.82,SKIPPED,8.78,8.78,9.82,9.82,9.82,4.87,5.66,5.66,0,3.46,4.97,4.97,9.82
3760813,270,,,,,,,,BONE MARROW/NEEDLE ASPIR,93.45,37.38,0,79.43,79.43,SKIPPED,71.02,71.02,79.43,79.43,79.43,39.38,45.79,45.79,0,28.04,40.18,40.18,79.43
3760902,270,,,,,,,,BURN ROLL,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3760932,270,,,,,,,,STERILE SLEEVE,37.8,15.12,0,32.13,32.13,SKIPPED,28.73,28.73,32.13,32.13,32.13,15.92,18.52,18.52,0,11.34,16.25,16.25,32.13
3760976,270,,,,,,,,CAST SHOEMED,93.45,37.38,0,79.43,79.43,SKIPPED,71.02,71.02,79.43,79.43,79.43,39.38,45.79,45.79,0,28.04,40.18,40.18,79.43
3760988,270,A4346,,,,,,,CATH 3WAY 18F,60.9,24.36,0,60.9,51.76,SKIPPED,60.9,60.9,51.76,51.76,51.76,25.67,29.84,29.84,0,18.27,26.19,26.19,51.76
3760990,270,,,,,,,,MISC. CATH KIT,132.36,52.94,0,112.51,112.51,SKIPPED,100.59,100.59,112.51,112.51,112.51,55.77,64.86,64.86,0,39.71,56.91,56.91,112.51
3761005,270,,,,,,,,CATH CARE TRAY,52.5,21,0,44.62,44.62,SKIPPED,39.9,39.9,44.62,44.62,44.62,22.13,25.72,25.72,0,15.75,22.58,22.58,44.62
3761017,270,,,,,,,,CATH FEMALE INTERMITTENT,34.65,13.86,0,29.45,29.45,SKIPPED,26.33,26.33,29.45,29.45,29.45,14.6,16.98,16.98,0,10.4,14.9,14.9,29.45
3761020,270,,,,,,,,CAUTERY TIP,52.5,21,0,44.62,44.62,SKIPPED,39.9,39.9,44.62,44.62,44.62,22.13,25.72,25.72,0,15.75,22.58,22.58,44.62
3761043,270,,,,,,,,CHEST DRAINAGE DBL SEAL,240.45,96.18,0,204.38,204.38,SKIPPED,182.74,182.74,204.38,204.38,204.38,101.32,117.82,117.82,0,72.14,103.39,103.39,204.38
3761079,270,,,,,,,,CHUX'S -10-,29.4,11.76,0,24.99,24.99,SKIPPED,22.34,22.34,24.99,24.99,24.99,12.39,14.41,14.41,0,8.82,12.64,12.64,24.99
3761085,270,,,,,,,,CHERY DISSECTOR,171.15,68.46,0,145.48,145.48,SKIPPED,130.07,130.07,145.48,145.48,145.48,72.12,83.86,83.86,0,51.34,73.59,73.59,145.48
3761095,270,,,,,,,,CHUX'S EACH,9.45,3.78,0,8.03,8.03,SKIPPED,7.18,7.18,8.03,8.03,8.03,3.98,4.63,4.63,0,2.84,4.06,4.06,8.03
3761100,270,,,,,,,,CHOLANG CATH AR,207.9,83.16,0,176.72,176.72,SKIPPED,158,158,176.72,176.72,176.72,87.61,101.87,101.87,0,62.37,89.4,89.4,176.72
3761160,270,L3660,,,,,,,CLAVICLE SPLINT,144.9,57.96,0,123.16,123.16,SKIPPED,110.12,110.12,123.16,123.16,123.16,61.06,71,71,0,43.47,62.31,62.31,123.16
3761200,270,,,,,,,,COLOSTOMY CLOSURE,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3761221,270,,,,,,,,CONNECTING TUBE1.8M,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3761245,270,,,,,,,,CANCELLOUS .05,60.9,24.36,0,51.76,51.76,SKIPPED,46.28,46.28,51.76,51.76,51.76,25.67,29.84,29.84,0,18.27,26.19,26.19,51.76
3761358,278,,,,,,,,CORTICAL BONE SCREW,275,110,0,233.75,233.75,SKIPPED,209,209,233.75,233.75,233.75,115.88,134.75,134.75,0,82.5,118.25,118.25,233.75
3761384,270,,,,,,,,MAYO STAND COVER,8.4,3.36,0,7.14,7.14,SKIPPED,6.38,6.38,7.14,7.14,7.14,3.54,4.12,4.12,0,2.52,3.61,3.61,7.14
3761409,278,,,,,,,,COMPRESSION PLATE/SC,678.3,271.32,0,576.56,576.56,SKIPPED,515.51,515.51,576.56,576.56,576.56,285.84,332.37,332.37,0,203.49,291.67,291.67,576.56
3761423,270,A4340,,,,,,,COUDE CATH 20F,47.25,18.9,0,47.25,40.16,SKIPPED,47.25,47.25,40.16,40.16,40.16,19.91,23.15,23.15,0,14.18,20.32,20.32,40.16
3761447,270,,,,,,,,CRUTCH PAIR,114.45,45.78,0,97.28,97.28,SKIPPED,86.98,86.98,97.28,97.28,97.28,48.23,56.08,56.08,0,34.34,49.21,49.21,97.28
3761465,270,,,,,,,,CYTOLOGY BRUSH-BARD,79.8,31.92,0,67.83,67.83,SKIPPED,60.65,60.65,67.83,67.83,67.83,33.62,39.1,39.1,0,23.94,34.31,34.31,67.83
3761500,270,,,,,,,,DERMATOME CUT HEAD,149.1,59.64,0,126.74,126.74,SKIPPED,113.32,113.32,126.74,126.74,126.74,62.83,73.06,73.06,0,44.73,64.11,64.11,126.74
3761512,270,,,,,,,,BEAVER BLADE,106.05,42.42,0,90.14,90.14,SKIPPED,80.6,80.6,90.14,90.14,90.14,44.69,51.96,51.96,0,31.82,45.6,45.6,90.14
3761524,270,,,,,,,,DERMATOME TAPE,70.35,28.14,0,59.8,59.8,SKIPPED,53.47,53.47,59.8,59.8,59.8,29.64,34.47,34.47,0,21.1,30.25,30.25,59.8
3761536,270,,,,,,,,KY-JELLY,44.1,17.64,0,37.48,37.48,SKIPPED,33.52,33.52,37.48,37.48,37.48,18.58,21.61,21.61,0,13.23,18.96,18.96,37.48
3761548,270,,,,,,,,DRAINAGE BAG,26.25,10.5,0,22.31,22.31,SKIPPED,19.95,19.95,22.31,22.31,22.31,11.06,12.86,12.86,0,7.88,11.29,11.29,22.31
3761555,270,,,,,,,,CHG SCRUB 2%,73.5,29.4,0,62.48,62.48,SKIPPED,55.86,55.86,62.48,62.48,62.48,30.98,36.02,36.02,0,22.05,31.61,31.61,62.48
3761558,270,,,,,,,,DISP BRONSCPT BOPSY,200.55,80.22,0,170.47,170.47,SKIPPED,152.42,152.42,170.47,170.47,170.47,84.52,98.27,98.27,0,60.16,86.24,86.24,170.47
3761601,270,,,,,,,,DUO DERM 4X4,58.8,23.52,0,49.98,49.98,SKIPPED,44.69,44.69,49.98,49.98,49.98,24.77,28.81,28.81,0,17.64,25.28,25.28,49.98
3761619,270,,,,,,,,DUO DERM 6X6 XTHIN,31.5,12.6,0,26.78,26.78,SKIPPED,23.94,23.94,26.78,26.78,26.78,13.28,15.44,15.44,0,9.45,13.55,13.55,26.78
3761625,270,,,,,,,,DONALDSON VENT TUBES,40.95,16.38,0,34.81,34.81,SKIPPED,31.12,31.12,34.81,34.81,34.81,17.26,20.07,20.07,0,12.28,17.61,17.61,34.81
3761637,270,,,,,,,,19 FR ROUND DRAIN,52.5,21,0,44.62,44.62,SKIPPED,39.9,39.9,44.62,44.62,44.62,22.13,25.72,25.72,0,15.75,22.58,22.58,44.62
3761675,270,,,,,,,,LOR SYRINGE,40.95,16.38,0,34.81,34.81,SKIPPED,31.12,31.12,34.81,34.81,34.81,17.26,20.07,20.07,0,12.28,17.61,17.61,34.81
3761773,270,,,,,,,,ENDO BITE BLOCK,26.25,10.5,0,22.31,22.31,SKIPPED,19.95,19.95,22.31,22.31,22.31,11.06,12.86,12.86,0,7.88,11.29,11.29,22.31
3761776,270,A4622,,,,,,,ENDO TUBE 7.0 MM,37.8,15.12,0,32.13,32.13,SKIPPED,28.73,28.73,32.13,32.13,32.13,15.92,18.52,18.52,0,11.34,16.25,16.25,32.13
3761779,270,,,,,,,,ENDO PACK,227.85,91.14,0,193.67,193.67,SKIPPED,173.17,173.17,193.67,193.67,193.67,96.02,111.65,111.65,0,68.36,97.98,97.98,193.67
3761785,270,,,,,,,,ENDO EMS STAPLER,200.55,80.22,0,170.47,170.47,SKIPPED,152.42,152.42,170.47,170.47,170.47,84.52,98.27,98.27,0,60.16,86.24,86.24,170.47
3761790,270,,,,,,,,ENDOSCOPE,301.35,120.54,0,256.15,256.15,SKIPPED,229.03,229.03,256.15,256.15,256.15,126.99,147.66,147.66,0,90.4,129.58,129.58,256.15
3761798,270,,,,,,,,EPIDURAL TRAY,87.15,34.86,0,74.08,74.08,SKIPPED,66.23,66.23,74.08,74.08,74.08,36.72,42.7,42.7,0,26.14,37.47,37.47,74.08
3761841,270,,,,,,,,ENEMA OIL KIT,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3761853,270,,,,,,,,EYE PAD,9.45,3.78,0,8.03,8.03,SKIPPED,7.18,7.18,8.03,8.03,8.03,3.98,4.63,4.63,0,2.84,4.06,4.06,8.03
3761935,270,,,,,,,,FEED TUBE 90 ADAPTOR,52.5,21,0,44.62,44.62,SKIPPED,39.9,39.9,44.62,44.62,44.62,22.13,25.72,25.72,0,15.75,22.58,22.58,44.62
3762083,270,J8499,,,,,,,FLEETS ENEMA 4.5 FL OZ,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3762108,270,,,,,,,,FOAM PAD,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3762122,270,,,,,,,,FOLEY W5CC,52.5,21,0,44.62,44.62,SKIPPED,39.9,39.9,44.62,44.62,44.62,22.13,25.72,25.72,0,15.75,22.58,22.58,44.62
3762184,270,A4316,,,,,,,FOLEY CATH 16,88.2,35.28,0,88.2,74.97,SKIPPED,88.2,88.2,74.97,74.97,74.97,37.17,43.22,43.22,0,26.46,37.93,37.93,74.97
3762446,270,,,,,,,,GROUNDING PAD GM,26.25,10.5,0,22.31,22.31,SKIPPED,19.95,19.95,22.31,22.31,22.31,11.06,12.86,12.86,0,7.88,11.29,11.29,22.31
3762449,270,,,,,,,,SAGITTAL SAW BLADE,23.1,9.24,0,19.64,19.64,SKIPPED,17.56,17.56,19.64,19.64,19.64,9.73,11.32,11.32,0,6.93,9.93,9.93,19.64
3762450,270,,,,,,,,GIA DLU,1887.5,755,0,1604.38,1604.38,SKIPPED,1434.5,1434.5,1604.38,1604.38,1604.38,795.4,924.88,924.88,0,566.25,811.63,811.63,1604.38
3762522,270,,,,,,,,HAND PENCIL LP,252,100.8,0,214.2,214.2,SKIPPED,191.52,191.52,214.2,214.2,214.2,106.19,123.48,123.48,0,75.6,108.36,108.36,214.2
3762528,270,,,,,,,,HAND PENCIL E,52.5,21,0,44.62,44.62,SKIPPED,39.9,39.9,44.62,44.62,44.62,22.13,25.72,25.72,0,15.75,22.58,22.58,44.62
3762590,270,,,,,,,,WOUND VAC SPONGE-KCI,648,259.2,0,550.8,550.8,SKIPPED,492.48,492.48,550.8,550.8,550.8,273.07,317.52,317.52,0,194.4,278.64,278.64,550.8
3762630,270,,,,,,,,HYDRASORB 4X4,12.6,5.04,0,10.71,10.71,SKIPPED,9.58,9.58,10.71,10.71,10.71,5.31,6.17,6.17,0,3.78,5.42,5.42,10.71
3762645,270,,,,,,,,"HYTAPE 1""",23.1,9.24,0,19.64,19.64,SKIPPED,17.56,17.56,19.64,19.64,19.64,9.73,11.32,11.32,0,6.93,9.93,9.93,19.64
3762660,270,,,,,,,,HYDROSORB 4X4 FEN,15.75,6.3,0,13.39,13.39,SKIPPED,11.97,11.97,13.39,13.39,13.39,6.63,7.72,7.72,0,4.72,6.77,6.77,13.39
3762677,270,,,,,,,,ICE PACK,23.1,9.24,0,19.64,19.64,SKIPPED,17.56,17.56,19.64,19.64,19.64,9.73,11.32,11.32,0,6.93,9.93,9.93,19.64
3762704,270,,,,,,,,SUCTION CATH 10FR,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3762787,270,,,,,,,,IOBAN,79.8,31.92,0,67.83,67.83,SKIPPED,60.65,60.65,67.83,67.83,67.83,33.62,39.1,39.1,0,23.94,34.31,34.31,67.83
3762805,270,,,,,,,,IRRIGATION SYRINGE,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3762829,270,,,,,,,,IDOFORM GAUZE ALL,28.35,11.34,0,24.1,24.1,SKIPPED,21.55,21.55,24.1,24.1,24.1,11.95,13.89,13.89,0,8.5,12.19,12.19,24.1
3762867,270,,,,,,,,J P FLAT DRAIN,114.45,45.78,0,97.28,97.28,SKIPPED,86.98,86.98,97.28,97.28,97.28,48.23,56.08,56.08,0,34.34,49.21,49.21,97.28
3762879,270,,,,,,,,J P RESERVOIR,112.35,44.94,0,95.5,95.5,SKIPPED,85.39,85.39,95.5,95.5,95.5,47.34,55.05,55.05,0,33.7,48.31,48.31,95.5
3762881,270,,,,,,,,J P SUCTION CONN,40.95,16.38,0,34.81,34.81,SKIPPED,31.12,31.12,34.81,34.81,34.81,17.26,20.07,20.07,0,12.28,17.61,17.61,34.81
3762893,270,,,,,,,,J P ROUND DRAIN,70.35,28.14,0,59.8,59.8,SKIPPED,53.47,53.47,59.8,59.8,59.8,29.64,34.47,34.47,0,21.1,30.25,30.25,59.8
3763035,270,,,,,,,,KLING 4 INCH,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3763047,270,,,,,,,,KLING 6 INCH,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3763061,270,,,,,,,,K-Y LG,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3763073,270,,,,,,,,KITTY TOURNEQUET,88.2,35.28,0,74.97,74.97,SKIPPED,67.03,67.03,74.97,74.97,74.97,37.17,43.22,43.22,0,26.46,37.93,37.93,74.97
3763207,270,,,,,,,,LAP SPONGE,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3763213,270,,,,,,,,LEG CAST LONG ADULT,265.65,106.26,0,225.8,225.8,SKIPPED,201.89,201.89,225.8,225.8,225.8,111.95,130.17,130.17,0,79.7,114.23,114.23,225.8
3763275,270,,,,,,,,LEG SPLINT POST LG,191.1,76.44,0,162.44,162.44,SKIPPED,145.24,145.24,162.44,162.44,162.44,80.53,93.64,93.64,0,57.33,82.17,82.17,162.44
3763290,270,,,,,,,,LEN F REDUCTION,57.75,23.1,0,49.09,49.09,SKIPPED,43.89,43.89,49.09,49.09,49.09,24.33,28.3,28.3,0,17.32,24.83,24.83,49.09
3763326,270,,,,,,,,ENDO CLIP,60.9,24.36,0,51.76,51.76,SKIPPED,46.28,46.28,51.76,51.76,51.76,25.67,29.84,29.84,0,18.27,26.19,26.19,51.76
3763330,270,,,,,,,,LAP PROBE CAUTERY,195.3,78.12,0,166,166,SKIPPED,148.43,148.43,166,166,166,82.3,95.7,95.7,0,58.59,83.98,83.98,166
3763388,278,C1764,,,,,,,LOOP RECORDER,13875,5550,0,11793.75,11793.75,SKIPPED,10545,10545,11793.75,11793.75,11793.75,5846.92,6798.75,6798.75,0,4162.5,5966.25,5966.25,11793.75
3763391,270,,,,,,,,WAFFLE HEEL ELEVATOR,73.5,29.4,0,62.48,62.48,SKIPPED,55.86,55.86,62.48,62.48,62.48,30.98,36.02,36.02,0,22.05,31.61,31.61,62.48
3763415,270,,,,,,,,LUMBAR PUNC TRAY,142,56.8,0,120.7,120.7,SKIPPED,107.92,107.92,120.7,120.7,120.7,59.84,69.58,69.58,0,42.6,61.06,61.06,120.7
3763433,272,,,,,,,,MVP0038 MIN INVASIVE SYS,3750.6,1500.24,0,3188.01,3188.01,SKIPPED,2850.46,2850.46,3188.01,3188.01,3188.01,1580.5,1837.79,1837.79,0,1125.18,1612.76,1612.76,3188.01
3763445,270,,,,,,,,MARKING PENCIL,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3763453,270,,,,,,,,MARLEXMESH 1 1/2 - 3,248.85,99.54,0,211.52,211.52,SKIPPED,189.13,189.13,211.52,211.52,211.52,104.87,121.94,121.94,0,74.66,107.01,107.01,211.52
3763477,270,A4349,,,,,,,LEG BAG,34.65,13.86,0,29.45,29.45,SKIPPED,7.56,7.56,29.45,29.45,29.45,14.6,16.98,16.98,0,10.4,14.9,14.9,29.45
3763495,270,,,,,,,,GRATE WHITE SHAVER,68.25,27.3,0,58.01,58.01,SKIPPED,51.87,51.87,58.01,58.01,58.01,28.76,33.44,33.44,0,20.48,29.35,29.35,58.01
3763503,270,,,,,,,,"MICROFOAM TAPE 1""",13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3763508,270,,,,,,,,"MICROFOAM TAPE 3""",16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3763516,270,,,,,,,,MICROSPORE TAPE,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3763530,270,,,,,,,,MICROPUNCTURE,132.3,52.92,0,112.46,112.46,SKIPPED,100.55,100.55,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,112.46
3763572,270,,,,,,,,MULTIFIRE GIA 60 (DL,522.9,209.16,0,444.46,444.46,SKIPPED,397.4,397.4,444.46,444.46,444.46,220.35,256.22,256.22,0,156.87,224.85,224.85,444.46
3763574,270,,,,,,,,MULTIFIRE GIA 60,522.9,209.16,0,444.46,444.46,SKIPPED,397.4,397.4,444.46,444.46,444.46,220.35,256.22,256.22,0,156.87,224.85,224.85,444.46
3763580,732,,,,,,,,TELEMETRY MONITOR-PER 24 HR PERIOD,1877.96,751.18,0,1596.27,1596.27,SKIPPED,1427.25,1427.25,1596.27,1596.27,1596.27,791.37,920.2,920.2,0,563.39,807.52,807.52,1596.27
3763629,270,A4461,,,,,,,POLY TRAP,16.8,6.72,0,14.28,14.28,SKIPPED,12.35,12.35,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3763643,270,,,,,,,,MULTI MED CATH,214.2,85.68,0,182.07,182.07,SKIPPED,162.79,162.79,182.07,182.07,182.07,90.27,104.96,104.96,0,64.26,92.11,92.11,182.07
3763694,270,,,,,,,,NASO-PHARNG AIRWAY,79.8,31.92,0,67.83,67.83,SKIPPED,60.65,60.65,67.83,67.83,67.83,33.62,39.1,39.1,0,23.94,34.31,34.31,67.83
3763700,270,,,,,,,,NEEDLE INSUF & ACCES,60.9,24.36,0,51.76,51.76,SKIPPED,46.28,46.28,51.76,51.76,51.76,25.67,29.84,29.84,0,18.27,26.19,26.19,51.76
3763748,270,,,,,,,,OPSITE,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3763785,270,,,,,,,,BACTERIA FILTER ITEM# 70-002862,7.48,2.99,0,6.36,6.36,SKIPPED,5.68,5.68,6.36,6.36,6.36,3.16,3.67,3.67,0,2.24,3.22,3.22,6.36
3763787,270,,,,,,,,"PANTY, DISP",23.1,9.24,0,19.64,19.64,SKIPPED,17.56,17.56,19.64,19.64,19.64,9.73,11.32,11.32,0,6.93,9.93,9.93,19.64
3763883,270,,,,,,,,PEROXIDE,9.45,3.78,0,8.03,8.03,SKIPPED,7.18,7.18,8.03,8.03,8.03,3.98,4.63,4.63,0,2.84,4.06,4.06,8.03
3763901,270,,,,,,,,Hoyer Lift Disposable Slings,187.48,74.99,0,159.36,159.36,SKIPPED,142.48,142.48,159.36,159.36,159.36,79.01,91.87,91.87,0,56.24,80.62,80.62,159.36
3764031,270,,,,,,,,PREM 25 DISP SKIN ST,129.15,51.66,0,109.78,109.78,SKIPPED,98.15,98.15,109.78,109.78,109.78,54.42,63.28,63.28,0,38.74,55.53,55.53,109.78
3764033,270,,,,,,,,PREM SURGICLIP M11.5,242.55,97.02,0,206.17,206.17,SKIPPED,184.34,184.34,206.17,206.17,206.17,102.21,118.85,118.85,0,72.76,104.3,104.3,206.17
3764037,270,,,,,,,,PREP TRAY,19.95,7.98,0,16.96,16.96,SKIPPED,15.16,15.16,16.96,16.96,16.96,8.41,9.78,9.78,0,5.98,8.58,8.58,16.96
3764049,270,,,,,,,,PROCTOSCOPY TRAY,55.65,22.26,0,47.3,47.3,SKIPPED,42.29,42.29,47.3,47.3,47.3,23.45,27.27,27.27,0,16.7,23.93,23.93,47.3
3764065,270,,,,,,,,RADIAL ARTERY CATH K,87.15,34.86,0,74.08,74.08,SKIPPED,66.23,66.23,74.08,74.08,74.08,36.72,42.7,42.7,0,26.14,37.47,37.47,74.08
3764068,270,,,,,,,,RAYTEC SPONGE,15.75,6.3,0,13.39,13.39,SKIPPED,11.97,11.97,13.39,13.39,13.39,6.63,7.72,7.72,0,4.72,6.77,6.77,13.39
3764075,270,,,,,,,,RAZOR PREP,11.55,4.62,0,9.82,9.82,SKIPPED,8.78,8.78,9.82,9.82,9.82,4.87,5.66,5.66,0,3.46,4.97,4.97,9.82
3764078,270,,,,,,,,RATH RET NET,120.75,48.3,0,102.64,102.64,SKIPPED,91.77,91.77,102.64,102.64,102.64,50.88,59.17,59.17,0,36.22,51.92,51.92,102.64
3764085,270,,,,,,,,RAT CLIP APPLIER ER3,438.9,175.56,0,373.06,373.06,SKIPPED,333.56,333.56,373.06,373.06,373.06,184.96,215.06,215.06,0,131.67,188.73,188.73,373.06
3764090,270,,,,,,,,RADIAL JAW II-COLONO,195.3,78.12,0,166,166,SKIPPED,148.43,148.43,166,166,166,82.3,95.7,95.7,0,58.59,83.98,83.98,166
3764099,270,,,,,,,,RECTAL EXAM,44.1,17.64,0,37.48,37.48,SKIPPED,33.52,33.52,37.48,37.48,37.48,18.58,21.61,21.61,0,13.23,18.96,18.96,37.48
3764138,270,,,,,,,,ROBINSON CATH,31.5,12.6,0,26.78,26.78,SKIPPED,23.94,23.94,26.78,26.78,26.78,13.28,15.44,15.44,0,9.45,13.55,13.55,26.78
3764164,270,,,,,,,,PUDDLE VAC,47.25,18.9,0,40.16,40.16,SKIPPED,35.91,35.91,40.16,40.16,40.16,19.91,23.15,23.15,0,14.18,20.32,20.32,40.16
3764166,270,,,,,,,,VASELINE DRESS 2X2,15.75,6.3,0,13.39,13.39,SKIPPED,11.97,11.97,13.39,13.39,13.39,6.63,7.72,7.72,0,4.72,6.77,6.77,13.39
3764176,270,,,,,,,,SALEM SUMP,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3764190,270,,,,,,,,SACROTAL SUPPORT,34.65,13.86,0,29.45,29.45,SKIPPED,26.33,26.33,29.45,29.45,29.45,14.6,16.98,16.98,0,10.4,14.9,14.9,29.45
3764200,270,,,,,,,,SCD COMPRESS UNIT P/,57.75,23.1,0,49.09,49.09,SKIPPED,43.89,43.89,49.09,49.09,49.09,24.33,28.3,28.3,0,17.32,24.83,24.83,49.09
3764265,270,L3650,,,,,,,SHLDR IMMOBL XLG,114.45,45.78,0,97.28,97.28,SKIPPED,86.98,86.98,97.28,97.28,97.28,48.23,56.08,56.08,0,34.34,49.21,49.21,97.28
3764304,270,,,,,,,,SIGMOIDOSCOPY,64.05,25.62,0,54.44,54.44,SKIPPED,48.68,48.68,54.44,54.44,54.44,26.99,31.38,31.38,0,19.22,27.54,27.54,54.44
3764316,270,,,,,,,,SILASTIC CATH,64.05,25.62,0,54.44,54.44,SKIPPED,48.68,48.68,54.44,54.44,54.44,26.99,31.38,31.38,0,19.22,27.54,27.54,54.44
3764345,270,,,,,,,,SNARE ASSEMBLE,79.8,31.92,0,67.83,67.83,SKIPPED,60.65,60.65,67.83,67.83,67.83,33.62,39.1,39.1,0,23.94,34.31,34.31,67.83
3764356,270,,,,,,,,SPIRAL ELECTRODE,37.8,15.12,0,32.13,32.13,SKIPPED,28.73,28.73,32.13,32.13,32.13,15.92,18.52,18.52,0,11.34,16.25,16.25,32.13
3764360,270,,,,,,,,SPINAL TRAY NEEDLE,107.1,42.84,0,91.04,91.04,SKIPPED,81.4,81.4,91.04,91.04,91.04,45.13,52.48,52.48,0,32.13,46.05,46.05,91.04
3764379,270,,,,,,,,"STAPLER, PROX 33MM",1348.2,539.28,0,1145.97,1145.97,SKIPPED,1024.63,1024.63,1145.97,1145.97,1145.97,568.14,660.62,660.62,0,404.46,579.73,579.73,1145.97
3764410,270,,,,,,,,STOCKINETTE-ORTHO IM,52.5,21,0,44.62,44.62,SKIPPED,39.9,39.9,44.62,44.62,44.62,22.13,25.72,25.72,0,15.75,22.58,22.58,44.62
3764417,270,,,,,,,,STOCKINETTE (ALL),11.55,4.62,0,9.82,9.82,SKIPPED,8.78,8.78,9.82,9.82,9.82,4.87,5.66,5.66,0,3.46,4.97,4.97,9.82
3764424,270,,,,,,,,STOPCOCK,11.55,4.62,0,9.82,9.82,SKIPPED,8.78,8.78,9.82,9.82,9.82,4.87,5.66,5.66,0,3.46,4.97,4.97,9.82
3764429,270,,,,,,,,SUCTION TUBING,9.45,3.78,0,8.03,8.03,SKIPPED,7.18,7.18,8.03,8.03,8.03,3.98,4.63,4.63,0,2.84,4.06,4.06,8.03
3764431,270,,,,,,,,SUCTION MACHINE,40.95,16.38,0,34.81,34.81,SKIPPED,31.12,31.12,34.81,34.81,34.81,17.26,20.07,20.07,0,12.28,17.61,17.61,34.81
3764443,270,,,,,,,,SUCTION CATH 14FR,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3764493,270,,,,,,,,SURGICAL 4X8,97.65,39.06,0,83,83,SKIPPED,74.21,74.21,83,83,83,41.15,47.85,47.85,0,29.3,41.99,41.99,83
3764520,270,,,,,,,,SUTURE TRAY SM,70.35,28.14,0,59.8,59.8,SKIPPED,53.47,53.47,59.8,59.8,59.8,29.64,34.47,34.47,0,21.1,30.25,30.25,59.8
3764544,270,,,,,,,,STERI STRIP 1/4 X 4,11.55,4.62,0,9.82,9.82,SKIPPED,8.78,8.78,9.82,9.82,9.82,4.87,5.66,5.66,0,3.46,4.97,4.97,9.82
3764556,270,,,,,,,,STERI STRIP 1/2 X 4,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3764583,270,,,,,,,,TA PREMIUM 55-3.5 (D,411.6,164.64,0,349.86,349.86,SKIPPED,312.82,312.82,349.86,349.86,349.86,173.45,201.68,201.68,0,123.48,176.99,176.99,349.86
3764586,270,,,,,,,,TEGADERM 2 3/8,8.4,3.36,0,7.14,7.14,SKIPPED,6.38,6.38,7.14,7.14,7.14,3.54,4.12,4.12,0,2.52,3.61,3.61,7.14
3764587,270,,,,,,,,"TEGADERM 4""",12.6,5.04,0,10.71,10.71,SKIPPED,9.58,9.58,10.71,10.71,10.71,5.31,6.17,6.17,0,3.78,5.42,5.42,10.71
3764607,270,,,,,,,,TELFA 2X3,8.4,3.36,0,7.14,7.14,SKIPPED,6.38,6.38,7.14,7.14,7.14,3.54,4.12,4.12,0,2.52,3.61,3.61,7.14
3764660,270,,,,,,,,MICROSCOPE DRAPE,71.4,28.56,0,60.69,60.69,SKIPPED,54.26,54.26,60.69,60.69,60.69,30.09,34.99,34.99,0,21.42,30.7,30.7,60.69
3764750,270,,,,,,,,TOOTHETTE,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3764847,270,,,,,,,,"NUGAUZE 1/4,1/2, OR 1 INCH",16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3764900,270,,,,,,,,T TUBE,31.5,12.6,0,26.78,26.78,SKIPPED,23.94,23.94,26.78,26.78,26.78,13.28,15.44,15.44,0,9.45,13.55,13.55,26.78
3764922,270,,,,,,,,UNNA BOOT,55.65,22.26,0,47.3,47.3,SKIPPED,42.29,42.29,47.3,47.3,47.3,23.45,27.27,27.27,0,16.7,23.93,23.93,47.3
3764948,270,,,,,,,,URI METER,76.65,30.66,0,65.15,65.15,SKIPPED,58.25,58.25,65.15,65.15,65.15,32.3,37.56,37.56,0,23,32.96,32.96,65.15
3764974,270,,,,,,,,VASELINE GAUGE 1X8,11.55,4.62,0,9.82,9.82,SKIPPED,8.78,8.78,9.82,9.82,9.82,4.87,5.66,5.66,0,3.46,4.97,4.97,9.82
3764986,270,,,,,,,,VASELINE DRESS 3X9,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3764987,270,,,,,,,,HEMACLIP ALL,360,144,0,306,306,SKIPPED,273.6,273.6,306,306,306,151.7,176.4,176.4,0,108,154.8,154.8,306
3764988,270,,,,,,,,THUNDERBEAT ALL,900,360,0,765,765,SKIPPED,684,684,765,765,765,379.26,441,441,0,270,387,387,765
3764989,270,,,,,,,,FOOD BOLUS BASKET,200,80,0,170,170,SKIPPED,152,152,170,170,170,84.28,98,98,0,60,86,86,170
3764990,270,,,,,,,,FOREIGN BODY BASKET,186.9,74.76,0,158.86,158.86,SKIPPED,142.04,142.04,158.86,158.86,158.86,78.76,91.58,91.58,0,56.07,80.37,80.37,158.86
3764991,272,,,,,,,,PULSA VAC,64,25.6,0,54.4,54.4,SKIPPED,48.64,48.64,54.4,54.4,54.4,26.97,31.36,31.36,0,19.2,27.52,27.52,54.4
3764992,270,,,,,,,,TALON GRASPER,278,111.2,0,236.3,236.3,SKIPPED,211.28,211.28,236.3,236.3,236.3,117.15,136.22,136.22,0,83.4,119.54,119.54,236.3
3764993,270,,,,,,,,THIN OFFSET BLADE,106.5,42.6,0,90.52,90.52,SKIPPED,80.94,80.94,90.52,90.52,90.52,44.88,52.18,52.18,0,31.95,45.8,45.8,90.52
3765295,270,,,,,,,,"PONSKY ""PULL PEG""",604.8,241.92,0,514.08,514.08,SKIPPED,459.65,459.65,514.08,514.08,514.08,254.86,296.35,296.35,0,181.44,260.06,260.06,514.08
3765344,270,L0140,,,,,,,CERVICAL COLLAR,123.9,49.56,0,105.32,105.32,SKIPPED,94.16,94.16,105.32,105.32,105.32,52.21,60.71,60.71,0,37.17,53.28,53.28,105.32
3765407,270,,,,,,,,ANGIOCATH,19.95,7.98,0,16.96,16.96,SKIPPED,15.16,15.16,16.96,16.96,16.96,8.41,9.78,9.78,0,5.98,8.58,8.58,16.96
3765433,270,,,,,,,,CHOLONGIGRAPHY CATH,91.35,36.54,0,77.65,77.65,SKIPPED,69.43,69.43,77.65,77.65,77.65,38.49,44.76,44.76,0,27.4,39.28,39.28,77.65
3765471,270,,,,,,,,CATH TRAY NON RETENT,64.05,25.62,0,54.44,54.44,SKIPPED,48.68,48.68,54.44,54.44,54.44,26.99,31.38,31.38,0,19.22,27.54,27.54,54.44
3765508,270,,,,,,,,GAUZE SPONGE 4X4,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3765522,270,,,,,,,,BLOOD FLUID WARM SET,64.05,25.62,0,54.44,54.44,SKIPPED,48.68,48.68,54.44,54.44,54.44,26.99,31.38,31.38,0,19.22,27.54,27.54,54.44
3765534,270,,,,,,,,Z DRAPE,25.2,10.08,0,21.42,21.42,SKIPPED,19.15,19.15,21.42,21.42,21.42,10.62,12.35,12.35,0,7.56,10.84,10.84,21.42
3765558,270,,,,,,,,DOPPLER SET,150.15,60.06,0,127.63,127.63,SKIPPED,114.11,114.11,127.63,127.63,127.63,63.27,73.57,73.57,0,45.04,64.56,64.56,127.63
3765560,270,,,,,,,,FLYTE HOOD,123.9,49.56,0,105.32,105.32,SKIPPED,94.16,94.16,105.32,105.32,105.32,52.21,60.71,60.71,0,37.17,53.28,53.28,105.32
3765609,270,,,,,,,,ENEMA SS TRAY,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3765685,270,,,,,,,,PEDIATRIC CATH KIT,37.8,15.12,0,32.13,32.13,SKIPPED,28.73,28.73,32.13,32.13,32.13,15.92,18.52,18.52,0,11.34,16.25,16.25,32.13
3765712,270,,,,,,,,ELASTIC BANDAGE 2,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3765724,270,,,,,,,,ELASTIC BANDAGE 3,19.95,7.98,0,16.96,16.96,SKIPPED,15.16,15.16,16.96,16.96,16.96,8.41,9.78,9.78,0,5.98,8.58,8.58,16.96
3765736,270,,,,,,,,ELASTIC BANDAGE 4,22.05,8.82,0,18.74,18.74,SKIPPED,16.76,16.76,18.74,18.74,18.74,9.29,10.8,10.8,0,6.62,9.48,9.48,18.74
3765748,270,,,,,,,,ELASTIC BANDAGE 6,26.25,10.5,0,22.31,22.31,SKIPPED,19.95,19.95,22.31,22.31,22.31,11.06,12.86,12.86,0,7.88,11.29,11.29,22.31
3765837,270,,,,,,,,FEEDING TUBE,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3765849,270,,,,,,,,DISP INST. KIT,487.5,195,0,414.38,414.38,SKIPPED,370.5,370.5,414.38,414.38,414.38,205.44,238.88,238.88,0,146.25,209.63,209.63,414.38
3765952,270,,,,,,,,KLING 2IN,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3765976,270,,,,,,,,FEMORAL PROS,7482.3,2992.92,0,6359.96,6359.96,SKIPPED,5686.55,5686.55,6359.96,6359.96,6359.96,3153.04,3666.33,3666.33,0,2244.69,3217.39,3217.39,6359.96
3766182,270,,,,,,,,TOPPER SPONGE 4X4,8.4,3.36,0,7.14,7.14,SKIPPED,6.38,6.38,7.14,7.14,7.14,3.54,4.12,4.12,0,2.52,3.61,3.61,7.14
3766194,270,,,,,,,,TROCAR-ALL SIZES,87.15,34.86,0,74.08,74.08,SKIPPED,66.23,66.23,74.08,74.08,74.08,36.72,42.7,42.7,0,26.14,37.47,37.47,74.08
3766295,270,,,,,,,,PENROSE DRAIN ANY SI,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3766435,270,,,,,,,,OP SITE KIT,19.95,7.98,0,16.96,16.96,SKIPPED,15.16,15.16,16.96,16.96,16.96,8.41,9.78,9.78,0,5.98,8.58,8.58,16.96
3766598,270,,,,,,,,LUKI TUBE,26.25,10.5,0,22.31,22.31,SKIPPED,19.95,19.95,22.31,22.31,22.31,11.06,12.86,12.86,0,7.88,11.29,11.29,22.31
3766601,270,,,,,,,,SHUNT SCOPE,181,72.4,0,153.85,153.85,SKIPPED,137.56,137.56,153.85,153.85,153.85,76.27,88.69,88.69,0,54.3,77.83,77.83,153.85
3766625,270,,,,,,,,WARMING BLANKET,149.1,59.64,0,126.74,126.74,SKIPPED,113.32,113.32,126.74,126.74,126.74,62.83,73.06,73.06,0,44.73,64.11,64.11,126.74
3766687,270,,,,,,,,ACETABULAR CUP,1085.7,434.28,0,922.84,922.84,SKIPPED,825.13,825.13,922.84,922.84,922.84,457.51,531.99,531.99,0,325.71,466.85,466.85,922.84
3766764,270,,,,,,,,GI SCOPE & TOWER,100,40,0,85,85,SKIPPED,76,76,85,85,85,42.14,49,49,0,30,43,43,85
3766776,270,,,,,,,,R BOBBIN VENT TUBE,16.8,6.72,0,14.28,14.28,SKIPPED,12.77,12.77,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,14.28
3768804,270,,,,,,,,OPEN SURG SOMKE EVACUATOR,138.6,55.44,0,117.81,117.81,SKIPPED,105.34,105.34,117.81,117.81,117.81,58.41,67.91,67.91,0,41.58,59.6,59.6,117.81
3768805,270,,,,,,,,T-CONNECTOR,9.45,3.78,0,8.03,8.03,SKIPPED,7.18,7.18,8.03,8.03,8.03,3.98,4.63,4.63,0,2.84,4.06,4.06,8.03
3768885,270,,,,,,,,COBAN ELASTIC BANDAG,22.05,8.82,0,18.74,18.74,SKIPPED,16.76,16.76,18.74,18.74,18.74,9.29,10.8,10.8,0,6.62,9.48,9.48,18.74
3768886,278,,,,,,,,LAPIDUS PLATE ARTHREX,2544,1017.6,0,2162.4,2162.4,SKIPPED,1933.44,1933.44,2162.4,2162.4,2162.4,1072.04,1246.56,1246.56,0,763.2,1093.92,1093.92,2162.4
3768887,278,,,,,,,,CANNULATED SCREW ARTHREX,312,124.8,0,265.2,265.2,SKIPPED,237.12,237.12,265.2,265.2,265.2,131.48,152.88,152.88,0,93.6,134.16,134.16,265.2
3768889,278,,,,,,,,STIMUBLAST DBM GEL,579,231.6,0,492.15,492.15,SKIPPED,440.04,440.04,492.15,492.15,492.15,243.99,283.71,283.71,0,173.7,248.97,248.97,492.15
3768890,272,,,,,,,,ENDO TUBE 2.5,5.82,2.33,0,4.95,4.95,SKIPPED,4.42,4.42,4.95,4.95,4.95,2.45,2.85,2.85,0,1.75,2.5,2.5,4.95
3768891,272,,,,,,,,ENDO TUBE 3,6.05,2.42,0,5.14,5.14,SKIPPED,4.6,4.6,5.14,5.14,5.14,2.55,2.96,2.96,0,1.82,2.6,2.6,5.14
3768892,272,,,,,,,,ENDO TUBE 5.5,4.16,1.66,0,3.54,3.54,SKIPPED,3.16,3.16,3.54,3.54,3.54,1.75,2.04,2.04,0,1.25,1.79,1.79,3.54
3768893,272,,,,,,,,ENDO TUBE 4,4,1.6,0,3.4,3.4,SKIPPED,3.04,3.04,3.4,3.4,3.4,1.69,1.96,1.96,0,1.2,1.72,1.72,3.4
3768894,272,,,,,,,,ENDO TUBE 4.5,8.09,3.24,0,6.88,6.88,SKIPPED,6.15,6.15,6.88,6.88,6.88,3.41,3.96,3.96,0,2.43,3.48,3.48,6.88
3768895,272,,,,,,,,ENDO TUBE 5. CUFF,3.77,1.51,0,3.2,3.2,SKIPPED,2.87,2.87,3.2,3.2,3.2,1.59,1.85,1.85,0,1.13,1.62,1.62,3.2
3768899,272,,,,,,,,CATH COUDE 12F,23.3,9.32,0,19.8,19.8,SKIPPED,17.71,17.71,19.8,19.8,19.8,9.82,11.42,11.42,0,6.99,10.02,10.02,19.8
3768900,272,,,,,,,,CATH COUDE 14F,22.88,9.15,0,19.45,19.45,SKIPPED,17.39,17.39,19.45,19.45,19.45,9.64,11.21,11.21,0,6.86,9.84,9.84,19.45
3768901,272,,,,,,,,CATH COUDE 18F,22.87,9.15,0,19.44,19.44,SKIPPED,17.38,17.38,19.44,19.44,19.44,9.63,11.21,11.21,0,6.86,9.83,9.83,19.44
3768905,272,,,,,,,,CATH 3-WAY 24FT,22.9,9.16,0,19.46,19.46,SKIPPED,17.4,17.4,19.46,19.46,19.46,9.65,11.22,11.22,0,6.87,9.85,9.85,19.46
3768907,272,,,,,,,,CATH 3-WAY 20FT,22.8,9.12,0,19.38,19.38,SKIPPED,17.33,17.33,19.38,19.38,19.38,9.6,11.17,11.17,0,6.84,9.8,9.8,19.38
3768908,272,,,,,,,,CATH 3-WAY 16FT,23.94,9.58,0,20.35,20.35,SKIPPED,18.19,18.19,20.35,20.35,20.35,10.08,11.73,11.73,0,7.18,10.29,10.29,20.35
3768912,272,,,,,,,,CATH FOLEY 16FT,8.92,3.57,0,7.58,7.58,SKIPPED,6.78,6.78,7.58,7.58,7.58,3.76,4.37,4.37,0,2.68,3.84,3.84,7.58
3768914,272,,,,,,,,CATH FOLEY 22FT,6.43,2.57,0,5.47,5.47,SKIPPED,4.89,4.89,5.47,5.47,5.47,2.7,3.15,3.15,0,1.93,2.76,2.76,5.47
3768916,272,,,,,,,,CATH FOLEY 18FT,9.01,3.6,0,7.66,7.66,SKIPPED,6.85,6.85,7.66,7.66,7.66,3.79,4.41,4.41,0,2.7,3.87,3.87,7.66
3768917,272,,,,,,,,CATH FOLEY 14FT,8.92,3.57,0,7.58,7.58,SKIPPED,6.78,6.78,7.58,7.58,7.58,3.76,4.37,4.37,0,2.68,3.84,3.84,7.58
3768918,272,,,,,,,,CATH FOLEY 12FT,8.92,3.57,0,7.58,7.58,SKIPPED,6.78,6.78,7.58,7.58,7.58,3.76,4.37,4.37,0,2.68,3.84,3.84,7.58
3768920,272,,,,,,,,CATH FOLEY TRY 18FT,34.71,13.88,0,29.5,29.5,SKIPPED,26.38,26.38,29.5,29.5,29.5,14.63,17.01,17.01,0,10.41,14.93,14.93,29.5
3768923,272,,,,,,,,CATH ROBINSON 12FT,0.95,0.38,0,0.81,0.81,SKIPPED,0.72,0.72,0.81,0.81,0.81,0.4,0.47,0.47,0,0.28,0.41,0.41,0.81
3768927,272,,,,,,,,ZIPLINE COVER,2.65,1.06,0,2.25,2.25,SKIPPED,2.01,2.01,2.25,2.25,2.25,1.12,1.3,1.3,0,0.8,1.14,1.14,2.25
3768930,270,C1781,,,,,,,"PARIETEX FLAT SHEET MESH 6""X4""",274.05,109.62,0,232.94,232.94,SKIPPED,208.28,208.28,232.94,232.94,232.94,115.48,134.28,134.28,0,82.22,117.84,117.84,232.94
3768931,270,,,,,,,,NASAL CANNULA,36,14.4,0,30.6,30.6,SKIPPED,27.36,27.36,30.6,30.6,30.6,15.17,17.64,17.64,0,10.8,15.48,15.48,30.6
3768932,270,,,,,,,,18 IN. TURNIQUIET,40,16,0,34,34,SKIPPED,30.4,30.4,34,34,34,16.86,19.6,19.6,0,12,17.2,17.2,34
3768933,270,,,,,,,,24 IN. TURNIQUIET,44,17.6,0,37.4,37.4,SKIPPED,33.44,33.44,37.4,37.4,37.4,18.54,21.56,21.56,0,13.2,18.92,18.92,37.4
3768934,270,,,,,,,,30 IN. TURNIQUIET,48,19.2,0,40.8,40.8,SKIPPED,36.48,36.48,40.8,40.8,40.8,20.23,23.52,23.52,0,14.4,20.64,20.64,40.8
3768935,270,,,,,,,,34 IN. TURNIQUIET,52,20.8,0,44.2,44.2,SKIPPED,39.52,39.52,44.2,44.2,44.2,21.91,25.48,25.48,0,15.6,22.36,22.36,44.2
3768936,270,,,,,,,,42 IN. TURNIQUIET,56,22.4,0,47.6,47.6,SKIPPED,42.56,42.56,47.6,47.6,47.6,23.6,27.44,27.44,0,16.8,24.08,24.08,47.6
3768937,270,,,,,,,,OPTIVAC FUSION VAC. BOWL,158,63.2,0,134.3,134.3,SKIPPED,120.08,120.08,134.3,134.3,134.3,66.58,77.42,77.42,0,47.4,67.94,67.94,134.3
3768938,270,,,,,,,,OPTIVAC TOTAL HIP KIT,284,113.6,0,241.4,241.4,SKIPPED,215.84,215.84,241.4,241.4,241.4,119.68,139.16,139.16,0,85.2,122.12,122.12,241.4
3768939,270,,,,,,,,HIP PREP KIT,236,94.4,0,200.6,200.6,SKIPPED,179.36,179.36,200.6,200.6,200.6,99.45,115.64,115.64,0,70.8,101.48,101.48,200.6
3768940,270,,,,,,,,2.0-2.5 DRILL,188,75.2,0,159.8,159.8,SKIPPED,142.88,142.88,159.8,159.8,159.8,79.22,92.12,92.12,0,56.4,80.84,80.84,159.8
3768941,270,,,,,,,,1.6 K-WIRE,112.5,45,0,95.62,95.62,SKIPPED,85.5,85.5,95.62,95.62,95.62,47.41,55.12,55.12,0,33.75,48.38,48.38,95.62
3768942,270,,,,,,,,OrthoMed K-Wire 6'' .7mm,5.2,2.08,0,4.42,4.42,SKIPPED,3.95,3.95,4.42,4.42,4.42,2.2,2.55,2.55,0,1.56,2.24,2.24,4.42
3768946,270,,,,,,,,OrthoMed K-Wire 6'' 1.6mm,5.2,2.08,0,4.42,4.42,SKIPPED,3.95,3.95,4.42,4.42,4.42,2.2,2.55,2.55,0,1.56,2.24,2.24,4.42
3768947,270,,,,,,,,JURGAN PIN BALL .7MM,12,4.8,0,10.2,10.2,SKIPPED,9.12,9.12,10.2,10.2,10.2,5.06,5.88,5.88,0,3.6,5.16,5.16,10.2
3768949,270,,,,,,,,JURGAN PIN BALL 1.1MM,12,4.8,0,10.2,10.2,SKIPPED,9.12,9.12,10.2,10.2,10.2,5.06,5.88,5.88,0,3.6,5.16,5.16,10.2
3768950,270,,,,,,,,JURGAN PIN BALL 1.4/1.6MM,12,4.8,0,10.2,10.2,SKIPPED,9.12,9.12,10.2,10.2,10.2,5.06,5.88,5.88,0,3.6,5.16,5.16,10.2
3768951,278,C1763,,,,,,,COMPOSITE CERV ALLOGRAFT,3545,1418,0,3013.25,3013.25,SKIPPED,2694.2,2694.2,3013.25,3013.25,3013.25,1493.86,1737.05,1737.05,0,1063.5,1524.35,1524.35,3013.25
3768952,270,,,,,,,,1.25 GUIDE WIRE,115.5,46.2,0,98.18,98.18,SKIPPED,87.78,87.78,98.18,98.18,98.18,48.68,56.6,56.6,0,34.65,49.67,49.67,98.18
3768953,270,,,,,,,,DRILL BIT (ALL SIZES),197.5,79,0,167.88,167.88,SKIPPED,150.1,150.1,167.88,167.88,167.88,83.23,96.78,96.78,0,59.25,84.93,84.93,167.88
3768954,270,,,,,,,,2.3 MAXCUTTER,292,116.8,0,248.2,248.2,SKIPPED,221.92,221.92,248.2,248.2,248.2,123.05,143.08,143.08,0,87.6,125.56,125.56,248.2
3768956,270,,,,,,,,9 MM CORING TREPHINE,1016,406.4,0,863.6,863.6,SKIPPED,772.16,772.16,863.6,863.6,863.6,428.14,497.84,497.84,0,304.8,436.88,436.88,863.6
3768957,270,,,,,,,,9-10 LONG EZ LOC,1076,430.4,0,914.6,914.6,SKIPPED,817.76,817.76,914.6,914.6,914.6,453.43,527.24,527.24,0,322.8,462.68,462.68,914.6
3768958,278,,,,,,,,LEAD 5076-45(PACEMAKER),1625,650,0,1381.25,1381.25,SKIPPED,1235,1235,1381.25,1381.25,1381.25,684.78,796.25,796.25,0,487.5,698.75,698.75,1381.25
3768959,278,,,,,,,,LEAD 5076-52(PACEMAKER),1625,650,0,1381.25,1381.25,SKIPPED,1235,1235,1381.25,1381.25,1381.25,684.78,796.25,796.25,0,487.5,698.75,698.75,1381.25
3768960,278,,,,,,,,"IPG,SED01,SENSIA(PACEMAKER)",9500,3800,0,8075,8075,SKIPPED,7220,7220,8075,8075,8075,4003.3,4655,4655,0,2850,4085,4085,8075
3768961,278,,,,,,,,1.5 JUGGERKNOT KIT,710,284,0,603.5,603.5,SKIPPED,539.6,539.6,603.5,603.5,603.5,299.19,347.9,347.9,0,213,305.3,305.3,603.5
3768962,278,,,,,,,,1.5 JUGGERKNOT ANCHOR,780,312,0,663,663,SKIPPED,592.8,592.8,663,663,663,328.69,382.2,382.2,0,234,335.4,335.4,663
3768963,278,,,,,,,,7x75 CANNULA,95,38,0,80.75,80.75,SKIPPED,72.2,72.2,80.75,80.75,80.75,40.03,46.55,46.55,0,28.5,40.85,40.85,80.75
3768964,278,,,,,,,,BIPOLAR PRESS FIT PROGRESSIVE,8750,3500,0,7437.5,7437.5,SKIPPED,6650,6650,7437.5,7437.5,7437.5,3687.25,4287.5,4287.5,0,2625,3762.5,3762.5,7437.5
3768965,278,,,,,,,,1.5MM LCP CONDYLAR PLATE,1888,755.2,0,1604.8,1604.8,SKIPPED,1434.88,1434.88,1604.8,1604.8,1604.8,795.6,925.12,925.12,0,566.4,811.84,811.84,1604.8
3768966,278,,,,,,,,1.5MM CORTEX SCREW(ALL SIZES),155,62,0,131.75,131.75,SKIPPED,117.8,117.8,131.75,131.75,131.75,65.32,75.95,75.95,0,46.5,66.65,66.65,131.75
3768967,278,,,,,,,,1.5MM LOCKING SCREW(ALL SIZES),383,153.2,0,325.55,325.55,SKIPPED,291.08,291.08,325.55,325.55,325.55,161.4,187.67,187.67,0,114.9,164.69,164.69,325.55
3768968,270,,,,,,,,1.1MM DRILL BIT,248,99.2,0,210.8,210.8,SKIPPED,188.48,188.48,210.8,210.8,210.8,104.51,121.52,121.52,0,74.4,106.64,106.64,210.8
3768969,278,,,,,,,,7x75 RIDGE CANNULA,95,38,0,80.75,80.75,SKIPPED,72.2,72.2,80.75,80.75,80.75,40.03,46.55,46.55,0,28.5,40.85,40.85,80.75
3768970,278,,,,,,,,LCP DHHS PLATE 4 HOLE,1995,798,0,1695.75,1695.75,SKIPPED,1516.2,1516.2,1695.75,1695.75,1695.75,840.69,977.55,977.55,0,598.5,857.85,857.85,1695.75
3768971,278,,,,,,,,4.5MM CORTEX SCREWS(ALL SIZES),83,33.2,0,70.55,70.55,SKIPPED,63.08,63.08,70.55,70.55,70.55,34.98,40.67,40.67,0,24.9,35.69,35.69,70.55
3768972,278,,,,,,,,5.0MM LOCKING SCREWS(ALL SIZES),1127.5,451,0,958.38,958.38,SKIPPED,856.9,856.9,958.38,958.38,958.38,475.13,552.48,552.48,0,338.25,484.83,484.83,958.38
3768973,278,,,,,,,,COMPRESSION SCREWS,151,60.4,0,128.35,128.35,SKIPPED,114.76,114.76,128.35,128.35,128.35,63.63,73.99,73.99,0,45.3,64.93,64.93,128.35
3768974,278,,,,,,,,HELIX SCREWS(ALL SIZES),1175,470,0,998.75,998.75,SKIPPED,893,893,998.75,998.75,998.75,495.14,575.75,575.75,0,352.5,505.25,505.25,998.75
3768975,278,,,,,,,,2.5MM GUIDE WIRE,166,66.4,0,141.1,141.1,SKIPPED,126.16,126.16,141.1,141.1,141.1,69.95,81.34,81.34,0,49.8,71.38,71.38,141.1
3768976,278,,,,,,,,2.8MM GUIDE WIRE,158,63.2,0,134.3,134.3,SKIPPED,120.08,120.08,134.3,134.3,134.3,66.58,77.42,77.42,0,47.4,67.94,67.94,134.3
3768977,272,,,,,,,,3.2MM DRILL BIT,1002.5,401,0,852.12,852.12,SKIPPED,761.9,761.9,852.12,852.12,852.12,422.46,491.22,491.22,0,300.75,431.08,431.08,852.12
3768978,278,,,,,,,,4.3MM DRILL BIT,1085,434,0,922.25,922.25,SKIPPED,824.6,824.6,922.25,922.25,922.25,457.22,531.65,531.65,0,325.5,466.55,466.55,922.25
3768979,278,,,,,,,,5.0MM CANNULATED DRILL BIT,1508,603.2,0,1281.8,1281.8,SKIPPED,1146.08,1146.08,1281.8,1281.8,1281.8,635.47,738.92,738.92,0,452.4,648.44,648.44,1281.8
3768980,278,,,,,,,,12MM/130 DEG TI CANN TROCH FIXATION NAIL,6113,2445.2,0,5196.05,5196.05,SKIPPED,4645.88,4645.88,5196.05,5196.05,5196.05,2576.02,2995.37,2995.37,0,1833.9,2628.59,2628.59,5196.05
3768981,278,,,,,,,,HELICAL BLADE(ALL SIZES),2053,821.2,0,1745.05,1745.05,SKIPPED,1560.28,1560.28,1745.05,1745.05,1745.05,865.13,1005.97,1005.97,0,615.9,882.79,882.79,1745.05
3768982,278,,,,,,,,4.9 LOCKING BOLT-36MM,623,249.2,0,529.55,529.55,SKIPPED,473.48,473.48,529.55,529.55,529.55,262.53,305.27,305.27,0,186.9,267.89,267.89,529.55
3768983,278,,,,,,,,130 DEG SET SCREW FOR TI TROCK FIX NAIL,570,228,0,484.5,484.5,SKIPPED,433.2,433.2,484.5,484.5,484.5,240.2,279.3,279.3,0,171,245.1,245.1,484.5
3768984,278,,,,,,,,2.5MM REAMING ROW W/ BALL TIP,997.5,399,0,847.88,847.88,SKIPPED,758.1,758.1,847.88,847.88,847.88,420.35,488.78,488.78,0,299.25,428.93,428.93,847.88
3768985,278,,,,,,,,TI-CRON STRAND W/ NEEDLE-PRICE PER STRAN,750,300,0,637.5,637.5,SKIPPED,570,570,637.5,637.5,637.5,316.05,367.5,367.5,0,225,322.5,322.5,637.5
3768986,278,,,,,,,,3.5MM LCP PROXIMAL HUMERUS 5 HOLE PLATE,5400,2160,0,4590,4590,SKIPPED,4104,4104,4590,4590,4590,2275.56,2646,2646,0,1620,2322,2322,4590
3768987,278,,,,,,,,TOGGLELOC PUSHER,313,125.2,0,266.05,266.05,SKIPPED,237.88,237.88,266.05,266.05,266.05,131.9,153.37,153.37,0,93.9,134.59,134.59,266.05
3768988,278,,,,,,,,TOGGLELOC ELBOW IMPLANT,2698,1079.2,0,2293.3,2293.3,SKIPPED,2050.48,2050.48,2293.3,2293.3,2293.3,1136.94,1322.02,1322.02,0,809.4,1160.14,1160.14,2293.3
3768989,272,,,,,,,,LAPROSCOPIC GRASPER,130,52,0,110.5,110.5,SKIPPED,98.8,98.8,110.5,110.5,110.5,54.78,63.7,63.7,0,39,55.9,55.9,110.5
3768990,272,,,,,,,,ETHICON PROXIMATE RELOADABLE STAPLER,201,80.4,0,170.85,170.85,SKIPPED,152.76,152.76,170.85,170.85,170.85,84.7,98.49,98.49,0,60.3,86.43,86.43,170.85
3768991,272,,,,,,,,ETHICON ENDOSCOPIC CURVED STAPLER,675,270,0,573.75,573.75,SKIPPED,513,513,573.75,573.75,573.75,284.44,330.75,330.75,0,202.5,290.25,290.25,573.75
3768992,272,,,,,,,,SECURE STRAPS,45,18,0,38.25,38.25,SKIPPED,34.2,34.2,38.25,38.25,38.25,18.96,22.05,22.05,0,13.5,19.35,19.35,38.25
3768993,272,,,,,,,,ETHICON HARMONIC SHEARS,643,257.2,0,546.55,546.55,SKIPPED,488.68,488.68,546.55,546.55,546.55,270.96,315.07,315.07,0,192.9,276.49,276.49,546.55
3768994,272,,,,,,,,LAPROSCOPIC KITTER,26,10.4,0,22.1,22.1,SKIPPED,19.76,19.76,22.1,22.1,22.1,10.96,12.74,12.74,0,7.8,11.18,11.18,22.1
3768995,272,,,,,,,,MED ALEXIS PORT,102,40.8,0,86.7,86.7,SKIPPED,77.52,77.52,86.7,86.7,86.7,42.98,49.98,49.98,0,30.6,43.86,43.86,86.7
3768996,278,,,,,,,,DIST 7 HOLE PLATE,3018.75,1207.5,0,2565.94,2565.94,SKIPPED,2294.25,2294.25,2565.94,2565.94,2565.94,1272.1,1479.19,1479.19,0,905.62,1298.06,1298.06,2565.94
3768997,278,,,,,,,,Olympus- REUTER BOBBIN VENT TUBES,50,20,0,42.5,42.5,SKIPPED,38,38,42.5,42.5,42.5,21.07,24.5,24.5,0,15,21.5,21.5,42.5
3768998,278,,,,,,,,CPR MINI SCUPION> ARTHREX,2375,950,0,2018.75,2018.75,SKIPPED,1805,1805,2018.75,2018.75,2018.75,1000.82,1163.75,1163.75,0,712.5,1021.25,1021.25,2018.75
3768999,272,,,,,,,,KCI WOUND VAC DRESSING FOAM,220,88,0,187,187,SKIPPED,167.2,167.2,187,187,187,92.71,107.8,107.8,0,66,94.6,94.6,187
3769001,272,,,,,,,,BAND MONOPTHY(PRODUCT# 121620),190,76,0,161.5,161.5,SKIPPED,144.4,144.4,161.5,161.5,161.5,80.07,93.1,93.1,0,57,81.7,81.7,161.5
3769002,270,,,,,,,,BX COVER,230,92,0,195.5,195.5,SKIPPED,174.8,174.8,195.5,195.5,195.5,96.92,112.7,112.7,0,69,98.9,98.9,195.5
37690023,272,,,,,,,,DLYS CATH KIT,2445,978,0,2078.25,2078.25,SKIPPED,1858.2,1858.2,2078.25,2078.25,2078.25,1030.32,1198.05,1198.05,0,733.5,1051.35,1051.35,2078.25
3769004,272,,,,,,,,PICC LINE DRESSING KIT,27.96,11.18,0,23.77,23.77,SKIPPED,21.25,21.25,23.77,23.77,23.77,11.78,13.7,13.7,0,8.39,12.02,12.02,23.77
3769005,272,,,,,,,,CENTRAL LINE DRESSING KIT,228,91.2,0,193.8,193.8,SKIPPED,173.28,173.28,193.8,193.8,193.8,96.08,111.72,111.72,0,68.4,98.04,98.04,193.8
3769006,272,,,,,,,,MINI SQUAIR SMOKE EVAC.,160,64,0,136,136,SKIPPED,121.6,121.6,136,136,136,67.42,78.4,78.4,0,48,68.8,68.8,136
3769010,278,,,,,,,,3.5 NON-LOCKING SCREW ALL SIZES(BIOMET),470,188,0,399.5,399.5,SKIPPED,357.2,357.2,399.5,399.5,399.5,198.06,230.3,230.3,0,141,202.1,202.1,399.5
3769011,278,,,,,,,,3.5 MULTI DIRECT. SCREWS ALL SIZES(BIO),463,185.2,0,393.55,393.55,SKIPPED,351.88,351.88,393.55,393.55,393.55,195.11,226.87,226.87,0,138.9,199.09,199.09,393.55
3769012,278,,,,,,,,4-HOLE ANATOMIC FIBULA(BIOMET),1748,699.2,0,1485.8,1485.8,SKIPPED,1328.48,1328.48,1485.8,1485.8,1485.8,736.61,856.52,856.52,0,524.4,751.64,751.64,1485.8
3769013,278,,,,,,,,2.7 DRILL BIT (BIOMET),212.5,85,0,180.62,180.62,SKIPPED,161.5,161.5,180.62,180.62,180.62,89.55,104.12,104.12,0,63.75,91.38,91.38,180.62
3769014,278,,,,,,,,2.5 DRILL BIT (BIOMET),255,102,0,216.75,216.75,SKIPPED,193.8,193.8,216.75,216.75,216.75,107.46,124.95,124.95,0,76.5,109.65,109.65,216.75
3769015,278,,,,,,,,LCP ONE THIRD TUBULAR PLATE(SYNTHES),625,250,0,531.25,531.25,SKIPPED,475,475,531.25,531.25,531.25,263.38,306.25,306.25,0,187.5,268.75,268.75,531.25
3769016,278,,,,,,,,2.5 DRILL BIT(SYNTHES),249,99.6,0,211.65,211.65,SKIPPED,189.24,189.24,211.65,211.65,211.65,104.93,122.01,122.01,0,74.7,107.07,107.07,211.65
3769017,278,,,,,,,,2.8 DRILL BIT(SYNTHES),1675,670,0,1423.75,1423.75,SKIPPED,1273,1273,1423.75,1423.75,1423.75,705.84,820.75,820.75,0,502.5,720.25,720.25,1423.75
3769018,278,,,,,,,,3.5 DRILL BIT(SYNTHES),265,106,0,225.25,225.25,SKIPPED,201.4,201.4,225.25,225.25,225.25,111.67,129.85,129.85,0,79.5,113.95,113.95,225.25
3769019,272,,,,,,,,EZLOC/ WASHERLOC DISP. KIT,1062,424.8,0,902.7,902.7,SKIPPED,807.12,807.12,902.7,902.7,902.7,447.53,520.38,520.38,0,318.6,456.66,456.66,902.7
3769020,278,,,,,,,,3/32 GUIDE PIN,390,156,0,331.5,331.5,SKIPPED,296.4,296.4,331.5,331.5,331.5,164.35,191.1,191.1,0,117,167.7,167.7,331.5
3769021,272,,,,,,,,PICC/CENTRAL LINE DRESSING KIT,28,11.2,0,23.8,23.8,SKIPPED,21.28,21.28,23.8,23.8,23.8,11.8,13.72,13.72,0,8.4,12.04,12.04,23.8
3769022,278,,,,,,,,CENTRAL LINE INCERT KIT,348,139.2,0,295.8,295.8,SKIPPED,264.48,264.48,295.8,295.8,295.8,146.65,170.52,170.52,0,104.4,149.64,149.64,295.8
3769023,278,,,,,,,,3.5mm (10mm-22mm) Screws-Posterior Crvl.,3056,1222.4,0,2597.6,2597.6,SKIPPED,2322.56,2322.56,2597.6,2597.6,2597.6,1287.8,1497.44,1497.44,0,916.8,1314.08,1314.08,2597.6
3769024,278,,,,,,,,24mm TWO LVL PLATE,4700,1880,0,3995,3995,SKIPPED,3572,3572,3995,3995,3995,1980.58,2303,2303,0,1410,2021,2021,3995
3769025,278,,,,,,,,3.5mm TAP,578,231.2,0,491.3,491.3,SKIPPED,439.28,439.28,491.3,491.3,491.3,243.57,283.22,283.22,0,173.4,248.54,248.54,491.3
3769026,272,,,,,,,,500mL CANISTER V.A.C ULTRA SYSTEM,82.4,32.96,0,70.04,70.04,SKIPPED,62.62,62.62,70.04,70.04,70.04,34.72,40.38,40.38,0,24.72,35.43,35.43,70.04
3769027,272,,,,,,,,MEPORE FILM (V.A.C),4.52,1.81,0,3.84,3.84,SKIPPED,3.44,3.44,3.84,3.84,3.84,1.9,2.21,2.21,0,1.36,1.94,1.94,3.84
3769028,272,,,,,,,,V.A.C GRANU FOAM SILVER DRESSING,165.96,66.38,0,141.07,141.07,SKIPPED,126.13,126.13,141.07,141.07,141.07,69.93,81.32,81.32,0,49.79,71.36,71.36,141.07
3769029,278,,,,,,,,2.5MM GUIDE WIRE(SYNTHES),112,44.8,0,95.2,95.2,SKIPPED,85.12,85.12,95.2,95.2,95.2,47.2,54.88,54.88,0,33.6,48.16,48.16,95.2
3769030,278,,,,,,,,2.8MM GUIDE WIRE(SYNTHES),158,63.2,0,134.3,134.3,SKIPPED,120.08,120.08,134.3,134.3,134.3,66.58,77.42,77.42,0,47.4,67.94,67.94,134.3
3769031,278,,,,,,,,5.0MM VA LOCKING SCREW ALL SIZE(SYNTHES),628,251.2,0,533.8,533.8,SKIPPED,477.28,477.28,533.8,533.8,533.8,264.64,307.72,307.72,0,188.4,270.04,270.04,533.8
3769032,278,,,,,,,,4.5MM CORTEX SCREW 38MM,83,33.2,0,70.55,70.55,SKIPPED,63.08,63.08,70.55,70.55,70.55,34.98,40.67,40.67,0,24.9,35.69,35.69,70.55
3769033,278,,,,,,,,4.5MM VALCP DISTAL FEMUR PLATE(10 HOLE),6120,2448,0,5202,5202,SKIPPED,4651.2,4651.2,5202,5202,5202,2578.97,2998.8,2998.8,0,1836,2631.6,2631.6,5202
3769034,272,,,,,,,,10MM-22MM FIXED DRILL BIT(POSTERIOR),446,178.4,0,379.1,379.1,SKIPPED,338.96,338.96,379.1,379.1,379.1,187.94,218.54,218.54,0,133.8,191.78,191.78,379.1
3769035,272,,,,,,,,3.5 TAP (POSTERIOR),616,246.4,0,523.6,523.6,SKIPPED,468.16,468.16,523.6,523.6,523.6,259.58,301.84,301.84,0,184.8,264.88,264.88,523.6
3769036,278,,,,,,,,8CM ROD(POSTERIOR),678,271.2,0,576.3,576.3,SKIPPED,515.28,515.28,576.3,576.3,576.3,285.71,332.22,332.22,0,203.4,291.54,291.54,576.3
3769037,278,,,,,,,,SM-XL ARCHED CROSS CONNECTOR(POSTERIOR),3825,1530,0,3251.25,3251.25,SKIPPED,2907,2907,3251.25,3251.25,3251.25,1611.86,1874.25,1874.25,0,1147.5,1644.75,1644.75,3251.25
3769038,278,,,,,,,,4.0 X 14 SCREWS,951,380.4,0,808.35,808.35,SKIPPED,722.76,722.76,808.35,808.35,808.35,400.75,465.99,465.99,0,285.3,408.93,408.93,808.35
3769039,272,,,,,,,,FIBULA SEGMENT CAST = 15CM,1392,556.8,0,1183.2,1183.2,SKIPPED,1057.92,1057.92,1183.2,1183.2,1183.2,586.59,682.08,682.08,0,417.6,598.56,598.56,1183.2
3769040,272,,,,,,,,CANNULATED DRILL BIT(ALL SIZES),504.7,201.88,0,429,429,SKIPPED,383.57,383.57,429,429,429,212.68,247.3,247.3,0,151.41,217.02,217.02,429
3769041,278,,,,,,,,3.5mm LO-PRO SCREW,375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3769042,278,C1823,,,,,,,IPG-PROTEGE(SJM) REF#3789,64738,25895.2,0,55027.3,55027.3,SKIPPED,0,0,55027.3,55027.3,55027.3,27280.59,31721.62,31721.62,0,19421.4,27837.34,27837.34,55027.3
3769043,272,,,,,,,,PATIENT PROGRAMER(SJM) REF#3852,3250,1300,0,2762.5,2762.5,SKIPPED,2470,2470,2762.5,2762.5,2762.5,1369.55,1592.5,1592.5,0,975,1397.5,1397.5,2762.5
3769044,272,,,,,,,,PRODIGY CHARGING SYSTEM(SJM) REF#3730,7180,2872,0,6103,6103,SKIPPED,5456.8,5456.8,6103,6103,6103,3025.65,3518.2,3518.2,0,2154,3087.4,3087.4,6103
3769045,278,,,,,,,,JAMSHIDI,775,310,0,658.75,658.75,SKIPPED,589,589,658.75,658.75,658.75,326.58,379.75,379.75,0,232.5,333.25,333.25,658.75
3769046,278,,,,,,,,TRINNET HYDRATED CERV BONE 5-12MM,5000,2000,0,4250,4250,SKIPPED,3800,3800,4250,4250,4250,2107,2450,2450,0,1500,2150,2150,4250
3769047,278,,,,,,,,5.0MM VALCP PLATE 8 HOLE,5848,2339.2,0,4970.8,4970.8,SKIPPED,4444.48,4444.48,4970.8,4970.8,4970.8,2464.35,2865.52,2865.52,0,1754.4,2514.64,2514.64,4970.8
3769048,272,,,,,,,,DHHS HELIX BLADE-95MM,940,376,0,799,799,SKIPPED,714.4,714.4,799,799,799,396.12,460.6,460.6,0,282,404.2,404.2,799
3769049,272,,,,,,,,THORASIC PEDICLE PROBE,3131,1252.4,0,2661.35,2661.35,SKIPPED,2379.56,2379.56,2661.35,2661.35,2661.35,1319.4,1534.19,1534.19,0,939.3,1346.33,1346.33,2661.35
3769050,272,,,,,,,,PEDICLE AWL,828,331.2,0,703.8,703.8,SKIPPED,629.28,629.28,703.8,703.8,703.8,348.92,405.72,405.72,0,248.4,356.04,356.04,703.8
3769051,272,,,,,,,,2.5 CURIFORM,780,312,0,663,663,SKIPPED,592.8,592.8,663,663,663,328.69,382.2,382.2,0,234,335.4,335.4,663
3769052,272,,,,,,,,CLICK X(SYNTHES),780,312,0,663,663,SKIPPED,592.8,592.8,663,663,663,328.69,382.2,382.2,0,234,335.4,335.4,663
3769053,278,,,,,,,,MAX BRAID PE(TELEFLEX),63,25.2,0,53.55,53.55,SKIPPED,47.88,47.88,53.55,53.55,53.55,26.55,30.87,30.87,0,18.9,27.09,27.09,53.55
3769054,279,,,,,,,,GAIT BELTS,10.6,4.24,0,9.01,9.01,SKIPPED,8.06,8.06,9.01,9.01,9.01,4.47,5.19,5.19,0,3.18,4.56,4.56,9.01
3769055,272,,,,,,,,HELIX BLADE,940,376,0,799,799,SKIPPED,714.4,714.4,799,799,799,396.12,460.6,460.6,0,282,404.2,404.2,799
3769056,278,,,,,,,,75mm FIXED TIBIA PLATE,4140,1656,0,3519,3519,SKIPPED,3146.4,3146.4,3519,3519,3519,1744.6,2028.6,2028.6,0,1242,1780.2,1780.2,3519
3769057,278,,,,,,,,11x71/75 EI/PS BEARING,5013,2005.2,0,4261.05,4261.05,SKIPPED,3809.88,3809.88,4261.05,4261.05,4261.05,2112.48,2456.37,2456.37,0,1503.9,2155.59,2155.59,4261.05
3769058,278,,,,,,,,10x40 SLINED STEM,3860,1544,0,3281,3281,SKIPPED,2933.6,2933.6,3281,3281,3281,1626.6,1891.4,1891.4,0,1158,1659.8,1659.8,3281
3769059,278,,,,,,,,CRUCIATE WING-LG,2275,910,0,1933.75,1933.75,SKIPPED,1729,1729,1933.75,1933.75,1933.75,958.68,1114.75,1114.75,0,682.5,978.25,978.25,1933.75
3769060,278,,,,,,,,75mm 360 TIBIA TRAY,7023,2809.2,0,5969.55,5969.55,SKIPPED,5337.48,5337.48,5969.55,5969.55,5969.55,2959.49,3441.27,3441.27,0,2106.9,3019.89,3019.89,5969.55
3769062,274,,,,,,,,PARAFO BOOT,284,113.6,0,241.4,241.4,SKIPPED,215.84,215.84,241.4,241.4,241.4,119.68,139.16,139.16,0,85.2,122.12,122.12,241.4
3769063,278,,,,,,,,SYNCHROMED II PUMP #NGP423334H,29500,11800,0,25075,25075,SKIPPED,22420,22420,25075,25075,25075,12431.3,14455,14455,0,8850,12685,12685,25075
3769064,278,,,,,,,,8731SC INTRTHECAL CATHERTER # HG0QFEL01,1824,729.6,0,1550.4,1550.4,SKIPPED,1386.24,1386.24,1550.4,1550.4,1550.4,768.63,893.76,893.76,0,547.2,784.32,784.32,1550.4
3769065,272,,,,,,,,COFLEX,29.5,11.8,0,25.08,25.08,SKIPPED,22.42,22.42,25.08,25.08,25.08,12.44,14.46,14.46,0,8.85,12.69,12.69,25.08
3769066,272,,,,,,,,ABSORBABLE RELOAD REF#VLOCA008L-COVIDIEN,249.7,99.88,0,212.24,212.24,SKIPPED,189.77,189.77,212.24,212.24,212.24,105.22,122.35,122.35,0,74.91,107.37,107.37,212.24
3769067,278,,,,,,,,INTRODUCER FOR GASTROSTOMY FEEDING TUBE,836,334.4,0,710.6,710.6,SKIPPED,635.36,635.36,710.6,710.6,710.6,352.29,409.64,409.64,0,250.8,359.48,359.48,710.6
3769068,278,,,,,,,,MIC GASTROSTOMY FEEDING TUBE,181,72.4,0,153.85,153.85,SKIPPED,137.56,137.56,153.85,153.85,153.85,76.27,88.69,88.69,0,54.3,77.83,77.83,153.85
3769069,278,,,,,,,,ENDO AUTO SUTURE,992,396.8,0,843.2,843.2,SKIPPED,753.92,753.92,843.2,843.2,843.2,418.03,486.08,486.08,0,297.6,426.56,426.56,843.2
3769070,278,,,,,,,,LEAD KIT 60CM-OCTRODE REF#3186,8439,3375.6,0,7173.15,7173.15,SKIPPED,6413.64,6413.64,7173.15,7173.15,7173.15,3556.19,4135.11,4135.11,0,2531.7,3628.77,3628.77,7173.15
3769071,278,,,,,,,,SWIFT LOCK ANCHOR-REF#1192,919,367.6,0,781.15,781.15,SKIPPED,698.44,698.44,781.15,781.15,781.15,387.27,450.31,450.31,0,275.7,395.17,395.17,781.15
3769072,272,,,,,,,,PRODIGY CHARGING SYSTEM-REF#3730,7539,3015.6,0,6408.15,6408.15,SKIPPED,5729.64,5729.64,6408.15,6408.15,6408.15,3176.93,3694.11,3694.11,0,2261.7,3241.77,3241.77,6408.15
3769073,272,,,,,,,,PATIENT PROGRAMER SPINE-REF#3853,3412.5,1365,0,2900.62,2900.62,SKIPPED,2593.5,2593.5,2900.62,2900.62,2900.62,1438.03,1672.12,1672.12,0,1023.75,1467.38,1467.38,2900.62
3769074,272,,,,,,,,MULTI LEAD TRIAL CABLE-REF#3013,550,220,0,467.5,467.5,SKIPPED,418,418,467.5,467.5,467.5,231.77,269.5,269.5,0,165,236.5,236.5,467.5
3769075,278,C1820,,,,,,,PROTEGE MRI IPG 16CH-REF# 3771,104100,41640,0,88485,88485,SKIPPED,79116,79116,88485,88485,88485,43867.74,51009,51009,0,31230,44763,44763,88485
3769076,278,,,,,,,,3CC STIMUBLAST CB PASTE,1250,500,0,1062.5,1062.5,SKIPPED,950,950,1062.5,1062.5,1062.5,526.75,612.5,612.5,0,375,537.5,537.5,1062.5
3769077,278,,,,,,,,3.0x34MM PARTIALLY THREADED SCREW,375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
3769078,272,,,,,,,,T-20 TORX DRIVER,798,319.2,0,678.3,678.3,SKIPPED,606.48,606.48,678.3,678.3,678.3,336.28,391.02,391.02,0,239.4,343.14,343.14,678.3
3769079,278,,,,,,,,7.5 SCREWS,4824,1929.6,0,4100.4,4100.4,SKIPPED,3666.24,3666.24,4100.4,4100.4,4100.4,2032.83,2363.76,2363.76,0,1447.2,2074.32,2074.32,4100.4
3769080,278,,,,,,,,TRINNECT (ALL SIZES) BIOMET,5250,2100,0,4462.5,4462.5,SKIPPED,3990,3990,4462.5,4462.5,4462.5,2212.35,2572.5,2572.5,0,1575,2257.5,2257.5,4462.5
3769081,272,,,,,,,,ENDOMARK,80,32,0,68,68,SKIPPED,60.8,60.8,68,68,68,33.71,39.2,39.2,0,24,34.4,34.4,68
3769082,272,,,,,,,,OPTIFOAM SILICONE FACE 3X3,7.58,3.03,0,6.44,6.44,SKIPPED,5.76,5.76,6.44,6.44,6.44,3.19,3.71,3.71,0,2.27,3.26,3.26,6.44
3769083,272,,,,,,,,OPTIFOAM SILICONE FACE 4X4,10.64,4.26,0,9.04,9.04,SKIPPED,8.09,8.09,9.04,9.04,9.04,4.49,5.21,5.21,0,3.19,4.58,4.58,9.04
3769084,272,,,,,,,,OPTIFOAM SILICONE FACE 6X6,19.38,7.75,0,16.47,16.47,SKIPPED,14.73,14.73,16.47,16.47,16.47,8.16,9.5,9.5,0,5.81,8.33,8.33,16.47
3769085,272,,,,,,,,OPTIFOAM SACRUM 10X9,11.68,4.67,0,9.93,9.93,SKIPPED,8.88,8.88,9.93,9.93,9.93,4.92,5.72,5.72,0,3.5,5.02,5.02,9.93
3769086,272,,,,,,,,ETHICON PHYSIOMESH 20X30 CM,4807.12,1922.85,0,4086.05,4086.05,SKIPPED,3653.41,3653.41,4086.05,4086.05,4086.05,2025.72,2355.49,2355.49,0,1442.14,2067.06,2067.06,4086.05
3769087,272,,,,,,,,ETHICON SECURESTRAP,1252,500.8,0,1064.2,1064.2,SKIPPED,951.52,951.52,1064.2,1064.2,1064.2,527.59,613.48,613.48,0,375.6,538.36,538.36,1064.2
3769088,272,,,,,,,,JUMPSTART COMP. DRESSING,24,9.6,0,20.4,20.4,SKIPPED,18.24,18.24,20.4,20.4,20.4,10.11,11.76,11.76,0,7.2,10.32,10.32,20.4
3769089,278,,,,,,,,LO-PRO MTP PLATE,2000,800,0,1700,1700,SKIPPED,1520,1520,1700,1700,1700,842.8,980,980,0,600,860,860,1700
3769090,272,,,,,,,,AQUACEL AG 3.5x10,182.46,72.98,0,155.09,155.09,SKIPPED,138.67,138.67,155.09,155.09,155.09,76.89,89.41,89.41,0,54.74,78.46,78.46,155.09
3769091,272,,,,,,,,AQUACEL AG 3.5x12,203.32,81.33,0,172.82,172.82,SKIPPED,154.52,154.52,172.82,172.82,172.82,85.68,99.63,99.63,0,61,87.43,87.43,172.82
3769092,270,,,,,,,,Aquacel AG Surgical 3.5x4,119.92,47.97,0,101.93,101.93,SKIPPED,91.14,91.14,101.93,101.93,101.93,50.54,58.76,58.76,0,35.98,51.57,51.57,101.93
3769093,272,,,,,,,,POWERPICC-5FR DUAL-LUME CATH TRAY,602.3,240.92,0,511.96,511.96,SKIPPED,457.75,457.75,511.96,511.96,511.96,253.81,295.13,295.13,0,180.69,258.99,258.99,511.96
3769094,258,,,,,,,,THERAPY FLUID- DIALYSIS,47.5,19,0,40.38,40.38,SKIPPED,36.1,36.1,40.38,40.38,40.38,20.02,23.28,23.28,0,14.25,20.43,20.43,40.38
3769095,270,,,,,,,,DIALYSIS CARTRIDGE,370,148,0,314.5,314.5,SKIPPED,281.2,281.2,314.5,314.5,314.5,155.92,181.3,181.3,0,111,159.1,159.1,314.5
3769096,270,,,,,,,,AQUACEL PRO SACRAL,24.12,9.65,0,20.5,20.5,SKIPPED,18.33,18.33,20.5,20.5,20.5,10.16,11.82,11.82,0,7.24,10.37,10.37,20.5
3769097,270,,,,,,,,AQUACEL HEEL,10.11,4.04,0,8.59,8.59,SKIPPED,7.68,7.68,8.59,8.59,8.59,4.26,4.95,4.95,0,3.03,4.35,4.35,8.59
3769098,270,,,,,,,,AQUACEL AG NON 5X5,9.91,3.96,0,8.42,8.42,SKIPPED,7.53,7.53,8.42,8.42,8.42,4.17,4.86,4.86,0,2.97,4.26,4.26,8.42
3769099,270,,,,,,,,AQUACEL AG 7X7 NON,17.54,7.02,0,14.91,14.91,SKIPPED,13.33,13.33,14.91,14.91,14.91,7.39,8.59,8.59,0,5.26,7.54,7.54,14.91
3769100,270,,,,,,,,AQUACEL EXTRA AG 4X5,20.63,8.25,0,17.54,17.54,SKIPPED,15.68,15.68,17.54,17.54,17.54,8.69,10.11,10.11,0,6.19,8.87,8.87,17.54
3769101,270,,,,,,,,AQUACEL EXTRA AG NON 4X5,7.86,3.14,0,6.68,6.68,SKIPPED,5.97,5.97,6.68,6.68,6.68,3.31,3.85,3.85,0,2.36,3.38,3.38,6.68
3769102,270,,,,,,,,ZINC OXIDE,77.46,30.98,0,65.84,65.84,SKIPPED,58.87,58.87,65.84,65.84,65.84,32.64,37.96,37.96,0,23.24,33.31,33.31,65.84
3769103,270,,,,,,,,"FLEXI SEAL, RECTAL",416,166.4,0,353.6,353.6,SKIPPED,316.16,316.16,353.6,353.6,353.6,175.3,203.84,203.84,0,124.8,178.88,178.88,353.6
3769104,272,,,,,,,,AQUACEL SURG. 3x6,58.24,23.3,0,49.5,49.5,SKIPPED,44.26,44.26,49.5,49.5,49.5,24.54,28.54,28.54,0,17.47,25.04,25.04,49.5
3769106,270,,,,,,,,BASIC PACK,84.55,33.82,0,71.87,71.87,SKIPPED,64.26,64.26,71.87,71.87,71.87,35.63,41.43,41.43,0,25.36,36.36,36.36,71.87
3769107,270,,,,,,,,BASIN SET,10.98,4.39,0,9.33,9.33,SKIPPED,8.34,8.34,9.33,9.33,9.33,4.63,5.38,5.38,0,3.29,4.72,4.72,9.33
3769108,270,,,,,,,,C-ARM DRAPE,91.8,36.72,0,78.03,78.03,SKIPPED,69.77,69.77,78.03,78.03,78.03,38.68,44.98,44.98,0,27.54,39.47,39.47,78.03
3769109,270,,,,,,,,DRAPE LAP INCISE,9.94,3.98,0,8.45,8.45,SKIPPED,7.55,7.55,8.45,8.45,8.45,4.18,4.87,4.87,0,2.98,4.27,4.27,8.45
3769110,270,,,,,,,,X-LONG EXTRM DRAPE,9.87,3.95,0,8.39,8.39,SKIPPED,7.5,7.5,8.39,8.39,8.39,4.16,4.84,4.84,0,2.96,4.24,4.24,8.39
3769111,270,,,,,,,,DRAPE LAPAROTOMY,9.23,3.69,0,7.85,7.85,SKIPPED,7.01,7.01,7.85,7.85,7.85,3.89,4.52,4.52,0,2.77,3.97,3.97,7.85
3769112,270,,,,,,,,DRAPE SHEET,10.55,4.22,0,8.97,8.97,SKIPPED,8.02,8.02,8.97,8.97,8.97,4.45,5.17,5.17,0,3.16,4.54,4.54,8.97
3769113,270,,,,,,,,EXTREMETY SHEET,12.85,5.14,0,10.92,10.92,SKIPPED,9.77,9.77,10.92,10.92,10.92,5.42,6.3,6.3,0,3.86,5.53,5.53,10.92
3769114,270,,,,,,,,GENERAL PACK,132.85,53.14,0,112.92,112.92,SKIPPED,100.97,100.97,112.92,112.92,112.92,55.99,65.1,65.1,0,39.86,57.13,57.13,112.92
3769115,270,,,,,,,,LAP CHOLE PACK,8.4,3.36,0,7.14,7.14,SKIPPED,6.38,6.38,7.14,7.14,7.14,3.54,4.12,4.12,0,2.52,3.61,3.61,7.14
3769116,270,,,,,,,,PODIATRY PACK,125.98,50.39,0,107.08,107.08,SKIPPED,95.74,95.74,107.08,107.08,107.08,53.09,61.73,61.73,0,37.79,54.17,54.17,107.08
3769117,272,,,,,,,,DERMABOND,79.3,31.72,0,67.4,67.4,SKIPPED,60.27,60.27,67.4,67.4,67.4,33.42,38.86,38.86,0,23.79,34.1,34.1,67.4
3769118,272,,,,,,,,KERLIX ROLL,13.65,5.46,0,11.6,11.6,SKIPPED,10.37,10.37,11.6,11.6,11.6,5.75,6.69,6.69,0,4.1,5.87,5.87,11.6
3769119,270,,,,,,,,COTTONOID PATTIES,16.37,6.55,0,13.91,13.91,SKIPPED,12.44,12.44,13.91,13.91,13.91,6.9,8.02,8.02,0,4.91,7.04,7.04,13.91
3769120,272,,,,,,,,"GLOVES, STERILE",6.5,2.6,0,5.52,5.52,SKIPPED,4.94,4.94,5.52,5.52,5.52,2.74,3.18,3.18,0,1.95,2.8,2.8,5.52
3769121,272,,,,,,,,"GOWN, STERILE",12.8,5.12,0,10.88,10.88,SKIPPED,9.73,9.73,10.88,10.88,10.88,5.39,6.27,6.27,0,3.84,5.5,5.5,10.88
3769122,270,,,,,,,,LIGHT HANDLES,7.55,3.02,0,6.42,6.42,SKIPPED,5.74,5.74,6.42,6.42,6.42,3.18,3.7,3.7,0,2.26,3.25,3.25,6.42
3769123,270,,,,,,,,SUTURE,12.75,5.1,0,10.84,10.84,SKIPPED,9.69,9.69,10.84,10.84,10.84,5.37,6.25,6.25,0,3.82,5.48,5.48,10.84
3769124,270,,,,,,,,BOVIE UNIT,60.7,24.28,0,51.6,51.6,SKIPPED,46.13,46.13,51.6,51.6,51.6,25.58,29.74,29.74,0,18.21,26.1,26.1,51.6
3769125,270,,,,,,,,PHOTO DOCUMENTATION,28.6,11.44,0,24.31,24.31,SKIPPED,21.74,21.74,24.31,24.31,24.31,12.05,14.01,14.01,0,8.58,12.3,12.3,24.31
3769126,270,,,,,,,,VIDEO TOWER,685,274,0,582.25,582.25,SKIPPED,520.6,520.6,582.25,582.25,582.25,288.66,335.65,335.65,0,205.5,294.55,294.55,582.25
3769127,272,,,,,,,,DRILL ORTHO/NEURO,59.5,23.8,0,50.58,50.58,SKIPPED,45.22,45.22,50.58,50.58,50.58,25.08,29.16,29.16,0,17.85,25.59,25.59,50.58
3769128,270,,,,,,,,MINI LEFGT APPARAT SYNTES,479,191.6,0,407.15,407.15,SKIPPED,364.04,364.04,407.15,407.15,407.15,201.85,234.71,234.71,0,143.7,205.97,205.97,407.15
3769129,270,,,,,,,,K-WIRE PIN CAP,11.7,4.68,0,9.94,9.94,SKIPPED,8.89,8.89,9.94,9.94,9.94,4.93,5.73,5.73,0,3.51,5.03,5.03,9.94
3769130,270,,,,,,,,MITEK UNDERWATER BOVIE,690.5,276.2,0,586.92,586.92,SKIPPED,524.78,524.78,586.92,586.92,586.92,290.98,338.34,338.34,0,207.15,296.92,296.92,586.92
3769131,270,,,,,,,,TOURNAQUET UNIT,55.95,22.38,0,47.56,47.56,SKIPPED,42.52,42.52,47.56,47.56,47.56,23.58,27.42,27.42,0,16.78,24.06,24.06,47.56
3769132,270,,,,,,,,STERILE INSTRUMENT TRAY,52,20.8,0,44.2,44.2,SKIPPED,39.52,39.52,44.2,44.2,44.2,21.91,25.48,25.48,0,15.6,22.36,22.36,44.2
3769133,270,,,,,,,,PRE-OP,376.23,150.49,0,319.8,319.8,SKIPPED,285.93,285.93,319.8,319.8,319.8,158.54,184.35,184.35,0,112.87,161.78,161.78,319.8
3769134,710,,,,,,,,PHASE 2 RECOVERY,201.02,80.41,0,170.87,170.87,SKIPPED,152.78,152.78,170.87,170.87,170.87,84.71,98.5,98.5,0,60.31,86.44,86.44,170.87
3769135,272,,,,,,,,IV START KIT,10.3,4.12,0,8.76,8.76,SKIPPED,7.83,7.83,8.76,8.76,8.76,4.34,5.05,5.05,0,3.09,4.43,4.43,8.76
3769136,272,,,,,,,,SECONDARY TUBING,5.5,2.2,0,4.68,4.68,SKIPPED,4.18,4.18,4.68,4.68,4.68,2.32,2.7,2.7,0,1.65,2.37,2.37,4.68
3769137,270,,,,,,,,MOUTH RINSE,5.4,2.16,0,4.59,4.59,SKIPPED,4.1,4.1,4.59,4.59,4.59,2.27,2.65,2.65,0,1.62,2.32,2.32,4.59
3769138,270,,,,,,,,MARKING PEN,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
3769139,270,,,,,,,,ORANGE Z GLIDER,3.9,1.56,0,3.32,3.32,SKIPPED,2.96,2.96,3.32,3.32,3.32,1.65,1.91,1.91,0,1.17,1.68,1.68,3.32
3769140,270,,,,,,,,WARMING FILTER,23,9.2,0,19.55,19.55,SKIPPED,17.48,17.48,19.55,19.55,19.55,9.69,11.27,11.27,0,6.9,9.89,9.89,19.55
3769141,270,,,,,,,,CLIPPERS,50,20,0,42.5,42.5,SKIPPED,38,38,42.5,42.5,42.5,21.07,24.5,24.5,0,15,21.5,21.5,42.5
3769142,270,,,,,,,,CHLORA PREP,4.55,1.82,0,3.87,3.87,SKIPPED,3.46,3.46,3.87,3.87,3.87,1.92,2.23,2.23,0,1.36,1.96,1.96,3.87
3769143,270,,,,,,,,OR TOWELS,4.44,1.78,0,3.77,3.77,SKIPPED,3.37,3.37,3.77,3.77,3.77,1.87,2.18,2.18,0,1.33,1.91,1.91,3.77
3769144,270,,,,,,,,VICRYL,21.28,8.51,0,18.09,18.09,SKIPPED,16.17,16.17,18.09,18.09,18.09,8.97,10.43,10.43,0,6.38,9.15,9.15,18.09
3769145,270,,,,,,,,SILK,16.36,6.54,0,13.91,13.91,SKIPPED,12.43,12.43,13.91,13.91,13.91,6.89,8.02,8.02,0,4.91,7.03,7.03,13.91
3769146,270,,,,,,,,SURGILON,10.32,4.13,0,8.77,8.77,SKIPPED,7.84,7.84,8.77,8.77,8.77,4.35,5.06,5.06,0,3.1,4.44,4.44,8.77
3769147,270,,,,,,,,MONOCRYL,9.76,3.9,0,8.3,8.3,SKIPPED,7.42,7.42,8.3,8.3,8.3,4.12,4.78,4.78,0,2.93,4.2,4.2,8.3
3769148,270,,,,,,,,PROLENE SUTURE,72,28.8,0,61.2,61.2,SKIPPED,54.72,54.72,61.2,61.2,61.2,30.34,35.28,35.28,0,21.6,30.96,30.96,61.2
3769149,270,,,,,,,,ETHILON,20.24,8.1,0,17.2,17.2,SKIPPED,15.38,15.38,17.2,17.2,17.2,8.53,9.92,9.92,0,6.07,8.7,8.7,17.2
3769150,270,,,,,,,,PDS,36.48,14.59,0,31.01,31.01,SKIPPED,27.72,27.72,31.01,31.01,31.01,15.38,17.88,17.88,0,10.94,15.69,15.69,31.01
3769151,270,,,,,,,,CHROMIC,6.58,2.63,0,5.59,5.59,SKIPPED,5,5,5.59,5.59,5.59,2.77,3.22,3.22,0,1.97,2.83,2.83,5.59
3769152,270,,,,,,,,ETHIBOND,35.36,14.14,0,30.06,30.06,SKIPPED,26.87,26.87,30.06,30.06,30.06,14.9,17.33,17.33,0,10.61,15.2,15.2,30.06
3769153,270,,,,,,,,NUROLONE,28.84,11.54,0,24.51,24.51,SKIPPED,21.92,21.92,24.51,24.51,24.51,12.15,14.13,14.13,0,8.65,12.4,12.4,24.51
3769154,270,,,,,,,,MAXBRIAD,50.84,20.34,0,43.21,43.21,SKIPPED,38.64,38.64,43.21,43.21,43.21,21.42,24.91,24.91,0,15.25,21.86,21.86,43.21
3769155,270,,,,,,,,TRICON,249.94,99.98,0,212.45,212.45,SKIPPED,189.95,189.95,212.45,212.45,212.45,105.32,122.47,122.47,0,74.98,107.47,107.47,212.45
3769156,270,,,,,,,,POWER PICC 6F 3L,470,188,0,399.5,399.5,SKIPPED,357.2,357.2,399.5,399.5,399.5,198.06,230.3,230.3,0,141,202.1,202.1,399.5
3769157,270,,,,,,,,ORTHO HOOD,103.01,41.2,0,87.56,87.56,SKIPPED,78.29,78.29,87.56,87.56,87.56,43.4,50.47,50.47,0,30.9,44.29,44.29,87.56
3769158,270,,,,,,,,2-TIER BACK TABLE COVER,71.4,28.56,0,60.69,60.69,SKIPPED,54.26,54.26,60.69,60.69,60.69,30.09,34.99,34.99,0,21.42,30.7,30.7,60.69
3769159,272,,,,,,,,BLUNT NEEDLE,2.25,0.9,0,1.91,1.91,SKIPPED,1.71,1.71,1.91,1.91,1.91,0.95,1.1,1.1,0,0.68,0.97,0.97,1.91
3769160,272,,,,,,,,"INSULATED BOVIE TIP 4""",63.2,25.28,0,53.72,53.72,SKIPPED,48.03,48.03,53.72,53.72,53.72,26.64,30.97,30.97,0,18.96,27.18,27.18,53.72
3769161,272,,,,,,,,COATED INSULATED BOVIE TIP,16.6,6.64,0,14.11,14.11,SKIPPED,12.62,12.62,14.11,14.11,14.11,7,8.13,8.13,0,4.98,7.14,7.14,14.11
3769162,272,,,,,,,,BIPOLAR DUAL CORD,61.36,24.54,0,52.16,52.16,SKIPPED,46.63,46.63,52.16,52.16,52.16,25.85,30.07,30.07,0,18.41,26.38,26.38,52.16
3769163,272,,,,,,,,CODMAN SURGICAL PATTIES 1X1,9.08,3.63,0,7.72,7.72,SKIPPED,6.9,6.9,7.72,7.72,7.72,3.82,4.45,4.45,0,2.72,3.9,3.9,7.72
3769164,272,,,,,,,,VESSEL LOOPS,4.84,1.94,0,4.11,4.11,SKIPPED,3.68,3.68,4.11,4.11,4.11,2.04,2.37,2.37,0,1.45,2.08,2.08,4.11
3769165,270,,,,,,,,OR BED,111.36,44.54,0,94.66,94.66,SKIPPED,84.63,84.63,94.66,94.66,94.66,46.92,54.57,54.57,0,33.41,47.88,47.88,94.66
3769166,270,,,,,,,,PAIN SURGERY SPECIALTY BED,55.82,22.33,0,47.45,47.45,SKIPPED,42.42,42.42,47.45,47.45,47.45,23.52,27.35,27.35,0,16.75,24,24,47.45
3769167,278,,,,,,,,CIRCULAR LOCK SCREWS,908,363.2,0,771.8,771.8,SKIPPED,690.08,690.08,771.8,771.8,771.8,382.63,444.92,444.92,0,272.4,390.44,390.44,771.8
3769168,272,,,,,,,,STRADIS TOTAL JOINT PACK,263.36,105.34,0,223.86,223.86,SKIPPED,200.15,200.15,223.86,223.86,223.86,110.98,129.05,129.05,0,79.01,113.24,113.24,223.86
3769169,272,,,,,,,,STRADIS GENERAL PACK,167.62,67.05,0,142.48,142.48,SKIPPED,127.39,127.39,142.48,142.48,142.48,70.64,82.13,82.13,0,50.29,72.08,72.08,142.48
3769170,272,,,,,,,,STRADIS NEURO PACK,232.74,93.1,0,197.83,197.83,SKIPPED,176.88,176.88,197.83,197.83,197.83,98.08,114.04,114.04,0,69.82,100.08,100.08,197.83
3769171,272,,,,,,,,STRADIS LAP CHOLE PACK,228.68,91.47,0,194.38,194.38,SKIPPED,173.8,173.8,194.38,194.38,194.38,96.36,112.05,112.05,0,68.6,98.33,98.33,194.38
3769172,272,,,,,,,,STRADIS PAIN PACK,45.08,18.03,0,38.32,38.32,SKIPPED,34.26,34.26,38.32,38.32,38.32,18.99,22.09,22.09,0,13.52,19.38,19.38,38.32
3769173,272,,,,,,,,STRADIS KNEE ARTHRO PACK,183.96,73.58,0,156.37,156.37,SKIPPED,139.81,139.81,156.37,156.37,156.37,77.52,90.14,90.14,0,55.19,79.1,79.1,156.37
3769174,272,,,,,,,,STRADIS ORTHO MINOR PACK,157.72,63.09,0,134.06,134.06,SKIPPED,119.87,119.87,134.06,134.06,134.06,66.46,77.28,77.28,0,47.32,67.82,67.82,134.06
3769175,272,,,,,,,,STRADIS SHOULDER ARTHRO PACK,171.04,68.42,0,145.38,145.38,SKIPPED,129.99,129.99,145.38,145.38,145.38,72.08,83.81,83.81,0,51.31,73.55,73.55,145.38
3769176,270,,,,,,,,NEEDLE BOX,32,12.8,0,27.2,27.2,SKIPPED,24.32,24.32,27.2,27.2,27.2,13.48,15.68,15.68,0,9.6,13.76,13.76,27.2
3769177,270,,,,,,,,ALEXIS RETRACTOR,317.54,127.02,0,269.91,269.91,SKIPPED,241.33,241.33,269.91,269.91,269.91,133.81,155.59,155.59,0,95.26,136.54,136.54,269.91
3769178,272,,,,,,,,15 FR JP DRAIN,72,28.8,0,61.2,61.2,SKIPPED,54.72,54.72,61.2,61.2,61.2,30.34,35.28,35.28,0,21.6,30.96,30.96,61.2
3769179,270,,,,,,,,CORE BX PUCH,85.7,34.28,0,72.84,72.84,SKIPPED,65.13,65.13,72.84,72.84,72.84,36.11,41.99,41.99,0,25.71,36.85,36.85,72.84
3769180,270,,,,,,,,SCOPE WARMER,17.85,7.14,0,15.17,15.17,SKIPPED,13.57,13.57,15.17,15.17,15.17,7.53,8.75,8.75,0,5.36,7.68,7.68,15.17
3769181,270,,,,,,,,PUNCTURE CLOSURE DEVICE,92.4,36.96,0,78.54,78.54,SKIPPED,70.22,70.22,78.54,78.54,78.54,38.94,45.28,45.28,0,27.72,39.73,39.73,78.54
3769182,272,,,,,,,,ENDO STICH,1031.58,412.63,0,876.84,876.84,SKIPPED,784,784,876.84,876.84,876.84,434.71,505.47,505.47,0,309.47,443.58,443.58,876.84
3769183,270,,,,,,,,ENDO STICH RELOAD,310.17,124.07,0,263.64,263.64,SKIPPED,235.73,235.73,263.64,263.64,263.64,130.7,151.98,151.98,0,93.05,133.37,133.37,263.64
3769184,270,,,,,,,,PURSE STRING DEVICE,336.99,134.8,0,286.44,286.44,SKIPPED,256.11,256.11,286.44,286.44,286.44,142.01,165.13,165.13,0,101.1,144.91,144.91,286.44
3769185,272,,,,,,,,GIA CUTTER,219.7,87.88,0,186.74,186.74,SKIPPED,166.97,166.97,186.74,186.74,186.74,92.58,107.65,107.65,0,65.91,94.47,94.47,186.74
3769186,272,,,,,,,,GIA RELOADS,1082.5,433,0,920.12,920.12,SKIPPED,822.7,822.7,920.12,920.12,920.12,456.17,530.42,530.42,0,324.75,465.48,465.48,920.12
3769187,272,,,,,,,,SUTURE PASSER,39,15.6,0,33.15,33.15,SKIPPED,29.64,29.64,33.15,33.15,33.15,16.43,19.11,19.11,0,11.7,16.77,16.77,33.15
3769188,270,,,,,,,,SUCTION IRRIGATOR,89.02,35.61,0,75.67,75.67,SKIPPED,67.66,67.66,75.67,75.67,75.67,37.51,43.62,43.62,0,26.71,38.28,38.28,75.67
3769189,278,,,,,,,,3.75x14 SCREWS (GENESYS SPINE),1155,462,0,981.75,981.75,SKIPPED,877.8,877.8,981.75,981.75,981.75,486.72,565.95,565.95,0,346.5,496.65,496.65,981.75
3769190,270,,,,,,,,CTRACK GALAXY,68.25,27.3,0,58.01,58.01,SKIPPED,51.87,51.87,58.01,58.01,58.01,28.76,33.44,33.44,0,20.48,29.35,29.35,58.01
3769191,272,,,,,,,,ORTHO SENSOR,1390,556,0,1181.5,1181.5,SKIPPED,1056.4,1056.4,1181.5,1181.5,1181.5,585.75,681.1,681.1,0,417,597.7,597.7,1181.5
3769192,270,,,,,,,,PLASTIC EQUIPMENT,52.5,21,0,44.62,44.62,SKIPPED,39.9,39.9,44.62,44.62,44.62,22.13,25.72,25.72,0,15.75,22.58,22.58,44.62
3769193,270,,,,,,,,DERMATOME,50.4,20.16,0,42.84,42.84,SKIPPED,38.3,38.3,42.84,42.84,42.84,21.24,24.7,24.7,0,15.12,21.67,21.67,42.84
3769194,270,,,,,,,,CHEST TUBE TRAY REF#MNS2995 CENTURION,86.5,34.6,0,73.52,73.52,SKIPPED,65.74,65.74,73.52,73.52,73.52,36.46,42.38,42.38,0,25.95,37.2,37.2,73.52
3769195,270,,,,,,,,VEIN PACK,54.95,21.98,0,46.71,46.71,SKIPPED,41.76,41.76,46.71,46.71,46.71,23.16,26.93,26.93,0,16.48,23.63,23.63,46.71
3769196,270,,,,,,,,INSTRAMENT PACK,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769197,270,,,,,,,,MICROINTRODUCER,31.95,12.78,0,27.16,27.16,SKIPPED,24.28,24.28,27.16,27.16,27.16,13.47,15.66,15.66,0,9.58,13.74,13.74,27.16
3769198,272,,,,,,,,INFILTRATION TUBING,8.95,3.58,0,7.61,7.61,SKIPPED,6.8,6.8,7.61,7.61,7.61,3.77,4.39,4.39,0,2.68,3.85,3.85,7.61
3769199,270,,,,,,,,SF INTRO KIT,31.95,12.78,0,27.16,27.16,SKIPPED,24.28,24.28,27.16,27.16,27.16,13.47,15.66,15.66,0,9.58,13.74,13.74,27.16
3769200,270,,,,,,,,GUIDE WIRE VEIN,11.95,4.78,0,10.16,10.16,SKIPPED,9.08,9.08,10.16,10.16,10.16,5.04,5.86,5.86,0,3.58,5.14,5.14,10.16
3769201,270,,,,,,,,ECHONEGIC NEEDLE,4.95,1.98,0,4.21,4.21,SKIPPED,3.76,3.76,4.21,4.21,4.21,2.09,2.43,2.43,0,1.48,2.13,2.13,4.21
3769202,270,,,,,,,,LASER MACHINE,211.25,84.5,0,179.56,179.56,SKIPPED,160.55,160.55,179.56,179.56,179.56,89.02,103.51,103.51,0,63.38,90.84,90.84,179.56
3769203,270,,,,,,,,HIBILCENS,3,1.2,0,2.55,2.55,SKIPPED,2.28,2.28,2.55,2.55,2.55,1.26,1.47,1.47,0,0.9,1.29,1.29,2.55
3769204,272,,,,,,,,ULTRASOUND GEL,2.95,1.18,0,2.51,2.51,SKIPPED,2.24,2.24,2.51,2.51,2.51,1.24,1.45,1.45,0,0.88,1.27,1.27,2.51
3769205,272,,,,,,,,ULTRASOUND COVERS,15.95,6.38,0,13.56,13.56,SKIPPED,12.12,12.12,13.56,13.56,13.56,6.72,7.82,7.82,0,4.78,6.86,6.86,13.56
3769206,272,,,,,,,,SCAPEL/BLADE,1.52,0.61,0,1.29,1.29,SKIPPED,1.16,1.16,1.29,1.29,1.29,0.64,0.74,0.74,0,0.46,0.65,0.65,1.29
3769207,272,,,,,,,,LASER FIBERS,69.9,27.96,0,59.42,59.42,SKIPPED,53.12,53.12,59.42,59.42,59.42,29.46,34.25,34.25,0,20.97,30.06,30.06,59.42
3769210,270,,,,,,,,KLEIN INFILTRATION MACHINE,32,12.8,0,27.2,27.2,SKIPPED,24.32,24.32,27.2,27.2,27.2,13.48,15.68,15.68,0,9.6,13.76,13.76,27.2
3769211,270,,,,,,,,LASER COOL TOUCH,370,148,0,314.5,314.5,SKIPPED,281.2,281.2,314.5,314.5,314.5,155.92,181.3,181.3,0,111,159.1,159.1,314.5
3769212,270,,,,,,,,THORACIC CATH 20F,15.18,6.07,0,12.9,12.9,SKIPPED,11.54,11.54,12.9,12.9,12.9,6.4,7.44,7.44,0,4.55,6.53,6.53,12.9
3769213,270,,,,,,,,THORACIC CATH 28F,15.76,6.3,0,13.4,13.4,SKIPPED,11.98,11.98,13.4,13.4,13.4,6.64,7.72,7.72,0,4.73,6.78,6.78,13.4
3769214,270,,,,,,,,THORACIC CATH 36F,17.38,6.95,0,14.77,14.77,SKIPPED,13.21,13.21,14.77,14.77,14.77,7.32,8.52,8.52,0,5.21,7.47,7.47,14.77
3769215,270,,,,,,,,PLEURAVACA CHEST DRAIN,95,38,0,80.75,80.75,SKIPPED,72.2,72.2,80.75,80.75,80.75,40.03,46.55,46.55,0,28.5,40.85,40.85,80.75
3769216,272,,,,,,,,CONMED CAMERA TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769217,272,,,,,,,,ARTHROSCOPY TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769218,272,,,,,,,,STRYKER DRILL SET,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769219,272,,,,,,,,ORTHO MAJOR TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769220,272,,,,,,,,OSTEOTOMES TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769221,272,,,,,,,,SHOULDER ARTHROSCOPY TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769222,272,,,,,,,,BIOMET CHARLOTTE TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769223,270,,,,,,,,KNEE POSTIONER,268,107.2,0,227.8,227.8,SKIPPED,203.68,203.68,227.8,227.8,227.8,112.94,131.32,131.32,0,80.4,115.24,115.24,227.8
3769224,270,,,,,,,,KNEE TRIANGLE,314,125.6,0,266.9,266.9,SKIPPED,238.64,238.64,266.9,266.9,266.9,132.32,153.86,153.86,0,94.2,135.02,135.02,266.9
3769225,272,,,,,,,,PLASTER SPLINT,84,33.6,0,71.4,71.4,SKIPPED,63.84,63.84,71.4,71.4,71.4,35.4,41.16,41.16,0,25.2,36.12,36.12,71.4
3769226,270,,,,,,,,2'' WEBRIL,9.6,3.84,0,8.16,8.16,SKIPPED,7.3,7.3,8.16,8.16,8.16,4.05,4.7,4.7,0,2.88,4.13,4.13,8.16
3769227,270,,,,,,,,3'' WEBRIL,9.6,3.84,0,8.16,8.16,SKIPPED,7.3,7.3,8.16,8.16,8.16,4.05,4.7,4.7,0,2.88,4.13,4.13,8.16
3769228,270,,,,,,,,4'' WEBRIL,9.6,3.84,0,8.16,8.16,SKIPPED,7.3,7.3,8.16,8.16,8.16,4.05,4.7,4.7,0,2.88,4.13,4.13,8.16
3769229,270,,,,,,,,6'' WEBRIL,9.6,3.84,0,8.16,8.16,SKIPPED,7.3,7.3,8.16,8.16,8.16,4.05,4.7,4.7,0,2.88,4.13,4.13,8.16
3769230,272,,,,,,,,XEROFOAM,14.87,5.95,0,12.64,12.64,SKIPPED,11.3,11.3,12.64,12.64,12.64,6.26,7.29,7.29,0,4.46,6.39,6.39,12.64
3769231,270,,,,,,,,ARM SLING XL,12.7,5.08,0,10.8,10.8,SKIPPED,9.65,9.65,10.8,10.8,10.8,5.35,6.22,6.22,0,3.81,5.46,5.46,10.8
3769232,272,,,,,,,,TICRON,250,100,0,212.5,212.5,SKIPPED,190,190,212.5,212.5,212.5,105.35,122.5,122.5,0,75,107.5,107.5,212.5
3769233,272,,,,,,,,GENERAL SUTURE,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769234,272,,,,,,,,MAXBRAID,214.58,85.83,0,182.39,182.39,SKIPPED,163.08,163.08,182.39,182.39,182.39,90.42,105.14,105.14,0,64.37,92.27,92.27,182.39
3769235,272,,,,,,,,FIBERWIRE,55,22,0,46.75,46.75,SKIPPED,41.8,41.8,46.75,46.75,46.75,23.18,26.95,26.95,0,16.5,23.65,23.65,46.75
3769236,270,,,,,,,,MINOR TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769237,270,,,,,,,,MAJOR TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769238,270,,,,,,,,LAP CHOLE TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769239,270,,,,,,,,LONG TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769240,270,,,,,,,,STRYKER CAMERA,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769241,270,,,,,,,,5MM STRYKER SCOPE,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769242,270,,,,,,,,10MM STRYKER SCOPE,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769243,270,,,,,,,,BOOK WALTER,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769244,270,,,,,,,,BAL FOUR,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769245,270,,,,,,,,PLASTIC TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769246,270,,,,,,,,RECTAL TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769247,272,,,,,,,,RECTAL RETRACTOR,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769248,270,,,,,,,,SMALL BASIN,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769249,270,,,,,,,,LARGE BASIN,50,20,0,42.5,42.5,SKIPPED,38,38,42.5,42.5,42.5,21.07,24.5,24.5,0,15,21.5,21.5,42.5
3769250,270,,,,,,,,PITCHER,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769251,270,,,,,,,,TONSIL TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769252,270,,,,,,,,BMT TRAY,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769253,270,,,,,,,,STRYKER BATTERIES,15.8,6.32,0,13.43,13.43,SKIPPED,12.01,12.01,13.43,13.43,13.43,6.65,7.74,7.74,0,4.74,6.79,6.79,13.43
3769254,270,,,,,,,,OSTEOTOMES,35.14,14.06,0,29.87,29.87,SKIPPED,26.71,26.71,29.87,29.87,29.87,14.81,17.22,17.22,0,10.54,15.11,15.11,29.87
3769255,272,,,,,,,,CHARNLEY RETRACTOR,27.19,10.88,0,23.11,23.11,SKIPPED,20.66,20.66,23.11,23.11,23.11,11.46,13.32,13.32,0,8.16,11.69,11.69,23.11
3769256,272,,,,,,,,KOLBEL RETRACTOR,28.03,11.21,0,23.83,23.83,SKIPPED,21.3,21.3,23.83,23.83,23.83,11.81,13.73,13.73,0,8.41,12.05,12.05,23.83
3769257,270,,,,,,,,DORNOCH FILTER,47,18.8,0,39.95,39.95,SKIPPED,35.72,35.72,39.95,39.95,39.95,19.81,23.03,23.03,0,14.1,20.21,20.21,39.95
3769258,270,,,,,,,,TRACH TUBES TTS 8.0 (5858670180),169.74,67.9,0,144.28,144.28,SKIPPED,129,129,144.28,144.28,144.28,71.53,83.17,83.17,0,50.92,72.99,72.99,144.28
3769259,270,,,,,,,,TRACH TUBES TTS 7.0 (5858670170),169.74,67.9,0,144.28,144.28,SKIPPED,129,129,144.28,144.28,144.28,71.53,83.17,83.17,0,50.92,72.99,72.99,144.28
3769260,270,,,,,,,,"MATTRESS, PRESSURE #MSC80710",67.82,27.13,0,57.65,57.65,SKIPPED,51.54,51.54,57.65,57.65,57.65,28.58,33.23,33.23,0,20.35,29.16,29.16,57.65
3769261,272,,,,,,,,4.5 SHAVER(PURPLE),215,86,0,182.75,182.75,SKIPPED,163.4,163.4,182.75,182.75,182.75,90.6,105.35,105.35,0,64.5,92.45,92.45,182.75
3769262,272,,,,,,,,3.5 ELITE SHAVER(BEIGE),215,86,0,182.75,182.75,SKIPPED,163.4,163.4,182.75,182.75,182.75,90.6,105.35,105.35,0,64.5,92.45,92.45,182.75
3769263,270,,,,,,,,90 DEGREE PROBE BURNER,250,100,0,212.5,212.5,SKIPPED,190,190,212.5,212.5,212.5,105.35,122.5,122.5,0,75,107.5,107.5,212.5
3769264,270,,,,,,,,50 DEGREE PROBE BURNER,186,74.4,0,158.1,158.1,SKIPPED,141.36,141.36,158.1,158.1,158.1,78.38,91.14,91.14,0,55.8,79.98,79.98,158.1
3769265,278,,,,,,,,SWIVELOCK ANCHORS,333,133.2,0,283.05,283.05,SKIPPED,253.08,253.08,283.05,283.05,283.05,140.33,163.17,163.17,0,99.9,143.19,143.19,283.05
3769266,272,,,,,,,,FIBERTAPE,1500,600,0,1275,1275,SKIPPED,1140,1140,1275,1275,1275,632.1,735,735,0,450,645,645,1275
3769267,272,,,,,,,,6X7 CANNULA,50,20,0,42.5,42.5,SKIPPED,38,38,42.5,42.5,42.5,21.07,24.5,24.5,0,15,21.5,21.5,42.5
3769268,272,,,,,,,,7X7 CANNULA,50,20,0,42.5,42.5,SKIPPED,38,38,42.5,42.5,42.5,21.07,24.5,24.5,0,15,21.5,21.5,42.5
3769269,272,,,,,,,,8.25X7 CANNULA,50,20,0,42.5,42.5,SKIPPED,38,38,42.5,42.5,42.5,21.07,24.5,24.5,0,15,21.5,21.5,42.5
3769270,270,,,,,,,,8X4 PASSPORT,64,25.6,0,54.4,54.4,SKIPPED,48.64,48.64,54.4,54.4,54.4,26.97,31.36,31.36,0,19.2,27.52,27.52,54.4
3769271,272,,,,,,,,PROVENA WOUND VAC DISP.,990,396,0,841.5,841.5,SKIPPED,752.4,752.4,841.5,841.5,841.5,417.19,485.1,485.1,0,297,425.7,425.7,841.5
3769272,272,,,,,,,,"BURR, 4.0",236,94.4,0,200.6,200.6,SKIPPED,179.36,179.36,200.6,200.6,200.6,99.45,115.64,115.64,0,70.8,101.48,101.48,200.6
3769273,272,,,,,,,,"SHAVER, 4.5",100,40,0,85,85,SKIPPED,76,76,85,85,85,42.14,49,49,0,30,43,43,85
3769274,272,,,,,,,,"SHAVER, 3.5",100,40,0,85,85,SKIPPED,76,76,85,85,85,42.14,49,49,0,30,43,43,85
3769275,272,,,,,,,,HEWSON SUTURE RETRIEVER,312,124.8,0,265.2,265.2,SKIPPED,237.12,237.12,265.2,265.2,265.2,131.48,152.88,152.88,0,93.6,134.16,134.16,265.2
3769276,272,,,,,,,,C-LINE ENDO,572,228.8,0,486.2,486.2,SKIPPED,434.72,434.72,486.2,486.2,486.2,241.04,280.28,280.28,0,171.6,245.96,245.96,486.2
3769277,272,,,,,,,,GRAFTJACKET MAX FORCE,9220,3688,0,7837,7837,SKIPPED,7007.2,7007.2,7837,7837,7837,3885.31,4517.8,4517.8,0,2766,3964.6,3964.6,7837
3769278,270,,,,,,,,ARM SLING,8,3.2,0,6.8,6.8,SKIPPED,6.08,6.08,6.8,6.8,6.8,3.37,3.92,3.92,0,2.4,3.44,3.44,6.8
3769279,272,,,,,,,,SPIDER SHOULDER DRAPE,178,71.2,0,151.3,151.3,SKIPPED,135.28,135.28,151.3,151.3,151.3,75.01,87.22,87.22,0,53.4,76.54,76.54,151.3
3769280,272,,,,,,,,MINI C-ARM DRAPE W/ FT SWITCH COVER,32,12.8,0,27.2,27.2,SKIPPED,24.32,24.32,27.2,27.2,27.2,13.48,15.68,15.68,0,9.6,13.76,13.76,27.2
3769281,270,,,,,,,,MINI C-ARM (EQUIPMENT),72,28.8,0,61.2,61.2,SKIPPED,54.72,54.72,61.2,61.2,61.2,30.34,35.28,35.28,0,21.6,30.96,30.96,61.2
3769282,270,,,,,,,,TRACH TUBE TTS 6.0,169.74,67.9,0,144.28,144.28,SKIPPED,129,129,144.28,144.28,144.28,71.53,83.17,83.17,0,50.92,72.99,72.99,144.28
3769283,272,,,,,,,,AQUAMANTYS BIPOLAR SEALER,2037.5,815,0,1731.88,1731.88,SKIPPED,1548.5,1548.5,1731.88,1731.88,1731.88,858.61,998.38,998.38,0,611.25,876.13,876.13,1731.88
3769284,272,,,,,,,,PULSAVAC INTRAMEDULLARY TIP,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
3769285,270,,,,,,,,HEEL OFF-LOADING DEVICE M70-100S,223.2,89.28,0,189.72,189.72,SKIPPED,169.63,169.63,189.72,189.72,189.72,94.06,109.37,109.37,0,66.96,95.98,95.98,189.72
3769286,270,,,,,,,,SURGIFOAM,120,48,0,102,102,SKIPPED,91.2,91.2,102,102,102,50.57,58.8,58.8,0,36,51.6,51.6,102
3769287,272,,,,,,,,AQUAMANTYS PLASMA CUTTER,1200,480,0,1020,1020,SKIPPED,912,912,1020,1020,1020,505.68,588,588,0,360,516,516,1020
3769288,272,,,,,,,,LARGE BORE Y-IRRING TUBING,35,14,0,29.75,29.75,SKIPPED,26.6,26.6,29.75,29.75,29.75,14.75,17.15,17.15,0,10.5,15.05,15.05,29.75
3769289,272,,,,,,,,SECONDARY IRRIG,35,14,0,29.75,29.75,SKIPPED,26.6,26.6,29.75,29.75,29.75,14.75,17.15,17.15,0,10.5,15.05,15.05,29.75
3769290,272,,,,,,,,MATCHHEAD BUR,293,117.2,0,249.05,249.05,SKIPPED,222.68,222.68,249.05,249.05,249.05,123.47,143.57,143.57,0,87.9,125.99,125.99,249.05
3769291,270,,,,,,,,"CERVICAL COLLAR, SOFT",37.5,15,0,31.88,31.88,SKIPPED,28.5,28.5,31.88,31.88,31.88,15.81,18.38,18.38,0,11.25,16.13,16.13,31.88
3769292,270,,,,,,,,ULTA WOUND VAC,131,52.4,0,111.35,111.35,SKIPPED,99.56,99.56,111.35,111.35,111.35,55.2,64.19,64.19,0,39.3,56.33,56.33,111.35
3769293,272,,,,,,,,EDIN CURVED BLADE,840,336,0,714,714,SKIPPED,638.4,638.4,714,714,714,353.98,411.6,411.6,0,252,361.2,361.2,714
3769294,272,,,,,,,,3.0 V-LOC,215,86,0,182.75,182.75,SKIPPED,163.4,163.4,182.75,182.75,182.75,90.6,105.35,105.35,0,64.5,92.45,92.45,182.75
3769295,272,,,,,,,,EXTERNAL CATHETERS,33.47,13.39,0,28.45,28.45,SKIPPED,25.44,25.44,28.45,28.45,28.45,14.1,16.4,16.4,0,10.04,14.39,14.39,28.45
3769296,270,,,,,,,,JOBST COMPRESSION HOSE(ALL SIZES),173.2,69.28,0,147.22,147.22,SKIPPED,131.63,131.63,147.22,147.22,147.22,72.99,84.87,84.87,0,51.96,74.48,74.48,147.22
3769297,270,,,,,,,,CATH COUDE 16F,22.8,9.12,0,19.38,19.38,SKIPPED,17.33,17.33,19.38,19.38,19.38,9.6,11.17,11.17,0,6.84,9.8,9.8,19.38
3769298,270,,,,,,,,KERRALITE COOL ADHESIVE 3X3,3.2,1.28,0,2.72,2.72,SKIPPED,2.43,2.43,2.72,2.72,2.72,1.35,1.57,1.57,0,0.96,1.38,1.38,2.72
3769299,270,,,,,,,,KERRALITE COOL ADHESIVE 3X5,4.82,1.93,0,4.1,4.1,SKIPPED,3.66,3.66,4.1,4.1,4.1,2.03,2.36,2.36,0,1.45,2.07,2.07,4.1
3769300,270,,,,,,,,NUDERM THIN 4X4,3.9,1.56,0,3.32,3.32,SKIPPED,2.96,2.96,3.32,3.32,3.32,1.65,1.91,1.91,0,1.17,1.68,1.68,3.32
3769301,270,,,,,,,,NU-GEL 25G,7.22,2.89,0,6.14,6.14,SKIPPED,5.49,5.49,6.14,6.14,6.14,3.04,3.54,3.54,0,2.17,3.1,3.1,6.14
3769302,270,,,,,,,,KERRAFOAM GENTLE 4X4,5.67,2.27,0,4.82,4.82,SKIPPED,4.31,4.31,4.82,4.82,4.82,2.39,2.78,2.78,0,1.7,2.44,2.44,4.82
3769303,270,,,,,,,,KERRAFOAM GENTLE 6X6,9.75,3.9,0,8.29,8.29,SKIPPED,7.41,7.41,8.29,8.29,8.29,4.11,4.78,4.78,0,2.92,4.19,4.19,8.29
3769304,270,,,,,,,,KERRAFOAM SACRAL-SMALL,12.82,5.13,0,10.9,10.9,SKIPPED,9.74,9.74,10.9,10.9,10.9,5.4,6.28,6.28,0,3.85,5.51,5.51,10.9
3769305,270,,,,,,,,KERRAFOAM SACRAL-LARGE,19.2,7.68,0,16.32,16.32,SKIPPED,14.59,14.59,16.32,16.32,16.32,8.09,9.41,9.41,0,5.76,8.26,8.26,16.32
3769306,270,,,,,,,,KERRAFOAM GENTLE-HEEL,20.82,8.33,0,17.7,17.7,SKIPPED,15.82,15.82,17.7,17.7,17.7,8.77,10.2,10.2,0,6.25,8.95,8.95,17.7
3769307,270,,,,,,,,KERRAFOAM SIMPLE NON-4X4,5.5,2.2,0,4.68,4.68,SKIPPED,4.18,4.18,4.68,4.68,4.68,2.32,2.7,2.7,0,1.65,2.37,2.37,4.68
3769308,270,,,,,,,,KERRAMAX CARE 5X6,6.9,2.76,0,5.86,5.86,SKIPPED,5.24,5.24,5.86,5.86,5.86,2.91,3.38,3.38,0,2.07,2.97,2.97,5.86
3769309,270,,,,,,,,KERRAMAX CARE 8X9,18.17,7.27,0,15.44,15.44,SKIPPED,13.81,13.81,15.44,15.44,15.44,7.65,8.9,8.9,0,5.45,7.81,7.81,15.44
3769310,270,,,,,,,,KERRAMAX CARE GENTEL 6X6,10.07,4.03,0,8.56,8.56,SKIPPED,7.65,7.65,8.56,8.56,8.56,4.24,4.93,4.93,0,3.02,4.33,4.33,8.56
3769311,270,,,,,,,,KERRACEL AG 4X5,18.27,7.31,0,15.53,15.53,SKIPPED,13.89,13.89,15.53,15.53,15.53,7.7,8.95,8.95,0,5.48,7.86,7.86,15.53
3769312,270,,,,,,,,KERRACEL AG .75X18,21.47,8.59,0,18.25,18.25,SKIPPED,16.32,16.32,18.25,18.25,18.25,9.05,10.52,10.52,0,6.44,9.23,9.23,18.25
3769313,270,,,,,,,,PROMONGRAN PRISMA,20.62,8.25,0,17.53,17.53,SKIPPED,15.67,15.67,17.53,17.53,17.53,8.69,10.1,10.1,0,6.19,8.87,8.87,17.53
3769314,270,,,,,,,,KERRACEL 4X5,5.9,2.36,0,5.02,5.02,SKIPPED,4.48,4.48,5.02,5.02,5.02,2.49,2.89,2.89,0,1.77,2.54,2.54,5.02
3769315,270,,,,,,,,ADAPTIC TOUCH 3X4,4.52,1.81,0,3.84,3.84,SKIPPED,3.44,3.44,3.84,3.84,3.84,1.9,2.21,2.21,0,1.36,1.94,1.94,3.84
3769316,270,,,,,,,,ADAPTIC 3X3,0.5,0.2,0,0.42,0.42,SKIPPED,0.38,0.38,0.42,0.42,0.42,0.22,0.24,0.24,0,0.15,0.22,0.22,0.42
3769317,270,,,,,,,,ADAPTIC 3X8,1.17,0.47,0,0.99,0.99,SKIPPED,0.89,0.89,0.99,0.99,0.99,0.49,0.57,0.57,0,0.35,0.5,0.5,0.99
3769318,270,,,,,,,,DYNA-FLEX,24.07,9.63,0,20.46,20.46,SKIPPED,18.29,18.29,20.46,20.46,20.46,10.14,11.79,11.79,0,7.22,10.35,10.35,20.46
3769319,270,,,,,,,,TOUCHLESS SPRAY ZINC,2.5,1,0,2.12,2.12,SKIPPED,1.9,1.9,2.12,2.12,2.12,1.06,1.22,1.22,0,0.75,1.08,1.08,2.12
3769320,270,,,,,,,,TOUCHLESS SPRAY ANTIFUNGAL,13,5.2,0,11.05,11.05,SKIPPED,9.88,9.88,11.05,11.05,11.05,5.48,6.37,6.37,0,3.9,5.59,5.59,11.05
3769321,272,,,,,,,,ANKLE FX SET,76.39,30.56,0,64.93,64.93,SKIPPED,58.06,58.06,64.93,64.93,64.93,32.19,37.43,37.43,0,22.92,32.85,32.85,64.93
3769322,272,,,,,,,,SPIDER 2 SHOULDER,59.03,23.61,0,50.18,50.18,SKIPPED,44.86,44.86,50.18,50.18,50.18,24.87,28.92,28.92,0,17.71,25.38,25.38,50.18
3769323,272,,,,,,,,T MAX BENCH CHAIR,28.09,11.24,0,23.88,23.88,SKIPPED,21.35,21.35,23.88,23.88,23.88,11.84,13.76,13.76,0,8.43,12.08,12.08,23.88
3769324,272,,,,,,,,YANKAUER,2.25,0.9,0,1.91,1.91,SKIPPED,1.71,1.71,1.91,1.91,1.91,0.95,1.1,1.1,0,0.68,0.97,0.97,1.91
3769325,278,,,,,,,,BIOCOMPSITE ACHILLES SPEED BRIDGE,4987.5,1995,0,4239.38,4239.38,SKIPPED,3790.5,3790.5,4239.38,4239.38,4239.38,2101.74,2443.88,2443.88,0,1496.25,2144.63,2144.63,4239.38
3769326,272,,,,,,,,DRG TUNNELER,1250,500,0,1062.5,1062.5,SKIPPED,950,950,1062.5,1062.5,1062.5,526.75,612.5,612.5,0,375,537.5,537.5,1062.5
3769327,278,,,,,,,,BONE ANCHORS WITH ARTHRO DEVICE,2500,1000,0,2125,2125,SKIPPED,1900,1900,2125,2125,2125,1053.5,1225,1225,0,750,1075,1075,2125
3769328,278,,,,,,,,TENDON ANCHORS,1000,400,0,850,850,SKIPPED,760,760,850,850,850,421.4,490,490,0,300,430,430,850
3769329,278,,,,,,,,BIOINDUCTIVE IMPLANT,6250,2500,0,5312.5,5312.5,SKIPPED,4750,4750,5312.5,5312.5,5312.5,2633.75,3062.5,3062.5,0,1875,2687.5,2687.5,5312.5
3769330,278,,,,,,,,ACCELL TBH FEM-ROUND,11132.5,4453,0,9462.62,9462.62,SKIPPED,8460.7,8460.7,9462.62,9462.62,9462.62,4691.24,5454.92,5454.92,0,3339.75,4786.98,4786.98,9462.62
3769331,278,,,,,,,,"IMPLANT SYSTEM, INTERNAL BRACE LIG/ AUG",2687.5,1075,0,2284.38,2284.38,SKIPPED,2042.5,2042.5,2284.38,2284.38,2284.38,1132.52,1316.88,1316.88,0,806.25,1155.63,1155.63,2284.38
3769332,278,,,,,,,,2.5X10MM SONIC ANCHOR,1837.5,735,0,1561.88,1561.88,SKIPPED,1396.5,1396.5,1561.88,1561.88,1561.88,774.33,900.38,900.38,0,551.25,790.13,790.13,1561.88
3769333,272,,,,,,,,DRILL MEASURING SLEEVE 4.3MM,958.75,383.5,0,814.94,814.94,SKIPPED,728.65,728.65,814.94,814.94,814.94,404.01,469.79,469.79,0,287.62,412.26,412.26,814.94
3769334,278,,,,,,,,HIP FX NAIL 130 11MMX180MM,8727.5,3491,0,7418.38,7418.38,SKIPPED,6632.9,6632.9,7418.38,7418.38,7418.38,3677.77,4276.48,4276.48,0,2618.25,3752.83,3752.83,7418.38
3769335,278,,,,,,,,HIP FX NAIL LAG SCREW 10.5MMX115MM,3305,1322,0,2809.25,2809.25,SKIPPED,2511.8,2511.8,2809.25,2809.25,2809.25,1392.73,1619.45,1619.45,0,991.5,1421.15,1421.15,2809.25
3769336,278,,,,,,,,HERO VENOUS OUTFLOW COMPONENT,6000,2400,0,5100,5100,SKIPPED,4560,4560,5100,5100,5100,2528.4,2940,2940,0,1800,2580,2580,5100
3769337,278,,,,,,,,HERO ARTERIAL GRAFT,2750,1100,0,2337.5,2337.5,SKIPPED,2090,2090,2337.5,2337.5,2337.5,1158.85,1347.5,1347.5,0,825,1182.5,1182.5,2337.5
3769338,272,,,,,,,,HERO ACCESSORY GRAFT KIT,1375,550,0,1168.75,1168.75,SKIPPED,1045,1045,1168.75,1168.75,1168.75,579.42,673.75,673.75,0,412.5,591.25,591.25,1168.75
3769339,278,,,,,,,,AMNIOFILL 500MG,3062.5,1225,0,2603.12,2603.12,SKIPPED,2327.5,2327.5,2603.12,2603.12,2603.12,1290.54,1500.62,1500.62,0,918.75,1316.88,1316.88,2603.12
3769340,278,,,,,,,,IMPLANT SYSTEM VP-211,485,194,0,412.25,412.25,SKIPPED,368.6,368.6,412.25,412.25,412.25,204.38,237.65,237.65,0,145.5,208.55,208.55,412.25
3769341,270,,,,,,,,TITAANIUM CATHETER CONNECTOR CC-2300,400,160,0,340,340,SKIPPED,304,304,340,340,340,168.56,196,196,0,120,172,172,340
3769342,272,,,,,,,,STANDARD ARCH CATHETER CF-5460,400,160,0,340,340,SKIPPED,304,304,340,340,340,168.56,196,196,0,120,172,172,340
3769343,272,,,,,,,,METAL FALLER TROCHAR FT-1100,187.5,75,0,159.38,159.38,SKIPPED,142.5,142.5,159.38,159.38,159.38,79.02,91.88,91.88,0,56.25,80.63,80.63,159.38
3769344,278,,,,,,,,IMPLANT STYLETTE CS-362,222.5,89,0,189.12,189.12,SKIPPED,169.1,169.1,189.12,189.12,189.12,93.77,109.02,109.02,0,66.75,95.68,95.68,189.12
3769345,270,,,,,,,,DISPOSABLE SPO2 SENSOR,39.38,15.75,0,33.47,33.47,SKIPPED,29.93,29.93,33.47,33.47,33.47,16.59,19.3,19.3,0,11.81,16.93,16.93,33.47
3769346,272,,,,,,,,"TERUMO RSS401,RSS501,RSS601,RSS701",30,12,0,25.5,25.5,SKIPPED,22.8,22.8,25.5,25.5,25.5,12.64,14.7,14.7,0,9,12.9,12.9,25.5
3769347,272,,,,,,,,TERUMO PINNACLE,68,27.2,0,57.8,57.8,SKIPPED,51.68,51.68,57.8,57.8,57.8,28.66,33.32,33.32,0,20.4,29.24,29.24,57.8
3769348,272,,,,,,,,STANDARD/LARGE TR BAND,119,47.6,0,101.15,101.15,SKIPPED,90.44,90.44,101.15,101.15,101.15,50.15,58.31,58.31,0,35.7,51.17,51.17,101.15
3769349,272,,,,,,,,GLIDEWIRE ADVANTAGE 180CM/300CM,259,103.6,0,220.15,220.15,SKIPPED,196.84,196.84,220.15,220.15,220.15,109.14,126.91,126.91,0,77.7,111.37,111.37,220.15
3769350,272,,,,,,,,PINNACLE RADIAL 45CM/90CM,337.5,135,0,286.88,286.88,SKIPPED,256.5,256.5,286.88,286.88,286.88,142.23,165.38,165.38,0,101.25,145.13,145.13,286.88
3769351,272,C1713,,,,,,,20-8000-000-07 TRACKERS,1137.5,455,0,966.88,966.88,SKIPPED,864.5,864.5,966.88,966.88,966.88,479.35,557.38,557.38,0,341.25,489.13,489.13,966.88
3769352,278,C1713,,,,,,,20-8000-000-10 150 PINS,200,80,0,170,170,SKIPPED,152,152,170,170,170,84.28,98,98,0,60,86,86,170
3769353,278,C1713,,,,,,,20-8000-000-11 80 PIN,200,80,0,170,170,SKIPPED,152,152,170,170,170,84.28,98,98,0,60,86,86,170
3769354,272,,,,,,,,"Nasal bridle, 18F Item #0501044116",431.35,172.54,0,366.65,366.65,SKIPPED,327.83,327.83,366.65,366.65,366.65,181.77,211.36,211.36,0,129.4,185.48,185.48,366.65
3769355,272,,,,,,,,VASHE BOTTLE 4oz,36.2,14.48,0,30.77,30.77,SKIPPED,27.51,27.51,30.77,30.77,30.77,15.26,17.74,17.74,0,10.86,15.57,15.57,30.77
3769356,272,,,,,,,,SURGICELL POWDER,782.5,313,0,665.12,665.12,SKIPPED,594.7,594.7,665.12,665.12,665.12,329.75,383.42,383.42,0,234.75,336.48,336.48,665.12
3769357,272,,,,,,,,"Cath, multi-med(All sizes)",363.72,145.49,0,309.16,309.16,SKIPPED,276.43,276.43,309.16,309.16,309.16,153.27,178.22,178.22,0,109.12,156.4,156.4,309.16
3769358,270,A4649,,,,,,,BRONCHOSCOPE SINGLE-USE,700,280,0,595,595,SKIPPED,532,532,595,595,595,294.98,343,343,0,210,301,301,595
3769359,270,,,,,,,,ZERO TIP RETRIEVAL BASKET,973.8,389.52,0,827.73,827.73,SKIPPED,740.09,740.09,827.73,827.73,827.73,410.36,477.16,477.16,0,292.14,418.73,418.73,827.73
3769360,270,,,,,,,,"SURGICEL 0.5""X2"" (Johnson&Johnson))",198.5,79.4,0,168.72,168.72,SKIPPED,150.86,150.86,168.72,168.72,168.72,83.65,97.26,97.26,0,59.55,85.36,85.36,168.72
3769361,270,,,,,,,,"Tegaderm Foam, 4x4",1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
3769362,270,,,,,,,,"Tegaderm Foam, 6x6",2.55,1.02,0,2.17,2.17,SKIPPED,1.94,1.94,2.17,2.17,2.17,1.08,1.25,1.25,0,0.76,1.1,1.1,2.17
3769363,270,,,,,,,,"Tegaderm Foam, Sm Sacral",13.12,5.25,0,11.15,11.15,SKIPPED,9.97,9.97,11.15,11.15,11.15,5.53,6.43,6.43,0,3.94,5.64,5.64,11.15
3769364,270,,,,,,,,"Tegaderm Foam, Lg Sacral",20.57,8.23,0,17.48,17.48,SKIPPED,15.63,15.63,17.48,17.48,17.48,8.67,10.08,10.08,0,6.17,8.85,8.85,17.48
3769365,270,,,,,,,,"Tegaderm Foam, Heel",16.05,6.42,0,13.64,13.64,SKIPPED,12.2,12.2,13.64,13.64,13.64,6.76,7.86,7.86,0,4.82,6.9,6.9,13.64
3769366,270,,,,,,,,Skin Protectant Applicator,18.4,7.36,0,15.64,15.64,SKIPPED,13.98,13.98,15.64,15.64,15.64,7.75,9.02,9.02,0,5.52,7.91,7.91,15.64
3790555,272,,,,,,,,RECIP SAW BLADE,940,376,0,799,799,SKIPPED,714.4,714.4,799,799,799,396.12,460.6,460.6,0,282,404.2,404.2,799
3850001,450,13101,,,,,,,RPR CMPLX TK 2.6-7.5CM,1241.06,496.42,522.99,1241.06,1054.9,SKIPPED,1241.06,1241.06,1054.9,1054.9,1054.9,522.99,608.12,608.12,SKIPPED,SKIPPED,533.66,533.66,1054.9
3850002,450,10121,,,,,,,I & RMVE FB SUBCUT,3896.99,1558.8,1642.2,3896.99,3312.44,SKIPPED,3896.99,3896.99,3312.44,3312.44,3312.44,1642.2,1909.53,1909.53,SKIPPED,SKIPPED,1675.71,1675.71,3312.44
3850005,450,12007,,,,,,,RPR SMP SCLP/NK/TRK/,642.18,256.87,270.62,642.18,545.85,SKIPPED,642.18,642.18,545.85,545.85,545.85,270.62,314.67,314.67,SKIPPED,SKIPPED,276.14,276.14,545.85
3850006,450,20552,,,,,,,INJ TRIGG POINT SING,631.32,252.53,143.64,536.62,536.62,SKIPPED,143.64,143.64,536.62,536.62,536.62,266.04,309.35,309.35,SKIPPED,SKIPPED,271.47,271.47,536.62
3850007,360,25500,,,,,,,closed treatment of radial shaft fractur,694.43,277.77,87.17,590.27,590.27,SKIPPED,531.76,531.76,590.27,590.27,590.27,292.63,87.17,87.17,SKIPPED,SKIPPED,298.6,298.6,590.27
3850010,450,56405,,,,,,,I&D VULVA PERINEAL A,726.06,290.42,242.82,617.15,617.15,SKIPPED,242.82,242.82,617.15,617.15,617.15,305.97,355.77,355.77,SKIPPED,SKIPPED,312.21,312.21,617.15
3850011,450,28490,,,,,,,TRT FX GRT TOE/PHAL,629.87,251.95,265.42,535.39,535.39,SKIPPED,494.19,494.19,535.39,535.39,535.39,265.42,308.64,308.64,SKIPPED,SKIPPED,270.84,270.84,535.39
3850012,450,25530,,,,,,,TR CSD ULNAR SFT FX,647.38,258.95,272.8,550.27,550.27,SKIPPED,531.76,531.76,550.27,550.27,550.27,272.8,317.22,317.22,SKIPPED,SKIPPED,278.37,278.37,550.27
3850014,450,10140,,,,,,,I&D HEMATOMA SEROMA,2916.47,1166.59,497.61,2479,2479,SKIPPED,497.61,497.61,2479,2479,2479,1229,1429.07,1429.07,SKIPPED,SKIPPED,1254.08,1254.08,2479
3850021,450,,,,,,,,PERTIONEAL LAVAGE,65.63,26.25,0,55.79,55.79,SKIPPED,49.88,49.88,55.79,55.79,55.79,27.66,32.16,32.16,0,19.69,28.22,28.22,55.79
3850024,450,51701,,,,,,,IN & OUT CATHETERIZA,242.56,97.02,0,242.56,206.18,SKIPPED,242.56,242.56,206.18,206.18,206.18,102.21,118.85,118.85,0,72.77,104.3,104.3,206.18
3850026,450,99281,,,,,,,ER LEVEL 1,378.49,151.4,0,326.14,321.72,SKIPPED,326.14,326.14,321.72,321.72,321.72,159.5,185.46,185.46,0,113.55,162.75,162.75,321.72
3850027,450,27752,,,,,,,TRT TIB SHFT FX CL/W,616.55,246.62,259.82,616.55,524.07,SKIPPED,616.55,616.55,524.07,524.07,524.07,259.82,302.11,302.11,SKIPPED,SKIPPED,265.12,265.12,524.07
3850028,450,10061,,,,,,,I&D ABSCESS COMP,279.28,111.71,117.69,279.28,237.39,SKIPPED,279.28,279.28,237.39,237.39,237.39,117.69,136.85,136.85,SKIPPED,SKIPPED,120.09,120.09,237.39
3850029,450,97597,,,,,,,DEBRIDE SKIN PART TH,485.67,194.27,0,412.82,412.82,SKIPPED,115.9,115.9,412.82,412.82,412.82,204.66,237.98,237.98,0,145.7,208.84,208.84,412.82
3850030,450,20550,,,,,,,INJ TENDON SHEATH TR,564.71,225.88,114.57,480,480,SKIPPED,114.57,114.57,480,480,480,237.97,276.71,276.71,SKIPPED,SKIPPED,242.83,242.83,480
3850031,450,25600,,,,,,,TR DIS RAD FX CL W/O,580.14,232.06,244.47,531.76,493.12,SKIPPED,531.76,531.76,493.12,493.12,493.12,244.47,284.27,284.27,SKIPPED,SKIPPED,249.46,249.46,493.12
3850033,450,29405,,,,,,,CAST LEG SHORT APPLY,477.88,191.15,201.38,406.2,406.2,SKIPPED,241.11,241.11,406.2,406.2,406.2,201.38,234.16,234.16,SKIPPED,SKIPPED,205.49,205.49,406.2
3850035,450,65220,,,,,,,RMVE FB EXT EYE W/O,705.83,282.33,0,705.83,599.96,SKIPPED,705.83,705.83,599.96,599.96,599.96,297.44,345.86,345.86,0,211.75,303.51,303.51,599.96
3850036,450,26600,,,,,,,METACA FX CL SNG W/O,472.72,189.09,199.2,472.72,401.81,SKIPPED,472.72,472.72,401.81,401.81,401.81,199.2,231.63,231.63,SKIPPED,SKIPPED,203.27,203.27,401.81
3850037,450,99282,,,,,,,ER LEVEL 2,687.13,274.85,0,592.09,584.06,SKIPPED,592.09,592.09,584.06,584.06,584.06,289.56,336.69,336.69,0,206.14,295.47,295.47,584.06
3850038,450,26605,,,,,,,METACAR FX CL SNG W/,1152.49,461,485.66,1020.78,979.62,SKIPPED,1020.78,1020.78,979.62,979.62,979.62,485.66,564.72,564.72,SKIPPED,SKIPPED,495.57,495.57,979.62
3850039,450,27550,,,,,,,TRT KNEE CLSD DISLOC,809.83,323.93,341.27,809.83,688.36,SKIPPED,809.83,809.83,688.36,688.36,688.36,341.27,396.82,396.82,SKIPPED,SKIPPED,348.23,348.23,688.36
3850040,450,27560,,,,,,,TRT PATELLAR CL DISL,791.2,316.48,333.42,791.2,672.52,SKIPPED,791.2,791.2,672.52,672.52,672.52,333.42,387.69,387.69,SKIPPED,SKIPPED,340.22,340.22,672.52
3850041,450,28510,,,,,,,TRT PHALANX FX CL W/,249.81,99.92,0,249.81,212.34,SKIPPED,249.81,249.81,212.34,212.34,212.34,105.27,122.41,122.41,0,74.94,107.42,107.42,212.34
3850042,410,94002,,,,,,,#VENTILATION MGMT 1S,850.16,340.06,0,850.16,722.64,SKIPPED,850.16,850.16,722.64,722.64,722.64,358.26,416.58,416.58,0,255.05,365.57,365.57,722.64
3850043,450,28470,,,,,,,TRT MT CL FX W/O MNP,526.72,210.69,221.96,526.72,447.71,SKIPPED,526.72,526.72,447.71,447.71,447.71,221.96,258.09,258.09,SKIPPED,SKIPPED,226.49,226.49,447.71
3850045,450,25560,,,,,,,TRT CL RAD/ULR FX W/,609.75,243.9,256.95,531.76,518.29,SKIPPED,531.76,531.76,518.29,518.29,518.29,256.95,298.78,298.78,SKIPPED,SKIPPED,262.19,262.19,518.29
3850047,450,,,,,,,,CHEST TUBE PLACEMENT,97.83,39.13,0,83.16,83.16,SKIPPED,74.35,74.35,83.16,83.16,83.16,41.23,47.94,47.94,0,29.35,42.07,42.07,83.16
3850048,450,99284,,,,,,,ER LEVEL 4,1959.86,783.94,0,1688.77,1665.88,SKIPPED,1688.77,1688.77,1665.88,1665.88,1665.88,825.89,960.33,960.33,0,587.96,842.74,842.74,1665.88
3850065,450,99283,,,,,,,ER LEVEL 3,1207.79,483.12,0,1040.72,1026.62,SKIPPED,1040.72,1040.72,1026.62,1026.62,1026.62,508.96,591.82,591.82,0,362.34,519.35,519.35,1026.62
3850067,450,25650,,,,,,,TRT ULNR STYLID CLSD,609.75,243.9,256.95,531.76,518.29,SKIPPED,531.76,531.76,518.29,518.29,518.29,256.95,298.78,298.78,SKIPPED,SKIPPED,262.19,262.19,518.29
3850068,450,24500,,,,,,,TRT HUMERAL SHFT FX,538.95,215.58,227.12,538.95,458.11,SKIPPED,538.95,538.95,458.11,458.11,458.11,227.12,264.09,264.09,SKIPPED,SKIPPED,231.75,231.75,458.11
3850069,450,11730,,,,,,,#AVUL NAIL PLATE SIN,260.65,104.26,0,260.65,221.55,SKIPPED,260.65,260.65,221.55,221.55,221.55,109.84,127.72,127.72,0,78.2,112.08,112.08,221.55
3850071,450,69200,,,,,,,RM FB EX AUD CAN W/O,248.19,99.28,0,248.19,210.96,SKIPPED,248.19,248.19,210.96,210.96,210.96,104.59,121.61,121.61,0,74.46,106.72,106.72,210.96
3850072,450,29085,,,,,,,CAST HAND/LOW FOREARM,363.03,145.21,152.98,308.58,308.58,SKIPPED,295.83,295.83,308.58,308.58,308.58,152.98,177.88,177.88,SKIPPED,SKIPPED,156.1,156.1,308.58
3850073,450,29550,,,,,,,STRAPPING TOES,307.15,122.86,0,265.81,261.08,SKIPPED,265.81,265.81,261.08,261.08,261.08,129.43,150.5,150.5,0,92.14,132.07,132.07,261.08
3850074,450,28630,,,,,,,TRT METAR JNT DISL C,507.23,202.89,0,437.76,431.15,SKIPPED,437.76,437.76,431.15,431.15,431.15,213.75,248.54,248.54,0,152.17,218.11,218.11,431.15
3850077,450,11004,,,,,,,DEBRIDE SKIN SUBCUT,463.81,185.52,0,463.81,394.24,SKIPPED,463.81,463.81,394.24,394.24,394.24,195.45,227.27,227.27,0,139.14,199.44,199.44,394.24
3850079,450,21480,,,,,,,TRT CLSD DISLOC TEMPOROMA,510.3,204.12,215.04,510.3,433.76,SKIPPED,510.3,510.3,433.76,433.76,433.76,215.04,250.05,250.05,SKIPPED,SKIPPED,219.43,219.43,433.76
3850080,450,99285,,,,,,,ER LEVEL 5,2871.18,1148.47,0,2474.04,2440.5,SKIPPED,2474.04,2474.04,2440.5,2440.5,2440.5,1209.92,1406.88,1406.88,0,861.35,1234.61,1234.61,2440.5
3850085,450,99291,,,,,,,ER CRITICAL CARE,4044.14,1617.66,0,3484.74,3437.52,SKIPPED,3484.74,3484.74,3437.52,3437.52,3437.52,1704.2,1981.63,1981.63,0,1213.24,1738.98,1738.98,3437.52
3850086,450,11760,,,,,,,REPAIR NAIL BED,389.3,155.72,0,389.3,330.9,SKIPPED,389.3,389.3,330.9,330.9,330.9,164.05,190.76,190.76,0,116.79,167.4,167.4,330.9
3850087,450,97597,,,,,,,#DEBRIDE SKIN FULL THICK,408.08,163.23,0,346.87,346.87,SKIPPED,115.9,115.9,346.87,346.87,346.87,171.96,199.96,199.96,0,122.42,175.47,175.47,346.87
3850089,450,29540,,,,,,,STRAPPING ANKLE/FOOT,116.33,46.53,0,98.88,98.88,SKIPPED,56.43,56.43,98.88,98.88,98.88,49.02,57,57,0,34.9,50.02,50.02,98.88
3850092,450,20103,,,,,,,EXPLORE WOUND EXTREMITY,2317.71,927.08,976.69,2317.71,1970.05,SKIPPED,2317.71,2317.71,1970.05,1970.05,1970.05,976.69,1135.68,1135.68,SKIPPED,SKIPPED,996.62,996.62,1970.05
3850094,450,26910,,,,,,,"AMPUATION OF HAND BONE, FINGER, THUMB",7221.9,2888.76,3043.31,7221.9,6138.62,SKIPPED,7221.9,7221.9,6138.62,6138.62,6138.62,3043.31,3538.73,3538.73,SKIPPED,SKIPPED,3105.42,3105.42,6138.62
3850095,450,51720,,,,,,,TRT BLADDER LESION,1074.64,429.86,0,913.44,913.44,SKIPPED,247.95,247.95,913.44,913.44,913.44,452.86,526.57,526.57,0,322.39,462.1,462.1,913.44
3850101,450,26770,,,,,,,TRT IP DISLOC W/O AN,452.95,181.18,0,452.95,385.01,SKIPPED,452.95,452.95,385.01,385.01,385.01,190.87,221.95,221.95,0,135.88,194.77,194.77,385.01
3850102,450,16025,,,,,,,DRS DEBR BURN MED W/,404.99,162,0,404.99,344.24,SKIPPED,404.99,404.99,344.24,344.24,344.24,170.67,198.45,198.45,0,121.5,174.15,174.15,344.24
3850103,450,56420,,,,,,,I & D BARTHOLINS CYS,646.87,258.75,272.59,549.84,549.84,SKIPPED,316.35,316.35,549.84,549.84,549.84,272.59,316.97,316.97,SKIPPED,SKIPPED,278.15,278.15,549.84
3850104,450,10060,,,,,,,I&D ABSCESS SMPLE/SN,288.66,115.46,0,288.66,245.36,SKIPPED,288.66,288.66,245.36,245.36,245.36,121.64,141.44,141.44,0,86.6,124.12,124.12,245.36
3850105,450,24640,,,,,,,TRT RHEAD SUBLUX FX,897.05,358.82,258.21,762.49,762.49,SKIPPED,258.21,258.21,762.49,762.49,762.49,378.02,439.55,439.55,SKIPPED,SKIPPED,385.73,385.73,762.49
3850106,450,10080,,,,,,,I&D PILONIDAL CYST S,280.88,112.35,0,280.88,238.75,SKIPPED,280.88,280.88,238.75,238.75,238.75,118.36,137.63,137.63,0,84.26,120.78,120.78,238.75
3850107,450,12020,,,,,,,"TRT WOUND SUPER, SMP",664.01,265.6,279.81,664.01,564.41,SKIPPED,664.01,664.01,564.41,564.41,564.41,279.81,325.36,325.36,SKIPPED,SKIPPED,285.52,285.52,564.41
3850108,450,10120,,,,,,,I&RMVE FB SUBQ SMPLE,353.78,141.51,149.09,353.78,300.71,SKIPPED,353.78,353.78,300.71,300.71,300.71,149.09,173.35,173.35,SKIPPED,SKIPPED,152.13,152.13,300.71
3850109,450,23500,,,,,,,TRT CLAVICULAR CLSD,396.61,158.64,167.13,396.61,337.12,SKIPPED,396.61,396.61,337.12,337.12,337.12,167.13,194.34,194.34,SKIPPED,SKIPPED,170.54,170.54,337.12
3850110,450,12001,,,,,,,RPR SMP SP NK TR 2.5,353.78,141.51,0,353.78,300.71,SKIPPED,353.78,353.78,300.71,300.71,300.71,149.09,173.35,173.35,0,106.13,152.13,152.13,300.71
3850111,450,13133,,,,,,,RP CPLX FH CK CHIN .,1017.67,407.07,0,865.02,865.02,SKIPPED,0,0,865.02,865.02,865.02,428.85,498.66,498.66,0,305.3,437.6,437.6,865.02
3850112,450,24650,,,,,,,TRT RAD NCK FX CL W/,501.14,200.46,211.18,501.14,425.97,SKIPPED,501.14,501.14,425.97,425.97,425.97,211.18,245.56,245.56,SKIPPED,SKIPPED,215.49,215.49,425.97
3850113,450,12002,,,,,,,RPR SMP SP NK TK 2.6,485.67,194.27,0,485.67,412.82,SKIPPED,485.67,485.67,412.82,412.82,412.82,204.66,237.98,237.98,0,145.7,208.84,208.84,412.82
3850114,450,26750,,,,,,,TRT DIS PHALANG CLSD,396.61,158.64,0,396.61,337.12,SKIPPED,396.61,396.61,337.12,337.12,337.12,167.13,194.34,194.34,0,118.98,170.54,170.54,337.12
3850115,450,12004,,,,,,,RR SMP SP NK TR 7.6-,622.07,248.83,0,622.07,528.76,SKIPPED,622.07,622.07,528.76,528.76,528.76,262.14,304.81,304.81,0,186.62,267.49,267.49,528.76
3850116,450,27502,,,,,,,TRT FEM SHAFT CLSD W,538.95,215.58,227.12,538.95,458.11,SKIPPED,538.95,538.95,458.11,458.11,458.11,227.12,264.09,264.09,SKIPPED,SKIPPED,231.75,231.75,458.11
3850117,450,28515,,,,,,,TR FX CD PHAL W/MAN,545.36,218.14,229.81,502.74,463.56,SKIPPED,502.74,502.74,463.56,463.56,463.56,229.81,267.23,267.23,SKIPPED,SKIPPED,234.5,234.5,463.56
3850118,450,12005,,,,,,,RP SMP SP NK TK 12.6,761.7,304.68,320.98,761.7,647.44,SKIPPED,761.7,761.7,647.44,647.44,647.44,320.98,373.23,373.23,SKIPPED,SKIPPED,327.53,327.53,647.44
3850120,450,12006,,,,,,,RP SMP SP NK TK20.1-,910.73,364.29,383.78,910.73,774.12,SKIPPED,910.73,910.73,774.12,774.12,774.12,383.78,446.26,446.26,SKIPPED,SKIPPED,391.61,391.61,774.12
3850122,450,12011,,,,,,,RPR SMPLE FC EAR 2.5,392.39,156.96,0,392.39,333.53,SKIPPED,392.39,392.39,333.53,333.53,333.53,165.36,192.27,192.27,0,117.72,168.73,168.73,333.53
3850123,450,46050,,,,,,,I&D PERINEAL ABSC SU,640.71,256.28,270,640.71,544.6,SKIPPED,640.71,640.71,544.6,544.6,544.6,270,313.95,313.95,SKIPPED,SKIPPED,275.51,275.51,544.6
3850124,450,11000,,,,,,,DEBRID SKN INFECT UP,497.97,199.19,0,423.27,423.27,SKIPPED,155.61,155.61,423.27,423.27,423.27,209.85,244.01,244.01,0,149.39,214.13,214.13,423.27
3850125,450,12013,,,,,,,RPR SMPLE FC EAR 2.6,532.16,212.86,0,532.16,452.34,SKIPPED,532.16,532.16,452.34,452.34,452.34,224.25,260.76,260.76,0,159.65,228.83,228.83,452.34
3850126,450,26720,,,,,,,TRT PHAL SHFT CLSD F,472.72,189.09,199.2,472.72,401.81,SKIPPED,472.72,472.72,401.81,401.81,401.81,199.2,231.63,231.63,SKIPPED,SKIPPED,203.27,203.27,401.81
3850127,450,12014,,,,,,,RPR SMPLE FC EAR 5.1,657.85,263.14,0,657.85,559.17,SKIPPED,657.85,657.85,559.17,559.17,559.17,277.22,322.35,322.35,0,197.36,282.88,282.88,559.17
3850128,450,11740,,,,,,,EVAC SUBLINGUAL HEMA,204.76,81.9,0,204.76,174.05,SKIPPED,204.76,204.76,174.05,174.05,174.05,86.29,100.33,100.33,0,61.43,88.05,88.05,174.05
3850129,450,12015,,,,,,,RPR SMPLE FC EAR7.6-,791.2,316.48,0,791.2,672.52,SKIPPED,791.2,791.2,672.52,672.52,672.52,333.42,387.69,387.69,0,237.36,340.22,340.22,672.52
3850130,450,24530,,,,,,,TRT SUPRACON/TRANSCO,488.85,195.54,206.01,488.85,415.52,SKIPPED,488.85,488.85,415.52,415.52,415.52,206.01,239.54,239.54,SKIPPED,SKIPPED,210.21,210.21,415.52
3850132,450,12016,,,,,,,RPR SMPL FC EAR12.6-,947.86,379.14,399.43,947.86,805.68,SKIPPED,947.86,947.86,805.68,805.68,805.68,399.43,464.45,464.45,SKIPPED,SKIPPED,407.58,407.58,805.68
3850133,450,24505,,,,,,,TRT HUM SHFT CLD FX,1573.54,629.42,663.09,1573.54,1337.51,SKIPPED,1573.54,1573.54,1337.51,1337.51,1337.51,663.09,771.03,771.03,SKIPPED,SKIPPED,676.62,676.62,1337.51
3850135,450,27786,,,,,,,TRT DIST FIB CLSD W/,513.29,205.32,216.3,513.29,436.3,SKIPPED,513.29,513.29,436.3,436.3,436.3,216.3,251.51,251.51,SKIPPED,SKIPPED,220.71,220.71,436.3
3850136,450,12031,,,,,,,RPR IMD SP TK EX 2.5,496.38,198.55,209.17,496.38,421.92,SKIPPED,496.38,496.38,421.92,421.92,421.92,209.17,243.23,243.23,SKIPPED,SKIPPED,213.44,213.44,421.92
3850137,450,27840,,,,,,,TRT ANKLE DISCLO W/O,594.2,237.68,250.4,594.2,505.07,SKIPPED,594.2,594.2,505.07,505.07,505.07,250.4,291.16,291.16,SKIPPED,SKIPPED,255.51,255.51,505.07
3850138,450,12032,,,,,,,RPR IMD SP TK EX 2.6,657.85,263.14,277.22,657.85,559.17,SKIPPED,657.85,657.85,559.17,559.17,559.17,277.22,322.35,322.35,SKIPPED,SKIPPED,282.88,282.88,559.17
3850140,450,12034,,,,,,,RPR IMD SP TK EX7.6-,820.68,328.27,345.83,820.68,697.58,SKIPPED,820.68,820.68,697.58,697.58,697.58,345.83,402.13,402.13,SKIPPED,SKIPPED,352.89,352.89,697.58
3850142,450,12035,,,,,,,RP IMD SP TK EX12.6-,1017.67,407.07,428.85,1017.67,865.02,SKIPPED,1017.67,1017.67,865.02,865.02,865.02,428.85,498.66,498.66,SKIPPED,SKIPPED,437.6,437.6,865.02
3850146,450,12041,,,,,,,RP IMD NK H/F 2.5=<,598.9,239.56,252.38,598.9,509.06,SKIPPED,598.9,598.9,509.06,509.06,509.06,252.38,293.46,293.46,SKIPPED,SKIPPED,257.53,257.53,509.06
3850147,450,59409,,,,,,,VAGINAL DELIVERY ONL,4992.38,1996.95,0,4992.38,4243.52,SKIPPED,4992.38,4992.38,4243.52,4243.52,4243.52,2103.79,2446.27,2446.27,0,1497.71,2146.72,2146.72,4243.52
3850148,450,12042,,,,,,,RP IMD NK H/F 2.6-7.,774.03,309.61,326.17,769.02,657.93,SKIPPED,769.02,769.02,657.93,657.93,657.93,326.17,379.27,379.27,SKIPPED,SKIPPED,332.83,332.83,657.93
3850149,450,27810,,,,,,,TR CL BIMALL AK FX W,616.55,246.62,259.82,616.55,524.07,SKIPPED,616.55,616.55,524.07,524.07,524.07,259.82,302.11,302.11,SKIPPED,SKIPPED,265.12,265.12,524.07
3850150,450,12044,,,,,,,RP IMD NK H/F 7.6-12,947.86,379.14,399.43,947.86,805.68,SKIPPED,947.86,947.86,805.68,805.68,805.68,399.43,464.45,464.45,SKIPPED,SKIPPED,407.58,407.58,805.68
3850151,450,30300,,,,,,,RMVE FOREIGN BDY INT,248.19,99.28,0,248.19,210.96,SKIPPED,248.19,248.19,210.96,210.96,210.96,104.59,121.61,121.61,0,74.46,106.72,106.72,210.96
3850153,450,11750,,,,,,,EX NAIL/MATRIX PART/,1185.18,474.07,456.57,1007.4,1007.4,SKIPPED,456.57,456.57,1007.4,1007.4,1007.4,499.44,580.74,580.74,SKIPPED,SKIPPED,509.63,509.63,1007.4
3850154,450,12051,,,,,,,RP IMD FC EAR 2.5=<,632.95,253.18,266.73,632.95,538.01,SKIPPED,632.95,632.95,538.01,538.01,538.01,266.73,310.15,310.15,SKIPPED,SKIPPED,272.17,272.17,538.01
3850155,450,28190,,,,,,,RMVE FB FOOT SUBCUTA,1213.2,485.28,0,1031.22,1031.22,SKIPPED,902.88,902.88,1031.22,1031.22,1031.22,511.25,594.47,594.47,0,363.96,521.68,521.68,1031.22
3850156,450,12052,,,,,,,RP IMD FC EAR 2.6-5.,845.47,338.19,356.28,769.02,718.65,SKIPPED,769.02,769.02,718.65,718.65,718.65,356.28,414.28,414.28,SKIPPED,SKIPPED,363.55,363.55,718.65
3850158,450,12053,,,,,,,RP IMD FC EAR 5.1-7.,1048.76,419.5,441.95,891.45,891.45,SKIPPED,769.02,769.02,891.45,891.45,891.45,441.95,513.89,513.89,SKIPPED,SKIPPED,450.97,450.97,891.45
3850159,450,69210,,,,,,,RMVE IMPACTED CERUME,252.88,101.15,0,252.88,214.95,SKIPPED,252.88,252.88,214.95,214.95,214.95,106.57,123.91,123.91,0,75.86,108.74,108.74,214.95
3850160,450,12054,,,,,,,RP IMD FC EAR 7.6-12,1261.18,504.47,531.46,1261.18,1072,SKIPPED,1261.18,1261.18,1072,1072,1072,531.46,617.98,617.98,SKIPPED,SKIPPED,542.31,542.31,1072
3850161,450,29075,,,,,,,CAST ARM SHORT APPLY,369.2,147.68,155.58,313.82,313.82,SKIPPED,271.89,271.89,313.82,313.82,313.82,155.58,180.91,180.91,SKIPPED,SKIPPED,158.76,158.76,313.82
3850162,450,12055,,,,,,,RP IMD FC EAR 12.6-2,1466.07,586.43,617.8,1466.07,1246.16,SKIPPED,1466.07,1466.07,1246.16,1246.16,1246.16,617.8,718.37,718.37,SKIPPED,SKIPPED,630.41,630.41,1246.16
3850163,450,10160,,,,,,,PUNCTURE ASPRATE ABS,300.98,120.39,0,300.98,255.83,SKIPPED,300.98,300.98,255.83,255.83,255.83,126.83,147.48,147.48,0,90.29,129.42,129.42,255.83
3850168,450,13120,,,,,,,RP CMPLX SP AM/LG1.1,742.39,296.96,312.85,742.39,631.03,SKIPPED,742.39,742.39,631.03,631.03,631.03,312.85,363.77,363.77,SKIPPED,SKIPPED,319.23,319.23,631.03
3850169,450,51703,,,,,,,CATH URETHRA COMP,637.41,254.96,0,541.8,541.8,SKIPPED,337.3,337.3,541.8,541.8,541.8,268.61,312.33,312.33,0,191.22,274.09,274.09,541.8
3850170,450,13121,,,,,,,RP CMPLX SP AM/LG2.6,1399.32,559.73,589.68,1399.32,1189.42,SKIPPED,1399.32,1399.32,1189.42,1189.42,1189.42,589.68,685.67,685.67,SKIPPED,SKIPPED,601.71,601.71,1189.42
3850171,450,29260,,,,,,,STRAPPING ELBOW/WRIS,303.74,121.5,0,258.18,258.18,SKIPPED,151.05,151.05,258.18,258.18,258.18,128,148.83,148.83,0,91.12,130.61,130.61,258.18
3850172,450,13122,,,,,,,RP CMPLX SP AM/LG EA,1396.26,558.5,0,1186.82,1186.82,SKIPPED,0,0,1186.82,1186.82,1186.82,588.38,684.17,684.17,0,418.88,600.39,600.39,1186.82
3850174,450,13131,,,,,,,CMX FH/CK/CH/H/F/1.1,1101.43,440.57,464.14,1101.43,936.22,SKIPPED,1101.43,1101.43,936.22,936.22,936.22,464.14,539.7,539.7,SKIPPED,SKIPPED,473.61,473.61,936.22
3850175,450,64400,,,,,,,INJECT ANESTHETIC AG,594.2,237.68,0,505.07,505.07,SKIPPED,408.69,408.69,505.07,505.07,505.07,250.4,291.16,291.16,0,178.26,255.51,255.51,505.07
3850176,450,13132,,,,,,,CMX FH/CK/CH/H/F2.6-,1818.12,727.25,766.15,1818.12,1545.4,SKIPPED,1818.12,1818.12,1545.4,1545.4,1545.4,766.15,890.88,890.88,SKIPPED,SKIPPED,781.79,781.79,1545.4
3850177,450,24600,,,,,,,TR CL ELBW DISLOC W/,724.46,289.78,305.29,724.46,615.79,SKIPPED,724.46,724.46,615.79,615.79,615.79,305.29,354.99,354.99,SKIPPED,SKIPPED,311.52,311.52,615.79
3850180,450,13151,,,,,,,CMX EYL NS EAR LP1.1,1371.32,548.53,577.88,1371.32,1165.62,SKIPPED,1371.32,1371.32,1165.62,1165.62,1165.62,577.88,671.95,671.95,SKIPPED,SKIPPED,589.67,589.67,1165.62
3850181,450,16020,,,,,,,DRESS/DEBRIDE BURN S,513.39,205.36,0,513.39,436.38,SKIPPED,513.39,513.39,436.38,436.38,436.38,216.34,251.56,251.56,0,154.02,220.76,220.76,436.38
3850182,360,20600,,,,,,,ACENTESIS ASP INT JN,142.72,57.09,0,121.31,121.31,SKIPPED,109.44,109.44,121.31,121.31,121.31,60.14,19.92,19.92,0,42.82,61.37,61.37,121.31
3850183,450,11765,,,,,,,WEDGE EX SKIN NAIL F,496.38,198.55,0,496.38,421.92,SKIPPED,496.38,496.38,421.92,421.92,421.92,209.17,243.23,243.23,0,148.91,213.44,213.44,421.92
3850184,450,20605,,,,,,,ACENTES ASP INJ JNT,184.67,73.87,0,156.97,156.97,SKIPPED,116.28,116.28,156.97,156.97,156.97,77.82,90.49,90.49,0,55.4,79.41,79.41,156.97
3850185,450,11043,,,,,,,DEBRIDE TISSUE MUSCLE,636.01,254.4,268.01,636.01,540.61,SKIPPED,636.01,636.01,540.61,540.61,540.61,268.01,311.64,311.64,SKIPPED,SKIPPED,273.48,273.48,540.61
3850186,450,20610,,,,,,,ACENTES ASP INJ JNT,1474.64,589.86,0,1253.44,1253.44,SKIPPED,138.51,138.51,1253.44,1253.44,1253.44,621.42,722.57,722.57,0,442.39,634.1,634.1,1253.44
3850187,450,28192,,,,,,,RMVE FB FOOT DEEP,3001.85,1200.74,1264.98,3001.85,2551.57,SKIPPED,3001.85,3001.85,2551.57,2551.57,2551.57,1264.98,1470.91,1470.91,SKIPPED,SKIPPED,1290.8,1290.8,2551.57
3850188,450,29105,,,,,,,SPLINT ARM LONG APPL,215.63,86.25,0,215.63,183.29,SKIPPED,215.63,215.63,183.29,183.29,183.29,90.87,105.66,105.66,0,64.69,92.72,92.72,183.29
3850190,450,29125,,,,,,,SPLINT ARM SHORT STA,184.67,73.87,0,184.67,156.97,SKIPPED,184.67,184.67,156.97,156.97,156.97,77.82,90.49,90.49,0,55.4,79.41,79.41,156.97
3850191,450,36556,,,,,,,INSERT CVP 5YR OR OL,3000.2,1200.08,1264.29,3000.2,2550.17,SKIPPED,3000.2,3000.2,2550.17,2550.17,2550.17,1264.29,1470.1,1470.1,SKIPPED,SKIPPED,1290.09,1290.09,2550.17
3850193,450,12045,,,,,,,RRR WD NK HD FT LYR,395.41,158.16,166.63,395.41,336.1,SKIPPED,395.41,395.41,336.1,336.1,336.1,166.63,193.75,193.75,SKIPPED,SKIPPED,170.03,170.03,336.1
3850194,450,29130,,,,,,,SPLINT FINGER STATIC,184.67,73.87,0,184.67,156.97,SKIPPED,184.67,184.67,156.97,156.97,156.97,77.82,90.49,90.49,0,55.4,79.41,79.41,156.97
3850195,450,26700,,,,,,,TRT METACARPO DIS W/,507.23,202.89,0,507.23,431.15,SKIPPED,507.23,507.23,431.15,431.15,431.15,213.75,248.54,248.54,0,152.17,218.11,218.11,431.15
3850197,450,36680,,,,,,,PLACE NEDLE INTRAOSS,496.38,198.55,0,496.38,421.92,SKIPPED,496.38,496.38,421.92,421.92,421.92,209.17,243.23,243.23,0,148.91,213.44,213.44,421.92
3850198,450,29505,,,,,,,SPLINT LEG LONG APPL,257.58,103.03,0,257.58,218.94,SKIPPED,257.58,257.58,218.94,218.94,218.94,108.54,126.21,126.21,0,77.27,110.76,110.76,218.94
3850200,450,29515,,,,,,,SPLINT LEG SHORT APP,215.63,86.25,0,212.04,183.29,SKIPPED,212.04,212.04,183.29,183.29,183.29,90.87,105.66,105.66,0,64.69,92.72,92.72,183.29
3850201,450,36589,,,,,,,RMVE CATH CENTRAL VENOUS,1941.8,776.72,818.27,1941.8,1650.53,SKIPPED,1941.8,1941.8,1650.53,1650.53,1650.53,818.27,951.48,951.48,SKIPPED,SKIPPED,834.97,834.97,1650.53
3850202,450,30901,,,,,,,CNTRL NS BLLED ANT S,349.1,139.64,0,349.1,296.74,SKIPPED,349.1,349.1,296.74,296.74,296.74,147.11,171.06,171.06,0,104.73,150.11,150.11,296.74
3850203,450,28660,,,,,,,TR CSD INTERPHAL W/O ANES,325.3,130.12,0,323.19,276.5,SKIPPED,323.19,323.19,276.5,276.5,276.5,137.08,159.4,159.4,0,97.59,139.88,139.88,276.5
3850204,450,30903,,,,,,,CNTRL NS BLLED ANT C,521.18,208.47,219.63,498.94,443,SKIPPED,498.94,498.94,443,443,443,219.63,255.38,255.38,SKIPPED,SKIPPED,224.11,224.11,443
3850206,450,30905,,,,,,,CNTRL NS BLLED POST,997.45,398.98,420.32,847.83,847.83,SKIPPED,498.94,498.94,847.83,847.83,847.83,420.32,488.75,488.75,SKIPPED,SKIPPED,428.9,428.9,847.83
3850208,450,31500,,,,,,,INTUBAT ENDO TRACK E,532.16,212.86,0,532.16,452.34,SKIPPED,532.16,532.16,452.34,452.34,452.34,224.25,260.76,260.76,0,159.65,228.83,228.83,452.34
3850213,450,42809,,,,,,,REMOVE FB PHARYNX,132.67,53.07,0,132.67,112.77,SKIPPED,132.67,132.67,112.77,112.77,112.77,55.91,65.01,65.01,0,39.8,57.05,57.05,112.77
3850215,450,25660,,,,,,,CLSD TRT FX FINGR/TOE/TRK,384.75,153.9,162.13,384.75,327.04,SKIPPED,384.75,384.75,327.04,327.04,327.04,162.13,188.53,188.53,SKIPPED,SKIPPED,165.44,165.44,327.04
3850216,450,43246,,,,,,,PLCE GASTROST TUBE P,1243.83,497.53,524.15,1243.83,1057.26,SKIPPED,1243.83,1243.83,1057.26,1057.26,1057.26,524.15,609.48,609.48,SKIPPED,SKIPPED,534.85,534.85,1057.26
3850217,450,32551,,,,,,,INSERTION OF CHEST TUBE,1239.47,495.79,0,1239.47,1053.55,SKIPPED,1239.47,1239.47,1053.55,1053.55,1053.55,522.31,607.34,607.34,0,371.84,532.97,532.97,1053.55
3850218,450,43762,,,,,,,CHG GASTROSTOMY TUBE,288.66,115.46,0,288.66,245.36,SKIPPED,288.66,288.66,245.36,245.36,245.36,121.64,141.44,141.44,0,86.6,124.12,124.12,245.36
3850219,450,20520,,,,,,,"RMVE F/B IN MUSCLE, SIMP",982.03,392.81,0,834.73,834.73,SKIPPED,630.99,630.99,834.73,834.73,834.73,413.82,481.19,481.19,0,294.61,422.27,422.27,834.73
3850220,450,43761,,,,,,,GASTRIC TUBE REPOSIT,637.41,254.96,268.61,637.41,541.8,SKIPPED,637.41,637.41,541.8,541.8,541.8,268.61,312.33,312.33,SKIPPED,SKIPPED,274.09,274.09,541.8
3850222,450,49080,,,,,,,PERITONEOCENTESIS IN,388.9,155.56,0,330.56,330.56,SKIPPED,295.56,295.56,330.56,330.56,330.56,163.89,190.56,190.56,0,116.67,167.23,167.23,330.56
3850224,450,51702,,,,,,,CAT URETHRA SMPLE,122.62,49.05,0,122.62,104.23,SKIPPED,122.62,122.62,104.23,104.23,104.23,51.68,60.08,60.08,0,36.79,52.73,52.73,104.23
3850225,450,46083,,,,,,,INCISION EXT HEMMORRHOID,432.92,173.17,0,432.92,367.98,SKIPPED,432.92,432.92,367.98,367.98,367.98,182.44,212.13,212.13,0,129.88,186.16,186.16,367.98
3850226,450,65205,,,,,,,RM FB EYE CONJUNE SU,257.58,103.03,0,257.58,218.94,SKIPPED,257.58,257.58,218.94,218.94,218.94,108.54,126.21,126.21,0,77.27,110.76,110.76,218.94
3850228,450,65210,,,,,,,RM FB EYE CONJUCT EM,288.66,115.46,0,288.66,245.36,SKIPPED,288.66,288.66,245.36,245.36,245.36,121.64,141.44,141.44,0,86.6,124.12,124.12,245.36
3850229,450,46600,,,,,,,DIAGNOSTIC ANOSCOPY,879.63,351.85,0,747.69,747.69,SKIPPED,498.94,498.94,747.69,747.69,747.69,370.68,431.02,431.02,0,263.89,378.24,378.24,747.69
3850230,761,99211,,,,,,,TREATMENT RM LEVEL 1,200.21,80.08,0,170.18,170.18,SKIPPED,44.32,44.32,170.18,170.18,170.18,84.37,98.1,98.1,0,60.06,86.09,86.09,170.18
3850231,761,99212,,,,,,,TREATMENT RM LEVEL 2,237.47,94.99,0,201.85,201.85,SKIPPED,122.74,122.74,201.85,201.85,201.85,100.07,116.36,116.36,0,71.24,102.11,102.11,201.85
3850232,450,62270,,,,,,,SPINAL LUMBAR DX,1396.26,558.5,588.38,1396.26,1186.82,SKIPPED,1396.26,1396.26,1186.82,1186.82,1186.82,588.38,684.17,684.17,SKIPPED,SKIPPED,600.39,600.39,1186.82
3850234,480,92960,,,,,,,CARDIOVERSION EXTERN,1205.28,482.11,0,1205.28,1024.49,SKIPPED,1205.28,1205.28,1024.49,1024.49,1024.49,507.9,590.59,590.59,0,361.58,518.27,518.27,1024.49
3850239,450,11042,,,,,,,DEB SUBQ TISSUE 20SQCM/<,1545.13,618.05,651.12,1476.3,1313.36,SKIPPED,1476.3,1476.3,1313.36,1313.36,1313.36,651.12,757.11,757.11,SKIPPED,SKIPPED,664.41,664.41,1313.36
3850242,360,54115,,,,,,,REMOVAL FB PENIS,1680.08,672.03,582.36,1680.08,1428.07,SKIPPED,1680.08,1680.08,1428.07,1428.07,1428.07,707.98,582.36,582.36,SKIPPED,SKIPPED,722.43,722.43,1428.07
3850243,450,46040,,,,,,,INCISION OF RECTAL ABSCES,5362.95,2145.18,2259.95,4558.51,4558.51,SKIPPED,4447.85,4447.85,4558.51,4558.51,4558.51,2259.95,2627.85,2627.85,SKIPPED,SKIPPED,2306.07,2306.07,4558.51
3850244,450,96372,,,,,,,INJECTION SUBQ IM,207.86,83.14,0,207.86,176.68,SKIPPED,207.86,207.86,176.68,176.68,176.68,87.59,101.85,101.85,0,62.36,89.38,89.38,176.68
3850245,450,40799,,,,,,,LIP SURGERY PROCEDURE,2114.41,845.76,0,1797.25,1797.25,SKIPPED,847.88,847.88,1797.25,1797.25,1797.25,891.02,1036.06,1036.06,0,634.32,909.2,909.2,1797.25
3850246,260,96374,,,,,,,INJECTION IV,207.86,83.14,0,207.86,176.68,SKIPPED,207.86,207.86,176.68,176.68,176.68,87.59,101.85,101.85,0,62.36,89.38,89.38,176.68
3850248,450,43753,,,,,,,GASTRIC INTUBATION,387.82,155.13,0,387.82,329.65,SKIPPED,387.82,387.82,329.65,329.65,329.65,163.42,190.03,190.03,0,116.35,166.76,166.76,329.65
3850250,450,96372,,,,,,,INJECTION ANTIBOTIC,207.86,83.14,0,207.86,176.68,SKIPPED,207.86,207.86,176.68,176.68,176.68,87.59,101.85,101.85,0,62.36,89.38,89.38,176.68
3850251,450,67700,,,,,,,DRAINAGE OF EYELID ABSCES,724.46,289.78,0,662.29,615.79,SKIPPED,662.29,662.29,615.79,615.79,615.79,305.29,354.99,354.99,0,217.34,311.52,311.52,615.79
3850252,450,25605,,,,,,,TRT DIS RAD FX CLSD,1436.89,574.76,605.5,1436.89,1221.36,SKIPPED,1436.89,1436.89,1221.36,1221.36,1221.36,605.5,704.08,704.08,SKIPPED,SKIPPED,617.86,617.86,1221.36
3850255,450,26775,,,,,,,CLSD REDUCTION FINGE,2922.31,1168.92,587.1,2483.96,2483.96,SKIPPED,587.1,587.1,2483.96,2483.96,2483.96,1231.46,1431.93,1431.93,SKIPPED,SKIPPED,1256.59,1256.59,2483.96
3850256,450,35201,,,,,,,RPR BLOOD VESSEL NECK,6137.1,2454.84,0,6137.1,5216.54,SKIPPED,6137.1,6137.1,5216.54,5216.54,5216.54,2586.17,3007.18,3007.18,0,1841.13,2638.95,2638.95,5216.54
3850257,761,92950,,,,,,,CPR,1225.67,490.27,0,1181.94,1041.82,SKIPPED,1181.94,1181.94,1041.82,1041.82,1041.82,516.5,600.58,600.58,0,367.7,527.04,527.04,1041.82
3850258,761,31500,,,,,,,INTUBAT ENDO TRAKE.,532.16,212.86,0,532.16,452.34,SKIPPED,532.16,532.16,452.34,452.34,452.34,224.25,260.76,260.76,0,159.65,228.83,228.83,452.34
3850260,391,36430,,,,,,,BLOOD TRANSFUSION 1-,1236.38,494.55,0,1050.92,1050.92,SKIPPED,167.58,167.58,1050.92,1050.92,1050.92,521.01,605.83,605.83,0,370.91,531.64,531.64,1050.92
3850261,450,43753,,,,,,,TX GASTRO INTUB W/ASP,170.72,68.29,0,170.72,145.11,SKIPPED,170.72,170.72,145.11,145.11,145.11,71.94,83.65,83.65,0,51.22,73.41,73.41,145.11
3850262,450,27808,,,,,,,CLSD TRT BIMALLEOLAR ANKLE FX W/O MANIP.,622.91,249.16,262.49,622.91,529.47,SKIPPED,622.91,622.91,529.47,529.47,529.47,262.49,305.23,305.23,SKIPPED,SKIPPED,267.85,267.85,529.47
3850263,450,25630,,,,,,,CLSD TRT OF FX WRIST W/O MANIP.,540.23,216.09,227.65,531.76,459.2,SKIPPED,531.76,531.76,459.2,459.2,459.2,227.65,264.71,264.71,SKIPPED,SKIPPED,232.3,232.3,459.2
3850264,450,28400,,,,,,,CLSD TRT CALCANEAL FX W/O MANIP.,465.26,186.1,196.06,465.26,395.47,SKIPPED,465.26,465.26,395.47,395.47,395.47,196.06,227.98,227.98,SKIPPED,SKIPPED,200.06,200.06,395.47
3850266,450,27552,,,,,,,CLS TRT OF PATELLAR DISLOCATION/ ANEST,4500.3,1800.12,1896.43,4500.3,3825.26,SKIPPED,4500.3,4500.3,3825.26,3825.26,3825.26,1896.43,2205.15,2205.15,SKIPPED,SKIPPED,1935.13,1935.13,3825.26
3850280,450,92950,,,,,,,CPR,1225.67,490.27,0,1181.94,1041.82,SKIPPED,1181.94,1181.94,1041.82,1041.82,1041.82,516.5,600.58,600.58,0,367.7,527.04,527.04,1041.82
3850285,450,26725,,,,,,,CLSD TX PHAL FX W/MA,727.67,291.07,306.64,618.52,618.52,SKIPPED,531.76,531.76,618.52,618.52,618.52,306.64,356.56,356.56,SKIPPED,SKIPPED,312.9,312.9,618.52
3850300,450,23650,,,,,,,CD TX SHLD W/MAN W/O,930.83,372.33,392.25,930.83,791.21,SKIPPED,930.83,930.83,791.21,791.21,791.21,392.25,456.11,456.11,SKIPPED,SKIPPED,400.26,400.26,791.21
3850301,450,25565,,,,,,,TREAT FRACTURE RADIUS & ULNA,1025.85,410.34,432.3,1025.85,871.97,SKIPPED,1025.85,1025.85,871.97,871.97,871.97,432.3,502.67,502.67,SKIPPED,SKIPPED,441.12,441.12,871.97
3850325,450,69209,,,,,,,REMOVE IMPACTED CERUMEN,87.26,34.9,0,87.26,74.17,SKIPPED,87.26,87.26,74.17,74.17,74.17,36.77,42.76,42.76,0,26.18,37.52,37.52,74.17
3850326,450,20102,,,,,,,EXPLORE WOUND ABDOMEN,4741.93,1896.77,0,4741.93,4030.64,SKIPPED,4741.93,4741.93,4030.64,4030.64,4030.64,1998.25,2323.55,2323.55,0,1422.58,2039.03,2039.03,4030.64
3850328,402,32555,,,,,,,ED US ASPIRATE PLEURA W/ IMAGING,1830.58,732.23,0,1830.58,1555.99,SKIPPED,1830.58,1830.58,1555.99,1555.99,1555.99,771.41,896.98,896.98,0,549.17,787.15,787.15,1555.99
3850329,402,76604,,,,,,,ED US CHEST,669.31,267.72,0,581.46,568.91,SKIPPED,581.46,581.46,568.91,568.91,568.91,282.04,137.3,137.3,0,73.48,287.8,287.8,568.91
3850330,402,76817,,,,,,,ED US PREGNANCY,709.59,283.84,0,603.15,603.15,SKIPPED,581.46,581.46,603.15,603.15,603.15,299.02,137.3,137.3,0,73.48,305.12,305.12,603.15
3850331,402,49083,,,,,,,ED US PARACENTESIS,1883.87,753.55,793.86,1883.87,1601.29,SKIPPED,1883.87,1883.87,1601.29,1601.29,1601.29,793.86,923.1,923.1,SKIPPED,SKIPPED,810.06,810.06,1601.29
3850332,402,76937,,,,,,,ED US VASCULAR,592.95,237.18,0,504.01,504.01,SKIPPED,87.53,87.53,504.01,504.01,504.01,249.87,290.55,290.55,0,177.88,254.97,254.97,504.01
3850333,402,76536,,,,,,,ED US HEAD AND NECK,838.1,335.24,0,712.38,712.38,SKIPPED,581.46,581.46,712.38,712.38,712.38,353.17,137.3,137.3,0,73.48,360.38,360.38,712.38
3850334,402,76642,,,,,,,ED US BREAST,405.46,162.18,0,344.64,344.64,SKIPPED,315.57,315.57,344.64,344.64,344.64,170.86,101.93,101.93,0,39.88,174.35,174.35,344.64
3850335,402,76870,,,,,,,ED US EXAM SCROTUM,901.59,360.64,0,766.35,766.35,SKIPPED,581.46,581.46,766.35,766.35,766.35,379.93,137.3,137.3,0,73.48,387.68,387.68,766.35
3850336,402,76999,,,,,,,ECHO EXAMINATION PROCEDURE,498.52,199.41,0,423.74,423.74,SKIPPED,315.57,315.57,423.74,423.74,423.74,210.07,101.93,101.93,0,39.88,214.36,214.36,423.74
3850337,450,27520,,,,,,,CLSD TRT PATELLAR FX W/O MANIPULATION,553.46,221.38,233.23,553.46,470.44,SKIPPED,553.46,553.46,470.44,470.44,470.44,233.23,271.2,271.2,SKIPPED,SKIPPED,237.99,237.99,470.44
3850338,450,27250,,,,,,,CLOSED TRT OF HIP DISLOCATION,869.66,347.86,366.47,869.66,739.21,SKIPPED,869.66,869.66,739.21,739.21,739.21,366.47,426.13,426.13,SKIPPED,SKIPPED,373.95,373.95,739.21
3850339,450,97605,,,,,,,NEGATIVE PRESSURE WUND THERAPY,416.85,166.74,0,416.85,354.32,SKIPPED,416.85,416.85,354.32,354.32,354.32,175.66,204.26,204.26,0,125.06,179.25,179.25,354.32
3850340,450,54220,,,,,,,IRRIGATION OF CORPORA CAVERNOSA,840,336,353.98,840,714,SKIPPED,840,840,714,714,714,353.98,411.6,411.6,SKIPPED,SKIPPED,361.2,361.2,714
3850426,450,29530,,,,,,,STRAPPING KNEE,316.05,126.42,0,316.05,268.64,SKIPPED,316.05,316.05,268.64,268.64,268.64,133.18,154.86,154.86,0,94.82,135.9,135.9,268.64
3853014,780,Q3014,,,,,,,TELEHEALTH FACILITY FEE,38.29,15.32,0,38.29,32.55,SKIPPED,38.29,38.29,32.55,32.55,32.55,27.04,18.76,18.76,0,11.49,27.59,27.59,32.55
3854068,450,90471,,,,,,,IMMUNIZATION ADM 1ST,153.58,61.43,0,153.58,130.54,SKIPPED,153.58,153.58,130.54,130.54,130.54,64.72,75.25,75.25,0,46.07,66.04,66.04,130.54
3854069,450,90472,,,,,,,IMMUNIZATION ADM ADDL,116.33,46.53,0,98.88,98.88,SKIPPED,61.37,61.37,98.88,98.88,98.88,49.02,57,57,0,34.9,50.02,50.02,98.88
3854071,260,96360,,,,,,,IV HYDRTION 1ST HOUR,677.96,271.18,0,576.27,576.27,SKIPPED,225.01,225.01,576.27,576.27,576.27,285.69,332.2,332.2,0,203.39,291.52,291.52,576.27
3854072,260,96361,,,,,,,IV HYDRATION ADDL HOUR,300.98,120.39,0,255.83,255.83,SKIPPED,66.5,66.5,255.83,255.83,255.83,126.83,147.48,147.48,0,90.29,129.42,129.42,255.83
3854073,260,96365,,,,,,,IV MED ADM 1ST HOUR,738.39,295.36,0,627.63,627.63,SKIPPED,351.17,351.17,627.63,627.63,627.63,311.16,361.81,361.81,0,221.52,317.51,317.51,627.63
3854074,260,96366,,,,,,,IV MED ADMIN ADDL HOUR,322.69,129.08,0,274.29,274.29,SKIPPED,105.69,105.69,274.29,274.29,274.29,135.98,158.12,158.12,0,96.81,138.76,138.76,274.29
3854075,260,96367,,,,,,,SEQUENTIAL MED INFUSION,253.28,101.31,0,215.29,215.29,SKIPPED,151.72,151.72,215.29,215.29,215.29,106.73,124.11,124.11,0,75.98,108.91,108.91,215.29
3854076,260,96368,,,,,,,CONCURRENT MED INFUSION,346.02,138.41,0,294.12,294.12,SKIPPED,100.56,100.56,294.12,294.12,294.12,145.81,169.55,169.55,0,103.81,148.79,148.79,294.12
3854077,260,96375,,,,,,,IV PUSH EA ADDL DRUG,322.69,129.08,0,274.29,274.29,SKIPPED,86.92,86.92,274.29,274.29,274.29,135.98,158.12,158.12,0,96.81,138.76,138.76,274.29
3854078,260,96376,,,,,,,IV PUSH SAME 30 MIN APART,299.39,119.76,0,254.48,254.48,SKIPPED,109.11,109.11,254.48,254.48,254.48,126.17,146.7,146.7,0,89.82,128.74,128.74,254.48
3854080,450,29065,,,,,,,APPLICATION CAST LONG ARM,743.1,297.24,297.54,631.64,631.64,SKIPPED,297.54,297.54,631.64,631.64,631.64,313.14,364.12,364.12,SKIPPED,SKIPPED,319.53,319.53,631.64
3854082,450,51798,,,,,,,BLADDER SCAN,339.72,135.89,0,288.76,288.76,SKIPPED,265.81,265.81,288.76,288.76,288.76,143.16,166.46,166.46,0,101.92,146.08,146.08,288.76
3854083,450,64450,,,,,,,NERVE BLK OTHER PERIPHERAL,1458.3,583.32,0,1239.56,1239.56,SKIPPED,249.66,249.66,1239.56,1239.56,1239.56,614.53,714.57,714.57,0,437.49,627.07,627.07,1239.56
3854084,450,99292,,,,,,,CRITICAL CARE ADDL 30 MIN,661.5,264.6,0,562.28,562.28,SKIPPED,538.7,538.7,562.28,562.28,562.28,278.76,324.14,324.14,0,198.45,284.45,284.45,562.28
3854086,450,46083,,,,,,,INCISE EXT HEMORRHOID,1039.38,415.75,0,883.47,883.47,SKIPPED,567.96,567.96,883.47,883.47,883.47,437.99,509.3,509.3,0,311.81,446.93,446.93,883.47
3854087,450,41899,,,,,,,DENTOALVEOLAR STRUCTURE,2572.05,1028.82,0,2186.24,2186.24,SKIPPED,847.88,847.88,2186.24,2186.24,2186.24,1083.86,1260.3,1260.3,0,771.62,1105.98,1105.98,2186.24
3854088,450,17250,,,,,,,TOPICAL CAUTERIZATION,600.37,240.15,0,600.37,510.31,SKIPPED,600.37,600.37,510.31,510.31,510.31,253,294.18,294.18,0,180.11,258.16,258.16,510.31
3854089,402,76705,,,,,,,ED US LIMITED ABDOMINAL,702.74,281.1,0,597.33,597.33,SKIPPED,581.46,581.46,597.33,597.33,597.33,296.14,137.3,137.3,0,73.48,302.18,302.18,597.33
3854090,480,93308,,,,,,,ED US LIMITED HEART,939.68,375.87,0,798.73,798.73,SKIPPED,386.98,386.98,798.73,798.73,798.73,395.98,289.96,289.96,0,148.02,404.06,404.06,798.73
3854091,402,76775,,,,,,,ED US LIMITED ANEURYSM,783.43,313.37,0,665.92,665.92,SKIPPED,581.46,581.46,665.92,665.92,665.92,330.13,137.3,137.3,0,73.48,336.87,336.87,665.92
3854092,402,76815,,,,,,,ED US LIMITED OB,429.78,171.91,0,429.78,365.31,SKIPPED,429.78,429.78,365.31,365.31,365.31,181.11,137.3,137.3,0,73.48,184.81,184.81,365.31
3854093,402,76857,,,,,,,ED US LIMITED PELVIC,625.03,250.01,0,581.46,531.28,SKIPPED,581.46,581.46,531.28,531.28,531.28,263.38,137.3,137.3,0,59.11,268.76,268.76,531.28
3854094,402,76830,,,,,,,ED US TRANSVAGINAL,705.83,282.33,0,599.96,599.96,SKIPPED,453.95,453.95,599.96,599.96,599.96,297.44,137.3,137.3,0,73.48,303.51,303.51,599.96
3854095,402,76775,,,,,,,ED US RENAL,783.43,313.37,0,665.92,665.92,SKIPPED,581.46,581.46,665.92,665.92,665.92,330.13,137.3,137.3,0,73.48,336.87,336.87,665.92
3854096,402,76705,,,,,,,ED US GB,702.74,281.1,0,597.33,597.33,SKIPPED,581.46,581.46,597.33,597.33,597.33,296.14,137.3,137.3,0,73.48,302.18,302.18,597.33
3854097,402,76930,,,,,,,ED US GUIDANCE PREICARDIOCENTESIS,425.49,170.2,0,361.67,361.67,SKIPPED,323.37,323.37,361.67,361.67,361.67,179.3,208.49,208.49,0,127.65,182.96,182.96,361.67
3854098,402,76942,,,,,,,ED US GUIDANCE FOR NEEDLE PLACEMENT,792.79,317.12,0,673.87,673.87,SKIPPED,142.19,142.19,673.87,673.87,673.87,334.08,388.47,388.47,0,237.84,340.9,340.9,673.87
3854099,402,76857,,,,,,,ED US URINARY BLADDER,625.03,250.01,0,581.46,531.28,SKIPPED,581.46,581.46,531.28,531.28,531.28,263.38,137.3,137.3,0,59.11,268.76,268.76,531.28
3854100,402,76882,,,,,,,ED US FOREIGN BODY,499.59,199.84,0,499.59,424.65,SKIPPED,499.59,499.59,424.65,424.65,424.65,210.52,137.3,137.3,0,59.11,214.82,214.82,424.65
3854101,450,41250,,,,,,,REPAIR OF TONGUE LAC.,885.14,354.06,0,752.37,752.37,SKIPPED,498.94,498.94,752.37,752.37,752.37,373,433.72,433.72,0,265.54,380.61,380.61,752.37
3854102,450,15120,,,,,,,S/GR FC EL NK GEN H/,8048.33,3219.33,3391.56,8048.33,6841.08,SKIPPED,8048.33,8048.33,6841.08,6841.08,6841.08,3391.56,3943.68,3943.68,SKIPPED,SKIPPED,3460.78,3460.78,6841.08
3854103,450,64405,,,,,,,NERVE BLOCK INJ OCCIPITAL,1688.53,675.41,0,1435.25,1435.25,SKIPPED,306.09,306.09,1435.25,1435.25,1435.25,711.55,827.38,827.38,0,506.56,726.07,726.07,1435.25
3854104,450,90792,,,,,,,PSYCH DIAGNOSTIC EVAL W/ MEDICAL SERVICE,357.81,143.12,0,304.14,304.14,SKIPPED,271.94,271.94,304.14,304.14,304.14,150.78,175.33,175.33,0,107.34,153.86,153.86,304.14
3854105,450,49450,,,,,,,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCU,1405.76,562.3,592.39,1405.76,1194.9,SKIPPED,1405.76,1405.76,1194.9,1194.9,1194.9,592.39,688.82,688.82,SKIPPED,SKIPPED,604.48,604.48,1194.9
3854106,450,12037,,,,,,,INTMD RPR S/TR/EXT >30.0 CM,2498.78,999.51,1052.99,2498.78,2123.96,SKIPPED,2498.78,2498.78,2123.96,2123.96,2123.96,1052.99,1224.4,1224.4,SKIPPED,SKIPPED,1074.48,1074.48,2123.96
3854107,450,45915,,,,,,,REMOVE RECTAL OBSTRUCTION,3813.93,1525.57,1607.19,3813.93,3241.84,SKIPPED,3813.93,3813.93,3241.84,3241.84,3241.84,1607.19,1868.83,1868.83,SKIPPED,SKIPPED,1639.99,1639.99,3241.84
3854108,450,27301,,,,,,,I&D DEEP ABSC-THIGH/KNEE,5763.93,2305.57,2428.92,5763.93,4899.34,SKIPPED,5763.93,5763.93,4899.34,4899.34,4899.34,2428.92,2824.33,2824.33,SKIPPED,SKIPPED,2478.49,2478.49,4899.34
3854109,450,24200,,,,,,,REMOVE FOREIGN BODY-ARM,2771.36,1108.54,0,2355.66,2355.66,SKIPPED,660.06,660.06,2355.66,2355.66,2355.66,1167.85,1357.97,1357.97,0,831.41,1191.68,1191.68,2355.66
3854111,450,27246,,,,,,,Closed treatment of greater trochanteric,581.5,232.6,245.05,581.5,494.28,SKIPPED,581.5,581.5,494.28,494.28,494.28,245.05,284.94,284.94,SKIPPED,SKIPPED,250.05,250.05,494.28
3854112,450,27500,,,,,,,"Closed treatment of femoral shaft fx, w/",1022.19,408.88,430.75,1020.78,868.86,SKIPPED,1020.78,1020.78,868.86,868.86,868.86,430.75,500.87,500.87,SKIPPED,SKIPPED,439.54,439.54,868.86
3854113,450,23570,,,,,,,Closed treatment of scapular fracture; w,451.56,180.62,190.29,451.56,383.83,SKIPPED,451.56,451.56,383.83,383.83,383.83,190.29,221.26,221.26,SKIPPED,SKIPPED,194.17,194.17,383.83
3854114,450,46320,,,,,,,REMOVAL HEMORRHOID CLOT,4385.31,1754.12,577.98,3727.51,3727.51,SKIPPED,577.98,577.98,3727.51,3727.51,3727.51,1847.97,2148.8,2148.8,SKIPPED,SKIPPED,1885.68,1885.68,3727.51
3854115,450,40800,,,,,,,DRAINAGE OF MOUTH LESION,839.28,335.71,0,801.99,713.39,SKIPPED,801.99,801.99,713.39,713.39,713.39,353.67,411.25,411.25,0,251.78,360.89,360.89,713.39
3854116,450,28400,,,,,,,CLOSED TRT CALCANEUS FX W/O MANIPULATION,488.52,195.41,205.86,488.52,415.24,SKIPPED,488.52,488.52,415.24,415.24,415.24,205.86,239.37,239.37,SKIPPED,SKIPPED,210.06,210.06,415.24
3854117,450,27520,,,,,,,TRT KNEECAP FX W/O MANIPULATION,581.13,232.45,244.89,581.13,493.96,SKIPPED,581.13,581.13,493.96,493.96,493.96,244.89,284.75,284.75,SKIPPED,SKIPPED,249.89,249.89,493.96
3854118,450,36625,,,,,,,INSERT CATH-ARTERY,503.57,201.43,0,428.03,428.03,SKIPPED,0,0,428.03,428.03,428.03,212.21,246.75,246.75,0,151.07,216.54,216.54,428.03
3854120,450,25622,,,,,,,CLOSED TRT OF WRIST BONE FX W/O MANIPULA,661.5,264.6,278.76,562.28,562.28,SKIPPED,531.76,531.76,562.28,562.28,562.28,278.76,324.14,324.14,SKIPPED,SKIPPED,284.45,284.45,562.28
3854121,450,16000,,,,,,,"INITIAL TREATMENT, FIRST DEGREE BURN",424.46,169.78,0,424.46,360.79,SKIPPED,424.46,424.46,360.79,360.79,360.79,178.87,207.99,207.99,0,127.34,182.52,182.52,360.79
3854122,450,25622,,,,,,,CLOSED TX CARPAL SCAPHOID FX,661.5,264.6,278.76,562.28,562.28,SKIPPED,531.76,531.76,562.28,562.28,562.28,278.76,324.14,324.14,SKIPPED,SKIPPED,284.45,284.45,562.28
3854123,450,24670,,,,,,,CLOSED TRT ULNAR FX PROXIMAL END W/O MAN,577.71,231.08,243.45,577.71,491.05,SKIPPED,577.71,577.71,491.05,491.05,491.05,243.45,283.08,283.08,SKIPPED,SKIPPED,248.42,248.42,491.05
3854124,450,23600,,,,,,,CLOSED TRT OF PROXIMAL HUMERAL FX W/O MA,606.38,242.55,255.53,531.76,515.42,SKIPPED,531.76,531.76,515.42,515.42,515.42,255.53,297.13,297.13,SKIPPED,SKIPPED,260.74,260.74,515.42
3854125,450,27816,,,,,,,CLSD TRT OF TRIMALLEOLAR ANKLE FX W/O MA,660.84,264.34,278.48,660.84,561.71,SKIPPED,660.84,660.84,561.71,561.71,561.71,278.48,323.81,323.81,SKIPPED,SKIPPED,284.16,284.16,561.71
3854126,450,25690,,,,,,,CLOSED TRT OF LUNATE DISLOCATION W/ MANI,2378.09,951.24,1002.13,2378.09,2021.38,SKIPPED,2378.09,2378.09,2021.38,2021.38,2021.38,1002.13,1165.26,1165.26,SKIPPED,SKIPPED,1022.58,1022.58,2021.38
3854127,450,26765,,,,,,,OPEN TRT DISTAL PHALANGEAL FX EACH,4778.24,1911.3,2013.55,4778.24,4061.5,SKIPPED,4778.24,4778.24,4061.5,4061.5,4061.5,2013.55,2341.34,2341.34,SKIPPED,SKIPPED,2054.64,2054.64,4061.5
3854128,450,21320,,,,,,,CLOSED TX NOSE FX W/STABILIZATION,4470.64,1788.26,1883.93,4470.64,3800.04,SKIPPED,4470.64,4470.64,3800.04,3800.04,3800.04,1883.93,2190.61,2190.61,SKIPPED,SKIPPED,1922.38,1922.38,3800.04
3854129,450,36569,,,,,,,INSERTION PICC W/O IMAGING 5YR +,2660.19,1064.08,1121,2660.19,2261.16,SKIPPED,2660.19,2660.19,2261.16,2261.16,2261.16,1121,1303.49,1303.49,SKIPPED,SKIPPED,1143.88,1143.88,2261.16
3854130,450,27760,,,,,,,CLOSED TRT MALLEOUS FX W/O MANIPULATION,623.74,249.5,262.85,623.74,530.18,SKIPPED,623.74,623.74,530.18,530.18,530.18,262.85,305.63,305.63,SKIPPED,SKIPPED,268.21,268.21,530.18
3854131,450,43760,,,,,,,CHANGE GASTROTOMY TUBE W/O GDNCE,769.55,307.82,324.29,654.12,654.12,SKIPPED,584.86,584.86,654.12,654.12,654.12,324.29,377.08,377.08,SKIPPED,SKIPPED,330.91,330.91,654.12
3854132,450,27246,,,,,,,CLSD GREATER TROCHANTERIC FX W/O MANIPUL,744.19,297.68,313.6,744.19,632.56,SKIPPED,744.19,744.19,632.56,632.56,632.56,313.6,364.65,364.65,SKIPPED,SKIPPED,320,320,632.56
3854133,450,28430,,,,,,,CLSD TX TALUS FX W/O MANIPULATION,579.03,231.61,244,531.76,492.18,SKIPPED,531.76,531.76,492.18,492.18,492.18,244,283.72,283.72,SKIPPED,SKIPPED,248.98,248.98,492.18
3854134,450,25028,,,,,,,I&D FOREAREM/WRIST DEEP ABCESS,4974.48,1989.79,2096.25,4974.48,4228.31,SKIPPED,4974.48,4974.48,4228.31,4228.31,4228.31,2096.25,2437.5,2437.5,SKIPPED,SKIPPED,2139.03,2139.03,4228.31
3854135,450,27230,,,,,,,CLSD FEMORAL FX PROX END NECK W/O MANIPU,834.59,333.84,351.69,834.59,709.4,SKIPPED,834.59,834.59,709.4,709.4,709.4,351.69,408.95,408.95,SKIPPED,SKIPPED,358.87,358.87,709.4
3854136,450,43762,,,,,,,REPLACE STOMACH STOMA TUBE,892.99,357.2,0,892.99,759.04,SKIPPED,892.99,892.99,759.04,759.04,759.04,376.31,437.57,437.57,0,267.9,383.99,383.99,759.04
3854137,450,27238,,,,,,,CLOSED TRT INTER/PERI/SUB FEM FX W/O MAN,1879.76,751.9,792.13,1879.76,1597.8,SKIPPED,1879.76,1879.76,1597.8,1597.8,1597.8,792.13,921.08,921.08,SKIPPED,SKIPPED,808.3,808.3,1597.8
3854138,480,29260,,,,,,,STRAPPING:ELBOW OR WRIST,251.37,100.55,0,213.66,213.66,SKIPPED,151.05,151.05,213.66,213.66,213.66,105.93,123.17,123.17,0,75.41,108.09,108.09,213.66
3854139,450,27220,,,,,,,CLSD TX ACETABULUM HIP/SOCKET FX W/O MAN,766.48,306.59,323,766.48,651.51,SKIPPED,766.48,766.48,651.51,651.51,651.51,323,375.58,375.58,SKIPPED,SKIPPED,329.59,329.59,651.51
3854140,450,12021,,,,,,,TX SUPERFICIAL WOUND DEHISCENCE W/ PACK,877.59,351.04,369.81,877.59,745.95,SKIPPED,877.59,877.59,745.95,745.95,745.95,369.81,430.02,430.02,SKIPPED,SKIPPED,377.36,377.36,745.95
3854141,450,27252,,,,,,,CLOSED TRT OF DISLOCATED HIM UNDER ANES,2127.28,850.91,896.44,2127.28,1808.19,SKIPPED,2127.28,2127.28,1808.19,1808.19,1808.19,896.44,1042.37,1042.37,SKIPPED,SKIPPED,914.73,914.73,1808.19
3854142,450,11301,,,,,,,SHAVE SKIN LESION 0.6-1.0 CM,355.43,142.17,0,355.43,302.12,SKIPPED,355.43,355.43,302.12,302.12,302.12,149.77,174.16,174.16,0,106.63,152.83,152.83,302.12
3854144,450,23605,,,,,,,CLOSED TRT PROXIMAL HUMERAL FX W/ MANIPU,2861.36,1144.54,1205.77,2861.36,2432.16,SKIPPED,2861.36,2861.36,2432.16,2432.16,2432.16,1205.77,1402.07,1402.07,SKIPPED,SKIPPED,1230.38,1230.38,2432.16
3854145,450,27244,,,,,,,"TX INTERTROCHANTERIC,PERITROCHANTERIC...",2608.2,1043.28,0,2608.2,2216.97,SKIPPED,2608.2,2608.2,2216.97,2216.97,2216.97,1099.1,1278.02,1278.02,0,782.46,1121.53,1121.53,2216.97
3854146,450,27818,,,,,,,CLOSED TRT TRIMALLEOLAR ANKLE FX,1769.25,707.7,745.56,1769.25,1503.86,SKIPPED,1769.25,1769.25,1503.86,1503.86,1503.86,745.56,866.93,866.93,SKIPPED,SKIPPED,760.78,760.78,1503.86
3854147,450,31530,,,,,,,"LARYNHSCOPY, DIRECT, OPERATIVE W/ FOREIG",4253.13,1701.25,1792.27,4253.13,3615.16,SKIPPED,4253.13,4253.13,3615.16,3615.16,3615.16,1792.27,2084.03,2084.03,SKIPPED,SKIPPED,1828.85,1828.85,3615.16
3854148,450,59025,,,,,,,NST MONITOR,629.14,251.66,0,534.77,534.77,SKIPPED,88.64,88.64,534.77,534.77,534.77,265.12,308.28,308.28,0,188.74,270.53,270.53,534.77
3854149,450,35207,,,,,,,"RPR BLOOD VESSEL, HAND OR FINGER",4969.27,1987.71,2094.05,4969.27,4223.88,SKIPPED,4969.27,4969.27,4223.88,4223.88,4223.88,2094.05,2434.94,2434.94,SKIPPED,SKIPPED,2136.79,2136.79,4223.88
3860001,981,13101,,,,,,,RPR CMPLX TR 2.6-7.5CM,1055.53,422.21,0,1055.53,897.2,SKIPPED,1055.53,1055.53,897.2,897.2,897.2,270.39,517.21,517.21,SKIPPED,SKIPPED,275.91,275.91,0
3860002,981,10121,,,,,,,I & RMVE FB SUBCUT,441.88,176.75,0,441.88,375.6,SKIPPED,441.88,441.88,375.6,375.6,375.6,200.66,216.52,216.52,SKIPPED,SKIPPED,204.76,204.76,0
3860005,981,12007,,,,,,,RPR SMP SCLP/NK/TRK/30C,351.59,140.64,0,351.59,298.85,SKIPPED,351.59,351.59,298.85,298.85,298.85,157.15,172.28,172.28,SKIPPED,SKIPPED,160.36,160.36,0
3860006,981,20552,,,,,,,INJ TRIGG POINT SING/MUL,91.33,36.53,0,91.33,77.63,SKIPPED,91.33,91.33,77.63,77.63,77.63,41.2,44.75,44.75,SKIPPED,SKIPPED,42.04,42.04,0
3860007,975,25500,,,,,,,closed treatment of radial shaft fractur,725.43,290.17,0,616.62,616.62,SKIPPED,531.76,531.76,616.62,616.62,616.62,285.61,355.46,355.46,SKIPPED,SKIPPED,291.44,291.44,0
3860010,981,56405,,,,,,,I&D OF VULVA/PERINEAL,256.22,102.49,0,242.82,217.79,SKIPPED,242.82,242.82,217.79,217.79,217.79,140.54,125.55,125.55,SKIPPED,SKIPPED,143.41,143.41,0
3860014,981,10140,,,,,,,I&D HEMATOMA SEROMA-PHY,282.6,113.04,0,282.6,240.21,SKIPPED,282.6,282.6,240.21,240.21,240.21,128.98,138.47,138.47,SKIPPED,SKIPPED,131.61,131.61,0
3860026,981,99281,,,,,,,E&M SELF LIMIT/MINOR PHY,50.74,20.3,0,50.74,43.13,SKIPPED,50.74,50.74,43.13,43.13,43.13,23.96,24.86,24.86,0,15.22,24.45,24.45,0
3860028,981,10061,,,,,,,I&D ABSCESS COMP PHY,427.71,171.08,0,427.71,363.55,SKIPPED,427.71,427.71,363.55,363.55,363.55,200.8,209.58,209.58,SKIPPED,SKIPPED,204.9,204.9,0
3860029,981,97597,,,,,,,DEBRIDE SKIN PART THICK,57.81,23.12,0,57.81,49.14,SKIPPED,57.81,57.81,49.14,49.14,49.14,39.82,28.33,28.33,0,17.34,40.63,40.63,0
3860035,981,65220,,,,,,,RMVE FB EXT EYE W/O PHY,101.25,40.5,0,101.25,86.06,SKIPPED,101.25,101.25,86.06,86.06,86.06,44.64,49.61,49.61,0,30.38,45.55,45.55,0
3860037,981,99282,,,,,,,E&M LOW MOD/SEVERITY PHY,98.92,39.57,0,98.92,84.08,SKIPPED,98.92,98.92,84.08,84.08,84.08,46.37,48.47,48.47,0,29.68,47.32,47.32,0
3860038,981,26605,,,,,,,TRT METACARPAL FRACTURE,866.79,346.72,0,866.79,736.77,SKIPPED,866.79,866.79,736.77,736.77,736.77,331.1,424.73,424.73,SKIPPED,SKIPPED,337.86,337.86,0
3860039,981,27550,,,,,,,PHY-TRT KNEE CLSD DISLOC,1125.83,450.33,0,1020.78,956.96,SKIPPED,1020.78,1020.78,956.96,956.96,956.96,521.45,551.66,551.66,SKIPPED,SKIPPED,532.09,532.09,0
3860040,981,27560,,,,,,,TRT PATELLAR CL DISLOCATE,840.91,336.36,0,840.91,714.77,SKIPPED,840.91,840.91,714.77,714.77,714.77,372.51,412.05,412.05,SKIPPED,SKIPPED,380.11,380.11,0
3860042,981,94002,,,,,,,#VENT MGMT 1ST DAY-PHYS,118.3,47.32,0,118.3,100.56,SKIPPED,118.3,118.3,100.56,100.56,100.56,101.6,57.97,57.97,0,35.49,103.67,103.67,0
3860048,981,99284,,,,,,,E&M HIGH SEV/URG EVA PHY,281,112.4,0,281,238.85,SKIPPED,281,281,238.85,238.85,238.85,133.36,137.69,137.69,0,84.3,136.08,136.08,0
3860065,981,99283,,,,,,,E&M MOD SEVERITY PHY,148.09,59.24,0,148.09,125.88,SKIPPED,148.09,148.09,125.88,125.88,125.88,78.79,72.56,72.56,0,44.43,80.4,80.4,0
3860069,981,11730,,,,,,,#AVUL NAIL PLATE SIN,134.02,53.61,0,134.02,113.92,SKIPPED,134.02,134.02,113.92,113.92,113.92,59.03,65.67,65.67,0,40.21,60.23,60.23,0
3860071,981,69200,,,,,,,RM FB EX AUD CAN W/O PHY,112.72,45.09,0,112.72,95.81,SKIPPED,112.72,112.72,95.81,95.81,95.81,51.53,55.23,55.23,0,33.82,52.58,52.58,0
3860072,981,29085,,,,,,,CAST HAND/LOW FOREARM-PHY,160.77,64.31,0,160.77,136.65,SKIPPED,160.77,160.77,136.65,136.65,136.65,72.81,78.78,78.78,SKIPPED,SKIPPED,74.3,74.3,0
3860073,981,29550,,,,,,,STRAPPING TOES PHY,27.94,11.18,0,27.94,23.75,SKIPPED,27.94,27.94,23.75,23.75,23.75,12.45,13.69,13.69,0,8.38,12.7,12.7,0
3860074,981,28630,,,,,,,TRT METAR JNT DISL C PHY,262.24,104.9,0,262.24,222.9,SKIPPED,262.24,262.24,222.9,222.9,222.9,120.87,128.5,128.5,0,78.67,123.34,123.34,0
3860077,981,11004,,,,,,,DEBRIDE SKIN SUBCUT-PHY,1391.6,556.64,0,1391.6,1182.86,SKIPPED,1391.6,1391.6,1182.86,1182.86,1182.86,614.8,681.88,681.88,0,417.48,627.35,627.35,0
3860079,981,21480,,,,,,,TRT CLSD DISLOC TEMPOROMA,77.02,30.81,0,77.02,65.47,SKIPPED,77.02,77.02,65.47,65.47,65.47,33.37,37.74,37.74,SKIPPED,SKIPPED,34.05,34.05,0
3860080,981,99285,,,,,,,E&M IMMED SIGNIF THR PHY,414.04,165.62,0,414.04,351.93,SKIPPED,414.04,414.04,351.93,351.93,351.93,193.51,202.88,202.88,0,124.21,197.46,197.46,0
3860081,981,13152,,,,,,,RPR CPLX FACE2.6-7.5CM-DR,1227.12,490.85,0,1227.12,1043.05,SKIPPED,1227.12,1227.12,1043.05,1043.05,1043.05,365.18,601.29,601.29,SKIPPED,SKIPPED,372.63,372.63,0
3860084,981,25565,,,,,,,FX TRT CLSD RAD SFT W/MAN,1103.22,441.29,0,1103.22,937.74,SKIPPED,1103.22,1103.22,937.74,937.74,937.74,513.98,540.58,540.58,SKIPPED,SKIPPED,524.47,524.47,0
3860085,981,99291,,,,,,,E&M CRITICAL CARE 1S PHY,744.68,297.87,0,744.68,632.98,SKIPPED,744.68,744.68,632.98,632.98,632.98,237.73,364.89,364.89,0,223.4,242.58,242.58,0
3860086,981,11760,,,,,,,REPAIR NAIL BED,429.78,171.91,0,429.78,365.31,SKIPPED,429.78,429.78,365.31,365.31,365.31,121.76,210.59,210.59,0,128.93,124.25,124.25,0
3860087,981,97597,,,,,,,#DEBRIDE SKIN FULL THICK,57.81,23.12,0,57.81,49.14,SKIPPED,57.81,57.81,49.14,49.14,49.14,39.82,28.33,28.33,0,17.34,40.63,40.63,0
3860089,981,29540,,,,,,,STRAPPING ANKLE/FOOT,44.06,17.62,0,44.06,37.45,SKIPPED,44.06,44.06,37.45,37.45,37.45,19.47,21.59,21.59,0,13.22,19.87,19.87,0
3860090,981,99292,,,,,,,E&M CRITICAL E/ADL 3 PHY,387.82,155.13,0,387.82,329.65,SKIPPED,387.82,387.82,329.65,329.65,329.65,119.35,190.03,190.03,0,116.35,121.79,121.79,0
3860092,981,20103,,,,,,,PHY-EXPLORE WD EXTREMITY,833.95,333.58,0,833.95,708.86,SKIPPED,833.95,833.95,708.86,708.86,708.86,374.96,408.64,408.64,SKIPPED,SKIPPED,382.61,382.61,0
3860094,981,26910,,,,,,,"AMPUATION OF HAND BONE, FINGER, THUMB",1585.73,634.29,0,1585.73,1347.87,SKIPPED,1585.73,1585.73,1347.87,1347.87,1347.87,851.01,777.01,777.01,SKIPPED,SKIPPED,868.38,868.38,0
3860095,981,51720,,,,,,,TRT BLADDER LESION,134.01,53.6,0,134.01,113.91,SKIPPED,134.01,134.01,113.91,113.91,113.91,47.38,65.66,65.66,0,40.2,48.35,48.35,0
3860101,981,26770,,,,,,,Trt IP Disloc WO Anes PHY,602.89,241.16,0,602.89,512.46,SKIPPED,602.89,602.89,512.46,512.46,512.46,287.97,295.42,295.42,0,180.87,293.85,293.85,0
3860102,981,16025,,,,,,,DRS DEBR BURN MED W/,310.1,124.04,0,310.1,263.58,SKIPPED,310.1,310.1,263.58,263.58,263.58,120.94,151.95,151.95,0,93.03,123.41,123.41,0
3860103,981,56420,,,,,,,I & D BARTHOLINS CYS PHY,215.39,86.16,0,215.39,183.08,SKIPPED,215.39,215.39,183.08,183.08,183.08,122.94,105.54,105.54,SKIPPED,SKIPPED,125.45,125.45,0
3860104,981,10060,,,,,,,I&D ABSCESS SMPLE/SN PHY,331.94,132.78,0,331.94,282.15,SKIPPED,331.94,331.94,282.15,282.15,282.15,115.12,162.65,162.65,0,99.58,117.47,117.47,0
3860105,981,24640,,,,,,,TRT RHEAD SUBLUX FX PHY,186.32,74.53,0,186.32,158.37,SKIPPED,186.32,186.32,158.37,158.37,158.37,89.54,91.3,91.3,SKIPPED,SKIPPED,91.37,91.37,0
3860106,981,10080,,,,,,,I&D PILONIDAL CYST S PHY,324.18,129.67,0,324.18,275.55,SKIPPED,324.18,324.18,275.55,275.55,275.55,114.34,158.85,158.85,0,97.25,116.67,116.67,0
3860108,981,10120,,,,,,,I&RMVE FB SUBQ SMPLE PHY,395.6,158.24,0,395.6,336.26,SKIPPED,395.6,395.6,336.26,336.26,336.26,113.63,193.84,193.84,SKIPPED,SKIPPED,115.95,115.95,0
3860110,981,12001,,,,,,,RPR SMP SP NK TR 2.5 PHY,106.48,42.59,0,106.48,90.51,SKIPPED,106.48,106.48,90.51,90.51,90.51,48.55,52.18,52.18,0,31.94,49.54,49.54,0
3860111,981,13133,,,,,,,PHY-RP CPLX FH CK CHIN,316,126.4,0,268.6,268.6,SKIPPED,0,0,268.6,268.6,268.6,136.17,154.84,154.84,0,94.8,138.95,138.95,0
3860113,981,12002,,,,,,,RPR SMP SP NK TK 2.6 PHY,140.94,56.38,0,140.94,119.8,SKIPPED,140.94,140.94,119.8,119.8,119.8,63.63,69.06,69.06,0,42.28,64.93,64.93,0
3860115,981,12004,,,,,,,RP SMP SP NK TR 7.6- PHY,175.43,70.17,0,175.43,149.12,SKIPPED,175.43,175.43,149.12,149.12,149.12,78.69,85.96,85.96,0,52.63,80.3,80.3,0
3860117,981,28515,,,,,,,TR FX CD PHAL W/MAN PHY,582.98,233.19,0,502.74,495.53,SKIPPED,502.74,502.74,495.53,495.53,495.53,157.31,285.66,285.66,SKIPPED,SKIPPED,160.52,160.52,0
3860118,981,12005,,,,,,,RP SMP SP NK TK 12.6 PHY,228.52,91.41,0,228.52,194.24,SKIPPED,228.52,228.52,194.24,194.24,194.24,102.48,111.97,111.97,SKIPPED,SKIPPED,104.57,104.57,0
3860120,981,12006,,,,,,,RP SMP SP NK TK20.1-30.0,280.34,112.14,0,280.34,238.29,SKIPPED,280.34,280.34,238.29,238.29,238.29,125.9,137.37,137.37,SKIPPED,SKIPPED,128.47,128.47,0
3860122,981,12011,,,,,,,RPR SMPLE FC EAR 2.5 PHY,132.56,53.02,0,132.56,112.68,SKIPPED,132.56,132.56,112.68,112.68,112.68,59.55,64.95,64.95,0,39.77,60.77,60.77,0
3860123,981,46050,,,,,,,I&D PERINEAL ABSC SUP-PHY,232.43,92.97,0,232.43,197.57,SKIPPED,232.43,232.43,197.57,197.57,197.57,109.7,113.89,113.89,SKIPPED,SKIPPED,111.94,111.94,0
3860125,981,12013,,,,,,,RPR SMPLE FC EAR 2.6 PHY,139.49,55.8,0,139.49,118.57,SKIPPED,139.49,139.49,118.57,118.57,118.57,62.73,68.35,68.35,0,41.85,64.01,64.01,0
3860127,981,12014,,,,,,,RPR SMPLE FC EAR 5.1 PHY,179.82,71.93,0,179.82,152.85,SKIPPED,179.82,179.82,152.85,152.85,152.85,80.59,88.11,88.11,0,53.95,82.23,82.23,0
3860128,981,11740,,,,,,,EVAC SUBLINGUAL HEMA PHY,78.08,31.23,0,78.08,66.37,SKIPPED,78.08,78.08,66.37,66.37,66.37,34.34,38.26,38.26,0,23.42,35.04,35.04,0
3860129,981,12015,,,,,,,RPR SMPLE FC EAR7.6- PHY,226.15,90.46,0,226.15,192.23,SKIPPED,226.15,226.15,192.23,192.23,192.23,101.74,110.81,110.81,0,67.84,103.82,103.82,0
3860132,981,12016,,,,,,,PHY-RPR SMPL FC EAR12.6-,307.6,123.04,0,307.6,261.46,SKIPPED,307.6,307.6,261.46,261.46,261.46,139.08,150.72,150.72,SKIPPED,SKIPPED,141.92,141.92,0
3860135,981,27786,,,,,,,TRT DIST FIB CLSD W/O MAN,552.08,220.83,0,552.08,469.27,SKIPPED,552.08,552.08,469.27,469.27,469.27,320.5,270.52,270.52,SKIPPED,SKIPPED,327.04,327.04,0
3860136,981,12031,,,,,,,RPR IMD SP TK EX 2.5 PHY,539.93,215.97,0,539.93,458.94,SKIPPED,539.93,539.93,458.94,458.94,458.94,164.52,264.57,264.57,SKIPPED,SKIPPED,167.88,167.88,0
3860137,981,27840,,,,,,,TRT ANKLE DISCLOC W/O ANE,880.54,352.22,0,880.54,748.46,SKIPPED,880.54,880.54,748.46,748.46,748.46,421.47,431.46,431.46,SKIPPED,SKIPPED,430.07,430.07,0
3860138,981,12032,,,,,,,RPR IMD SP TK EX 2.6 PHY,701.14,280.46,0,701.14,595.97,SKIPPED,701.14,701.14,595.97,595.97,595.97,206.11,343.56,343.56,SKIPPED,SKIPPED,210.32,210.32,0
3860140,981,12034,,,,,,,RPR IMD SP TK EX7.6- PHY,497.31,198.92,0,497.31,422.71,SKIPPED,497.31,497.31,422.71,422.71,422.71,222.9,243.68,243.68,SKIPPED,SKIPPED,227.45,227.45,0
3860142,981,12035,,,,,,,RP IMMD SP TK EX12.6-20.0,574.47,229.79,0,574.47,488.3,SKIPPED,574.47,574.47,488.3,488.3,488.3,260.95,281.49,281.49,SKIPPED,SKIPPED,266.28,266.28,0
3860146,981,12041,,,,,,,RP IMD NK H/F 2.5=< PHY,359.84,143.94,0,359.84,305.86,SKIPPED,359.84,359.84,305.86,305.86,305.86,156.88,176.32,176.32,SKIPPED,SKIPPED,160.08,160.08,0
3860147,981,59409,,,,,,,VAGINAL DELIVERY ONLY,2289.42,915.77,0,2289.42,1946.01,SKIPPED,2289.42,2289.42,1946.01,1946.01,1946.01,855.1,1121.82,1121.82,0,686.83,872.55,872.55,0
3860148,981,12042,,,,,,,RP IMD NK H/F 2.6-7. PHY,479.3,191.72,0,479.3,407.4,SKIPPED,479.3,479.3,407.4,407.4,407.4,212.94,234.86,234.86,SKIPPED,SKIPPED,217.29,217.29,0
3860150,981,12044,,,,,,,RP IMD NK H/F 7.6-12 PHY,515.45,206.18,0,515.45,438.13,SKIPPED,515.45,515.45,438.13,438.13,438.13,231.79,252.57,252.57,SKIPPED,SKIPPED,236.52,236.52,0
3860151,981,30300,,,,,,,RMVE FOREIGN BDY INT PHY,291.74,116.7,0,291.74,247.98,SKIPPED,291.74,291.74,247.98,247.98,247.98,137.7,142.95,142.95,0,87.52,140.51,140.51,0
3860153,981,11750,,,,,,,Ex Nail/Mat PartComp PHY,243.74,97.5,0,243.74,207.18,SKIPPED,243.74,243.74,207.18,207.18,207.18,111.66,119.43,119.43,SKIPPED,SKIPPED,113.94,113.94,0
3860154,981,12051,,,,,,,RP IMD FC EAR 2.5=< PHY,410.07,164.03,0,410.07,348.56,SKIPPED,410.07,410.07,348.56,348.56,348.56,183.9,200.93,200.93,SKIPPED,SKIPPED,187.65,187.65,0
3860155,450,28190,,,,,,,RMVE FB FOOT SUBCUTAN,1256.62,502.65,0,1068.13,1068.13,SKIPPED,902.88,902.88,1068.13,1068.13,1068.13,529.54,615.74,615.74,0,376.99,540.35,540.35,1068.13
3860156,981,12052,,,,,,,RP IMD FC EAR 2.6-5. PHY,488.43,195.37,0,488.43,415.17,SKIPPED,488.43,488.43,415.17,415.17,415.17,216.52,239.33,239.33,SKIPPED,SKIPPED,220.94,220.94,0
3860158,981,12053,,,,,,,RP IMD FC EAR 5.1-7. PHY,522.81,209.12,0,522.81,444.39,SKIPPED,522.81,522.81,444.39,444.39,444.39,232.94,256.18,256.18,SKIPPED,SKIPPED,237.69,237.69,0
3860159,981,69210,,,,,,,RMVE IMPACTED CERUME PHY,78.9,31.56,0,78.9,67.06,SKIPPED,78.9,78.9,67.06,67.06,67.06,35.9,38.66,38.66,0,23.67,36.63,36.63,0
3860160,981,12054,,,,,,,RP IMMD FC EAR 7.6-1 PHY,533.83,213.53,0,533.83,453.76,SKIPPED,533.83,533.83,453.76,453.76,453.76,236.79,261.58,261.58,SKIPPED,SKIPPED,241.62,241.62,0
3860161,981,29075,,,,,,,CAST ARM SHORT APPLY-PHY,148.16,59.26,0,148.16,125.94,SKIPPED,148.16,148.16,125.94,125.94,125.94,66.74,72.6,72.6,SKIPPED,SKIPPED,68.1,68.1,0
3860162,981,12055,,,,,,,RP IMD FC EAR 12.6-2,728.15,291.26,0,728.15,618.93,SKIPPED,728.15,728.15,618.93,618.93,618.93,323.12,356.79,356.79,SKIPPED,SKIPPED,329.71,329.71,0
3860163,981,10160,,,,,,,PUNCTURE ASPRATE ABS PHY,347.62,139.05,0,347.62,295.48,SKIPPED,347.62,347.62,295.48,295.48,295.48,104.09,170.33,170.33,0,104.29,106.21,106.21,0
3860168,981,13120,,,,,,,RP CMPLX SP AM/LG 1.1,775.85,310.34,0,775.85,659.47,SKIPPED,775.85,775.85,659.47,659.47,659.47,254.05,380.17,380.17,SKIPPED,SKIPPED,259.23,259.23,0
3860170,981,13121,,,,,,,Rp Cmplx Am/Lg2.6-7.5 PHY,641.41,256.56,0,641.41,545.2,SKIPPED,641.41,641.41,545.2,545.2,545.2,280.29,314.29,314.29,SKIPPED,SKIPPED,286.01,286.01,0
3860172,981,13122,,,,,,,RP CMPLX SP AM/LG EA+5,206.52,82.61,0,175.54,175.54,SKIPPED,0,0,175.54,175.54,175.54,89.4,101.19,101.19,0,61.96,91.22,91.22,0
3860174,981,13131,,,,,,,CMX FH/CK/CH/H/F/1.1 PHY,600.46,240.18,0,600.46,510.39,SKIPPED,600.46,600.46,510.39,510.39,510.39,263.42,294.23,294.23,SKIPPED,SKIPPED,268.8,268.8,0
3860175,981,64400,,,,,,,INJECT ANESTHETIC AG,171.39,68.56,0,171.39,145.68,SKIPPED,171.39,171.39,145.68,145.68,145.68,53.92,83.98,83.98,0,51.42,55.02,55.02,0
3860176,981,13132,,,,,,,CMX FH/CK/CH/H/F2.6-7.5,755.59,302.24,0,755.59,642.25,SKIPPED,755.59,755.59,642.25,642.25,642.25,329.75,370.24,370.24,SKIPPED,SKIPPED,336.48,336.48,0
3860177,981,24600,,,,,,,TR CL ELBW DISLOC W/ PHY,791.15,316.46,0,791.15,672.48,SKIPPED,791.15,791.15,672.48,672.48,672.48,374.56,387.66,387.66,SKIPPED,SKIPPED,382.2,382.2,0
3860180,981,13151,,,,,,,CMx EYL NS EAR LP1.1,688.86,275.54,0,688.86,585.53,SKIPPED,688.86,688.86,585.53,585.53,585.53,302.91,337.54,337.54,SKIPPED,SKIPPED,309.09,309.09,0
3860181,981,16020,,,,,,,DRESS/DEBRIDE BURN S PHY,130.32,52.13,0,130.32,110.77,SKIPPED,130.32,130.32,110.77,110.77,110.77,59.25,63.86,63.86,0,39.1,60.46,60.46,0
3860182,975,20600,,,,,,,ACENTESIS ASP INT JN PHY,128.5,51.4,0,109.44,109.22,SKIPPED,109.44,109.44,109.22,109.22,109.22,38.96,62.96,62.96,0,38.55,39.76,39.76,0
3860183,981,11765,,,,,,,WEDGE EX SKIN NAIL F PHY,223.45,89.38,0,223.45,189.93,SKIPPED,223.45,223.45,189.93,189.93,189.93,100.89,109.49,109.49,0,67.04,102.95,102.95,0
3860184,981,20605,,,,,,,ACENTES ASP INJ JNT PHY,90.54,36.22,0,90.54,76.96,SKIPPED,90.54,90.54,76.96,76.96,76.96,40.49,44.36,44.36,0,27.16,41.32,41.32,0
3860185,981,11043,,,,,,,DEBRIDE TISSUE MUSCLE,373.46,149.38,0,373.46,317.44,SKIPPED,373.46,373.46,317.44,317.44,317.44,166.79,183,183,SKIPPED,SKIPPED,170.19,170.19,0
3860186,981,20610,,,,,,,ACENTES ASP INJ MAJ PHY,110.95,44.38,0,110.95,94.31,SKIPPED,110.95,110.95,94.31,94.31,94.31,49.19,54.37,54.37,0,33.28,50.19,50.19,0
3860188,981,29105,,,,,,,SPLINT ARM LONG APPL PHY,141.36,56.54,0,141.36,120.16,SKIPPED,141.36,141.36,120.16,120.16,120.16,44.83,69.27,69.27,0,42.41,45.74,45.74,0
3860190,981,29125,,,,,,,SPLINT ARM SHORT STA PHY,94.55,37.82,0,94.55,80.37,SKIPPED,94.55,94.55,80.37,80.37,80.37,43.15,46.33,46.33,0,28.36,44.03,44.03,0
3860191,981,36556,,,,,,,INSERT CVP 5YR OR OL PHY,236.33,94.53,0,236.33,200.88,SKIPPED,236.33,236.33,200.88,200.88,200.88,91.88,115.8,115.8,SKIPPED,SKIPPED,93.76,93.76,0
3860193,981,12045,,,,,,,RRR WD NK HD FT LYR PHY,643.34,257.34,0,643.34,546.84,SKIPPED,643.34,643.34,546.84,546.84,546.84,294.39,315.24,315.24,SKIPPED,SKIPPED,300.4,300.4,0
3860194,981,29130,,,,,,,SPLINT FINGER STATIC PHY,69.35,27.74,0,69.35,58.95,SKIPPED,69.35,69.35,58.95,58.95,58.95,31.61,33.98,33.98,0,20.8,32.26,32.26,0
3860195,981,26700,,,,,,,TRT METACARPO DIS W/ PHY,718.01,287.2,0,610.31,610.31,SKIPPED,531.76,531.76,610.31,610.31,610.31,344.72,351.82,351.82,0,215.4,351.76,351.76,0
3860197,981,36680,,,,,,,PLACE NEDLE INTRAOSS PHY,141.72,56.69,0,141.72,120.46,SKIPPED,141.72,141.72,120.46,120.46,120.46,63.73,69.44,69.44,0,42.52,65.03,65.03,0
3860198,981,29505,,,,,,,SPLINT LEG LONG APPL PHY,120.55,48.22,0,120.55,102.47,SKIPPED,120.55,120.55,102.47,102.47,102.47,55.5,59.07,59.07,0,36.16,56.63,56.63,0
3860200,981,29515,,,,,,,SPLINT LEG SHORT APP PHY,119.15,47.66,0,119.15,101.28,SKIPPED,119.15,119.15,101.28,101.28,101.28,53.32,58.38,58.38,0,35.74,54.41,54.41,0
3860201,975,36589,,,,,,,RMVE CATH CENTRAL VENOUS,329.78,131.91,0,329.78,280.31,SKIPPED,329.78,329.78,280.31,280.31,280.31,149.33,161.59,161.59,SKIPPED,SKIPPED,152.38,152.38,0
3860202,981,30901,,,,,,,CNTRL NS BLLED ANT S PHY,135.72,54.29,0,135.72,115.36,SKIPPED,135.72,135.72,115.36,115.36,115.36,61.39,66.5,66.5,0,40.72,62.64,62.64,0
3860203,981,28660,,,,,,,TR CSD INTERPHAL W/O ANES,356.6,142.64,0,323.19,303.11,SKIPPED,323.19,323.19,303.11,303.11,303.11,101.34,174.73,174.73,0,106.98,103.41,103.41,0
3860204,981,30903,,,,,,,CNTRL NS BLLED ANT CMPLZ,188.61,75.44,0,188.61,160.32,SKIPPED,188.61,188.61,160.32,160.32,160.32,83.63,92.42,92.42,SKIPPED,SKIPPED,85.34,85.34,0
3860206,981,30905,,,,,,,CNTL NS BLLED POST-PHY,252.12,100.85,0,252.12,214.3,SKIPPED,252.12,252.12,214.3,214.3,214.3,114.37,123.54,123.54,SKIPPED,SKIPPED,116.7,116.7,0
3860208,981,31500,,,,,,,INTUBAT ENDO TRACK E PHY,342.08,136.83,0,342.08,290.77,SKIPPED,342.08,342.08,290.77,290.77,290.77,153.75,167.62,167.62,0,102.62,156.89,156.89,0
3860213,981,42809,,,,,,,REMOVE FB PHARYNX,164.85,65.94,0,164.85,140.12,SKIPPED,164.85,164.85,140.12,140.12,140.12,138.38,80.78,80.78,0,49.46,141.2,141.2,0
3860214,981,36556,,,,,,,CVP PLACE PERCU>AGE 5,236.33,94.53,0,236.33,200.88,SKIPPED,236.33,236.33,200.88,200.88,200.88,91.88,115.8,115.8,SKIPPED,SKIPPED,93.76,93.76,0
3860215,981,25660,,,,,,,CLSD TRT FX FINGR/TOE/TRK,979.88,391.95,0,979.88,832.9,SKIPPED,979.88,979.88,832.9,832.9,832.9,495.32,480.14,480.14,SKIPPED,SKIPPED,505.43,505.43,0
3860217,981,32551,,,,,,,INSERTION CHEST TUBE-PHY,379.48,151.79,0,379.48,322.56,SKIPPED,379.48,379.48,322.56,322.56,322.56,169.08,185.95,185.95,0,113.84,172.53,172.53,0
3860218,981,43762,,,,,,,CHG GASTROSTOMY TUBE,564.71,225.88,0,564.71,480,SKIPPED,564.71,564.71,480,480,480,40.18,276.71,276.71,0,169.41,41,41,0
3860219,981,20520,,,,,,,"RMVE F/B IN MUSCLE, SIMPL",350.29,140.12,0,350.29,297.75,SKIPPED,350.29,350.29,297.75,297.75,297.75,161.46,171.64,171.64,0,105.09,164.75,164.75,0
3860220,981,43761,,,,,,,GASTRIC TUBE REPOSIT,250.29,100.12,0,250.29,212.75,SKIPPED,250.29,250.29,212.75,212.75,212.75,112.87,122.64,122.64,SKIPPED,SKIPPED,115.17,115.17,0
3860222,981,49080,,,,,,,PERITONEOCENTESIS INITIAL,577.6,231.04,0,490.96,490.96,SKIPPED,438.98,438.98,490.96,490.96,490.96,0,283.02,283.02,0,173.28,0,0,0
3860225,981,46083,,,,,,,INCISE EXT HEMMORRHOID-PH,255.38,102.15,0,255.38,217.07,SKIPPED,255.38,255.38,217.07,217.07,217.07,120.43,125.14,125.14,0,76.61,122.89,122.89,0
3860226,981,65205,,,,,,,RM FB EYE CONJUNE SU PHY,105.82,42.33,0,105.82,89.95,SKIPPED,105.82,105.82,89.95,89.95,89.95,31.94,51.85,51.85,0,31.75,32.59,32.59,0
3860228,981,65210,,,,,,,RM FB EYE CONJUCT EM PHY,126.75,50.7,0,126.75,107.74,SKIPPED,126.75,126.75,107.74,107.74,107.74,39.6,62.11,62.11,0,38.02,40.41,40.41,0
3860229,981,46600,,,,,,,PHY-DIAGNOSTIC ANOSCOPY,98.65,39.46,0,98.65,83.85,SKIPPED,98.65,98.65,83.85,83.85,83.85,44.35,48.34,48.34,0,29.6,45.26,45.26,0
3860232,981,62270,,,,,,,SPINAL LUMBAR DX PHY,188.04,75.22,0,188.04,159.83,SKIPPED,188.04,188.04,159.83,159.83,159.83,67.03,92.14,92.14,SKIPPED,SKIPPED,68.4,68.4,0
3860234,981,92960,,,,,,,CARDIOVERSION EXTERN PHY,339.84,135.94,0,339.84,288.86,SKIPPED,339.84,339.84,288.86,288.86,288.86,119.18,166.52,166.52,0,101.95,121.61,121.61,0
3860239,981,11042,,,,,,,PHY-DEB SUBQ TISSUE 20CM<,148.75,59.5,0,148.75,126.44,SKIPPED,148.75,148.75,126.44,126.44,126.44,65.59,72.89,72.89,SKIPPED,SKIPPED,66.93,66.93,0
3860242,981,54115,,,,,,,REMOVAL FB PENIS,1029.27,411.71,0,1029.27,874.88,SKIPPED,1029.27,1029.27,874.88,874.88,874.88,465.99,504.34,504.34,SKIPPED,SKIPPED,475.5,475.5,0
3860243,981,46040,,,,,,,PHY-INCISION RECTAL ABSCE,990.4,396.16,0,990.4,841.84,SKIPPED,990.4,990.4,841.84,841.84,841.84,466.78,485.3,485.3,SKIPPED,SKIPPED,476.31,476.31,0
3860245,981,40799,,,,,,,PHY-LIP SURGERY PROCEDURE,2148.72,859.49,0,1826.41,1826.41,SKIPPED,847.88,847.88,1826.41,1826.41,1826.41,0,1052.87,1052.87,0,644.62,0,0,0
3860248,981,43752,,,,,,,GASTRIC INTUBATION,99.36,39.74,0,99.36,84.46,SKIPPED,99.36,99.36,84.46,84.46,84.46,44.07,48.69,48.69,0,29.81,44.97,44.97,0
3860251,981,67700,,,,,,,DRAINAGE EYELID ABSC-PHY,277.06,110.82,0,277.06,235.5,SKIPPED,277.06,277.06,235.5,235.5,235.5,126.01,135.76,135.76,0,83.12,128.58,128.58,0
3860252,981,25605,,,,,,,TRT DIS RAD FX CLSD PHY,1206.07,482.43,0,1206.07,1025.16,SKIPPED,1206.07,1206.07,1025.16,1025.16,1025.16,563.95,590.97,590.97,SKIPPED,SKIPPED,575.46,575.46,0
3860255,981,26775,,,,,,,PHY-CLSD REDUCT FINGER,815.71,326.28,0,693.35,693.35,SKIPPED,587.1,587.1,693.35,693.35,693.35,391.09,399.7,399.7,SKIPPED,SKIPPED,399.07,399.07,0
3860260,981,36430,,,,,,,BLOOD TRANSFUSION 1- PHY,81.12,32.45,0,81.12,68.95,SKIPPED,81.12,81.12,68.95,68.95,68.95,41.8,39.75,39.75,0,24.34,42.65,42.65,0
3860262,981,27808,,,,,,,CLSD TRT BIMALLEOLAR ANKLE FX W/O MANIP.,660.95,264.38,0,660.95,561.81,SKIPPED,660.95,660.95,561.81,561.81,561.81,340.11,323.87,323.87,SKIPPED,SKIPPED,347.05,347.05,0
3860263,981,25630,,,,,,,CLSD TRT OF FX WRIST W/O MANIP.,614.65,245.86,0,531.76,522.45,SKIPPED,531.76,531.76,522.45,522.45,522.45,315.53,301.18,301.18,SKIPPED,SKIPPED,321.97,321.97,0
3860264,981,28400,,,,,,,CLSD TRT CALCANEAL FX W/O MANIP.,492.8,197.12,0,492.8,418.88,SKIPPED,492.8,492.8,418.88,418.88,418.88,253.83,241.47,241.47,SKIPPED,SKIPPED,259.01,259.01,0
3860266,981,27552,,,,,,,CLS TRT OF PATELLAR DISLOCATION/ ANEST,1295.03,518.01,0,1295.03,1100.78,SKIPPED,1295.03,1295.03,1100.78,1100.78,1100.78,695.41,634.56,634.56,SKIPPED,SKIPPED,709.6,709.6,0
3860280,981,92950,,,,,,,CPR PHY,451.58,180.63,0,451.58,383.84,SKIPPED,451.58,451.58,383.84,383.84,383.84,201.99,221.27,221.27,0,135.47,206.11,206.11,0
3860285,981,26725,,,,,,,CLSD TX PHAL FX W/MA PHY,770.95,308.38,0,655.31,655.31,SKIPPED,531.76,531.76,655.31,655.31,655.31,337.59,377.77,377.77,SKIPPED,SKIPPED,344.48,344.48,0
3860300,981,23650,,,,,,,CD TX SHLD W/MAN W/O PHY,974.25,389.7,0,974.25,828.11,SKIPPED,974.25,974.25,828.11,828.11,828.11,326.75,477.38,477.38,SKIPPED,SKIPPED,333.42,333.42,0
3860301,981,29065,,,,,,,CAST LONG ARM,212.54,85.02,0,212.54,180.66,SKIPPED,212.54,212.54,180.66,180.66,180.66,73.78,104.14,104.14,SKIPPED,SKIPPED,75.29,75.29,0
3860304,975,64450,,,,,,,NERVE BLK OTHER PERIPHERAL,139.63,55.85,0,139.63,118.69,SKIPPED,139.63,139.63,118.69,118.69,118.69,46.2,68.42,68.42,0,41.89,47.14,47.14,0
3860306,981,41899,,,,,,,DENTOALVEOLAR STRUCTURE,310.23,124.09,0,310.23,263.7,SKIPPED,310.23,310.23,263.7,263.7,263.7,0,152.01,152.01,0,93.07,0,0,0
3860307,981,17250,,,,,,,TOPICAL AUTERIZATION PRO,111.77,44.71,0,111.77,95,SKIPPED,111.77,111.77,95,95,95,40.55,54.77,54.77,0,33.53,41.38,41.38,0
3860308,981,11000,,,,,,,DEBRID SKIN INFECT UP-PROF,69.3,27.72,0,69.3,58.9,SKIPPED,69.3,69.3,58.9,58.9,58.9,30.5,33.96,33.96,0,20.79,31.12,31.12,0
3860309,981,76705,,,,,,,ED US LIMITED ABDOMINAL,71.14,28.46,0,71.14,60.47,SKIPPED,71.14,71.14,60.47,60.47,60.47,31.75,71.14,71.14,0,71.14,32.4,32.4,0
3860310,981,93308,,,,,,,ED US LIMITED HEART,77.6,31.04,0,77.6,65.96,SKIPPED,77.6,77.6,65.96,65.96,65.96,27.82,77.6,77.6,0,77.6,28.39,28.39,0
3860311,981,76775,,,,,,,ED US LIMITED ANEURYSM,69.46,27.78,0,69.46,59.04,SKIPPED,69.46,69.46,59.04,59.04,59.04,30.98,69.46,69.46,0,69.46,31.61,31.61,0
3860312,981,76815,,,,,,,ED US LIMITED OB,78.66,31.46,0,78.66,66.86,SKIPPED,78.66,78.66,66.86,66.86,66.86,34.83,78.66,78.66,0,73.48,35.54,35.54,0
3860313,981,76857,,,,,,,ED US LIMITED PELVIC,75.45,30.18,0,75.45,64.13,SKIPPED,75.45,75.45,64.13,64.13,64.13,26.29,75.45,75.45,0,59.11,26.83,26.83,0
3860314,981,76830,,,,,,,ED US TRANSVAGINAL,83.75,33.5,0,83.75,71.19,SKIPPED,83.75,83.75,71.19,71.19,71.19,37.13,83.75,83.75,0,73.48,37.89,37.89,0
3860315,981,76775,,,,,,,ED US RENAL,69.46,27.78,0,69.46,59.04,SKIPPED,69.46,69.46,59.04,59.04,59.04,30.98,69.46,69.46,0,69.46,31.61,31.61,0
3860316,981,76705,,,,,,,ED US GB,71.14,28.46,0,71.14,60.47,SKIPPED,71.14,71.14,60.47,60.47,60.47,31.75,71.14,71.14,0,71.14,32.4,32.4,0
3860317,981,76930,,,,,,,ED US GUIDANCE PERICARDIOCENTESIS,79.68,31.87,0,67.73,67.73,SKIPPED,60.56,60.56,67.73,67.73,67.73,37.33,39.04,39.04,0,23.9,38.09,38.09,0
3860318,981,76942,,,,,,,ED US GUIDANCE FOR NEEDLE PLACEMENT,78.08,31.23,0,78.08,66.37,SKIPPED,78.08,78.08,66.37,66.37,66.37,34.11,38.26,38.26,0,23.42,34.81,34.81,0
3860319,981,76857,,,,,,,ED US URINARY BLADDER,75.45,30.18,0,75.45,64.13,SKIPPED,75.45,75.45,64.13,64.13,64.13,26.29,75.45,75.45,0,59.11,26.83,26.83,0
3860320,981,76882,,,,,,,ED US FOREIGN BODY,59.21,23.68,0,59.21,50.33,SKIPPED,59.21,59.21,50.33,50.33,50.33,25.9,59.21,59.21,0,59.11,26.43,26.43,0
3860321,981,41250,,,,,,,REPAIR OF TONGUE LAC. PROF,450.69,180.28,0,450.69,383.09,SKIPPED,450.69,450.69,383.09,383.09,383.09,166.43,220.84,220.84,0,135.21,169.83,169.83,0
3860322,981,15120,,,,,,,S/GR FC EL NK GEN H/ PROF,2119.1,847.64,0,2119.1,1801.24,SKIPPED,2119.1,2119.1,1801.24,1801.24,1801.24,750.18,1038.36,1038.36,SKIPPED,SKIPPED,765.49,765.49,0
3860323,981,24505,,,,,,,TRT HUM SHFT CLD FX,1292.8,517.12,0,1292.8,1098.88,SKIPPED,1292.8,1292.8,1098.88,1098.88,1098.88,499.72,633.47,633.47,SKIPPED,SKIPPED,509.92,509.92,0
3860324,981,64405,,,,,,,NERVE BLOCK INJ OCCIPITAL,175.96,70.38,0,175.96,149.57,SKIPPED,175.96,175.96,149.57,149.57,149.57,56.71,86.22,86.22,0,52.79,57.87,57.87,0
3860325,981,69209,,,,,,,REMOVE IMPACTED CERUMEN,49.32,19.73,0,49.32,41.92,SKIPPED,49.32,49.32,41.92,41.92,41.92,16.61,24.17,24.17,0,14.8,16.95,16.95,0
3860326,981,20102,,,,,,,EXPLORE WOUND ABDOMEN,610.76,244.3,0,610.76,519.15,SKIPPED,610.76,610.76,519.15,519.15,519.15,276.82,299.27,299.27,0,183.23,282.47,282.47,0
3860328,981,76604,,,,,,,ED US CHEST,65.25,26.1,0,65.25,55.46,SKIPPED,65.25,65.25,55.46,55.46,55.46,31.01,65.25,65.25,0,65.25,31.64,31.64,0
3860329,981,32555,,,,,,,ED US ASPIRATE PLEURA W/ IMAGING,271.81,108.72,0,271.81,231.04,SKIPPED,271.81,271.81,231.04,231.04,231.04,120.65,133.19,133.19,0,81.54,123.11,123.11,0
3860330,402,76817,,,,,,,ED US PREGNANCY,248.87,99.55,0,248.87,211.54,SKIPPED,248.87,248.87,211.54,211.54,211.54,104.87,137.3,137.3,0,73.48,107.01,107.01,211.54
3860331,981,76937,,,,,,,ED US VASCULAR,34.7,13.88,0,34.7,29.5,SKIPPED,34.7,34.7,29.5,29.5,29.5,15.13,17,17,0,10.41,15.44,15.44,0
3860332,981,49083,,,,,,,ED US PARACENTESIS,263.17,105.27,0,263.17,223.69,SKIPPED,263.17,263.17,223.69,223.69,223.69,116.23,128.95,128.95,SKIPPED,SKIPPED,118.6,118.6,0
3860333,981,76536,,,,,,,ED US HEAD AND NECK,67.71,27.08,0,67.71,57.55,SKIPPED,67.71,67.71,57.55,57.55,57.55,30.58,67.71,67.71,0,67.71,31.2,31.2,0
3860334,981,76642,,,,,,,ED US BREAST,82.09,32.84,0,82.09,69.78,SKIPPED,82.09,82.09,69.78,69.78,69.78,36.37,82.09,82.09,0,39.88,37.11,37.11,0
3860335,981,76870,,,,,,,ED US EXAM SCROTUM,76.95,30.78,0,76.95,65.41,SKIPPED,76.95,76.95,65.41,65.41,65.41,34.44,76.95,76.95,0,73.48,35.14,35.14,0
3860336,981,76999,,,,,,,ECHO EXAMINATION PROCEDURE,201.02,80.41,0,201.02,170.87,SKIPPED,201.02,201.02,170.87,170.87,170.87,0,101.93,101.93,0,39.88,0,0,0
3860337,981,27520,,,,,,,CLSD TRT PATELLAR FX W/O MANIPULATION,644.74,257.9,0,644.74,548.03,SKIPPED,644.74,644.74,548.03,548.03,548.03,334.1,315.92,315.92,SKIPPED,SKIPPED,340.92,340.92,0
3860338,981,27250,,,,,,,CLOSED TRT OF HIP DISLOCATION,363.09,145.24,0,363.09,308.63,SKIPPED,363.09,363.09,308.63,308.63,308.63,193.94,177.91,177.91,SKIPPED,SKIPPED,197.9,197.9,0
3860339,981,97605,,,,,,,NEGATIVE PRESSURE WUND THERAPY,52.35,20.94,0,52.35,44.5,SKIPPED,52.35,52.35,44.5,44.5,44.5,27.87,25.65,25.65,0,15.7,28.44,28.44,0
3860340,981,54220,,,,,,,IRRIGATION OF CORPORA CAVERNOSA,270.42,108.17,0,270.42,229.86,SKIPPED,270.42,270.42,229.86,229.86,229.86,144.16,132.51,132.51,SKIPPED,SKIPPED,147.1,147.1,0
3860426,981,29530,,,,,,,STRAPPING KNEE,37.53,15.01,0,37.53,31.9,SKIPPED,37.53,37.53,31.9,31.9,31.9,20.14,18.39,18.39,0,11.26,20.55,20.55,0
3864105,981,49450,,,,,,,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCU,162.69,65.08,0,162.69,138.29,SKIPPED,162.69,162.69,138.29,138.29,138.29,71.05,79.72,79.72,SKIPPED,SKIPPED,72.5,72.5,0
3864106,981,12037,,,,,,,INTMD RPR S/TR/EXT >30.0 CM,1245.51,498.2,0,1245.51,1058.68,SKIPPED,1245.51,1245.51,1058.68,1058.68,1058.68,354.27,610.3,610.3,SKIPPED,SKIPPED,361.5,361.5,0
3864107,981,45915,,,,,,,REMOVE RECTAL OBSTRUCTION,864.36,345.74,0,864.36,734.71,SKIPPED,864.36,864.36,734.71,734.71,734.71,252.48,423.54,423.54,SKIPPED,SKIPPED,257.63,257.63,0
3864108,981,27301,,,,,,,I&D DEEP ABSC-THIGH/KNEE,1197.67,479.07,0,1197.67,1018.02,SKIPPED,1197.67,1197.67,1018.02,1018.02,1018.02,553.63,586.86,586.86,SKIPPED,SKIPPED,564.93,564.93,0
3864109,981,24200,,,,,,,REMOVE FOREIGN BODY-ARM,331.79,132.72,0,331.79,282.02,SKIPPED,331.79,331.79,282.02,282.02,282.02,154.99,162.58,162.58,0,99.54,158.15,158.15,0
3864110,981,27197,,,,,,,"Closed treatment pelvic ring fx, unil or",285.31,114.12,0,285.31,242.51,SKIPPED,285.31,285.31,242.51,242.51,242.51,146.81,139.8,139.8,0,85.59,149.81,149.81,0
3864111,981,27246,,,,,,,Closed treatment of greater trochanteric,916.62,366.65,0,916.62,779.13,SKIPPED,916.62,916.62,779.13,779.13,779.13,424.87,449.14,449.14,SKIPPED,SKIPPED,433.54,433.54,0
3864112,981,27500,,,,,,,"Closed treatment of femoral shaft fx, w/",1140.18,456.07,0,1020.78,969.15,SKIPPED,1020.78,1020.78,969.15,969.15,969.15,527.16,558.69,558.69,SKIPPED,SKIPPED,537.92,537.92,0
3864113,981,23570,,,,,,,Closed treatment of scapular fracture; w,541.68,216.67,0,541.68,460.43,SKIPPED,541.68,541.68,460.43,460.43,460.43,268.77,265.42,265.42,SKIPPED,SKIPPED,274.26,274.26,0
3864114,981,46320,,,,,,,REMOVAL HEMORRHOID CLOT,256.04,102.42,0,256.04,217.63,SKIPPED,256.04,256.04,217.63,217.63,217.63,123.97,125.46,125.46,SKIPPED,SKIPPED,126.5,126.5,0
3864115,981,40800,,,,,,,DRAINAGE OF MOUTH LESION,284.57,113.83,0,284.57,241.88,SKIPPED,284.57,284.57,241.88,241.88,241.88,130.79,139.44,139.44,0,85.37,133.46,133.46,0
3864116,981,28400,,,,,,,CLOSED TRT CALCANEUS FX W/O MANIPULATION,520.59,208.24,0,520.59,442.5,SKIPPED,520.59,520.59,442.5,442.5,442.5,253.83,255.09,255.09,SKIPPED,SKIPPED,259.01,259.01,0
3864117,981,27520,,,,,,,TRT KNEECAP FX W/O MANIPULATION,676.98,270.79,0,676.98,575.43,SKIPPED,676.98,676.98,575.43,575.43,575.43,334.1,331.72,331.72,SKIPPED,SKIPPED,340.92,340.92,0
3864119,981,36625,,,,,,,INSERT CATH-ARTERY,252.43,100.97,0,214.57,214.57,SKIPPED,0,0,214.57,214.57,214.57,114.25,123.69,123.69,0,75.73,116.58,116.58,0
3864121,981,16000,,,,,,,"INITAIL TREATMENT, FIRST DEGREE BURN",101.51,40.6,0,101.51,86.28,SKIPPED,101.51,101.51,86.28,86.28,86.28,48.99,49.74,49.74,0,30.45,49.99,49.99,0
3864122,981,25622,,,,,,,CLOSED TX CARPAL SCAPHOID FX,609.28,243.71,0,531.76,517.89,SKIPPED,531.76,531.76,517.89,517.89,517.89,315.54,298.55,298.55,SKIPPED,SKIPPED,321.98,321.98,0
3864123,981,24670,,,,,,,CLOSED TRT ULNAR FX PROXIMAL END W/O MAN,574.96,229.98,0,574.96,488.72,SKIPPED,574.96,574.96,488.72,488.72,488.72,297.48,281.73,281.73,SKIPPED,SKIPPED,303.55,303.55,0
3864124,981,23600,,,,,,,CLOSED TRT OF PROXIMAL HUMERAL FX W/O MA,673.21,269.28,0,572.23,572.23,SKIPPED,531.76,531.76,572.23,572.23,572.23,350.79,329.87,329.87,SKIPPED,SKIPPED,357.95,357.95,0
3864125,981,27816,,,,,,,CLSD TRT OF TRIMALLEOLAR ANKLE FX W/O MA,631.51,252.6,0,631.51,536.78,SKIPPED,631.51,631.51,536.78,536.78,536.78,326.33,309.44,309.44,SKIPPED,SKIPPED,332.99,332.99,0
3864126,981,25690,,,,,,,CLOSED TRT OF LUNATE DISLOCATION W/ MANI,1055.33,422.13,0,1055.33,897.03,SKIPPED,1055.33,1055.33,897.03,897.03,897.03,541.98,517.11,517.11,SKIPPED,SKIPPED,553.04,553.04,0
3864127,981,26765,,,,,,,OPEN TRT DISTAL PHALANGEAL FX EACH,1081.01,432.4,0,1081.01,918.86,SKIPPED,1081.01,1081.01,918.86,918.86,918.86,552.46,529.69,529.69,SKIPPED,SKIPPED,563.73,563.73,0
3864128,981,21320,,,,,,,CLOSED TX NOSE FX W/STABILIZATION,286.39,114.56,0,286.39,243.43,SKIPPED,286.39,286.39,243.43,243.43,243.43,103.98,140.33,140.33,SKIPPED,SKIPPED,106.1,106.1,0
3864129,981,36569,,,,,,,INSERTION PICC W/O IMAGING 5YR +,200.43,80.17,0,200.43,170.37,SKIPPED,200.43,200.43,170.37,170.37,170.37,101.91,98.21,98.21,SKIPPED,SKIPPED,103.99,103.99,0
3864130,981,27760,,,,,,,CLOSED TRT MALLEOUS FX W/O MANIPULATION,664.5,265.8,0,664.5,564.82,SKIPPED,664.5,664.5,564.82,564.82,564.82,341.54,325.6,325.6,SKIPPED,SKIPPED,348.51,348.51,0
3864131,981,43760,,,,,,,CHANGE GASTROTOMY TUBE W/O GDNCE,424.46,169.78,0,360.79,360.79,SKIPPED,322.59,322.59,360.79,360.79,360.79,53.27,207.99,207.99,SKIPPED,SKIPPED,54.36,54.36,0
3864132,981,27246,,,,,,,CLSD GREATER TROCHANTERIC FX W/O MANIPUL,830.91,332.36,0,830.91,706.27,SKIPPED,830.91,830.91,706.27,706.27,706.27,424.87,407.15,407.15,SKIPPED,SKIPPED,433.54,433.54,0
3864133,981,28430,,,,,,,CLSD TX TALUS FX W/O MANIPULATION,455.01,182,0,455.01,386.76,SKIPPED,455.01,455.01,386.76,386.76,386.76,233.48,222.95,222.95,SKIPPED,SKIPPED,238.25,238.25,0
3864134,981,25028,,,,,,,I&D FOREAREM/WRIST DEEP ABCESS,1435.28,574.11,0,1435.28,1219.99,SKIPPED,1435.28,1435.28,1219.99,1219.99,1219.99,781.74,703.29,703.29,SKIPPED,SKIPPED,797.69,797.69,0
3864135,981,27230,,,,,,,CLSD FEMORAL FX PROX END NECK W/O MANIPU,188.99,75.6,0,535.72,160.64,SKIPPED,188.99,188.99,160.64,160.64,160.64,525.01,92.61,92.61,SKIPPED,SKIPPED,535.72,535.72,0
3864136,981,27810,,,,,,,CLOSED TX BIMALLEOLAR ANKLE FX,914.83,365.93,0,914.83,777.61,SKIPPED,914.83,914.83,777.61,777.61,777.61,469.64,448.27,448.27,SKIPPED,SKIPPED,479.22,479.22,0
3864137,981,43762,,,,,,,REPLACE STOMACH STOMA TUBE,80.44,32.18,0,80.44,68.37,SKIPPED,80.44,80.44,68.37,68.37,68.37,40.18,39.42,39.42,0,24.13,41,41,0
3864138,981,27238,,,,,,,CLOSED TRT INTER/PERI/SUB FEM FX W/O MAN,1002.81,401.12,0,1002.81,852.39,SKIPPED,1002.81,1002.81,852.39,852.39,852.39,513.86,491.38,491.38,SKIPPED,SKIPPED,524.35,524.35,0
3864139,981,29260,,,,,,,STRAPPING:ELBOW OR WRIST,42.09,16.84,0,42.09,35.78,SKIPPED,42.09,42.09,35.78,35.78,35.78,21.33,20.62,20.62,0,12.63,21.77,21.77,0
3864140,981,27220,,,,,,,CLSD TX ACETABULUM HIP/SOCKET FX W/O MAN,884.8,353.92,0,884.8,752.08,SKIPPED,884.8,884.8,752.08,752.08,752.08,452.47,433.55,433.55,SKIPPED,SKIPPED,461.7,461.7,0
3864141,981,12021,,,,,,,TX SUPERFICIAL WOUND DEHISCENCE W/ PACK,299.24,119.7,0,299.24,254.35,SKIPPED,299.24,299.24,254.35,254.35,254.35,153.41,146.63,146.63,SKIPPED,SKIPPED,156.54,156.54,0
3864142,981,27252,,,,,,,CLOSED TRT OF DISLOCATED HIM UNDER ANES,1617.33,646.93,0,1617.33,1374.73,SKIPPED,1617.33,1617.33,1374.73,1374.73,1374.73,824.39,792.49,792.49,SKIPPED,SKIPPED,841.21,841.21,0
3864143,981,11301,,,,,,,SHAVE SKIN LESION 0.6-1.0 CM,110.03,44.01,0,110.03,93.53,SKIPPED,110.03,110.03,93.53,93.53,93.53,55.77,53.91,53.91,0,33.01,56.91,56.91,0
3864144,981,23605,,,,,,,CLODED TRT PROXIMAL HUMERAL FX W/ MANIPU,878.39,351.36,0,878.39,746.63,SKIPPED,878.39,878.39,746.63,746.63,746.63,471.62,430.41,430.41,SKIPPED,SKIPPED,481.24,481.24,0
3864145,981,27244,,,,,,,"TX INTERTROCHANTERIC,PERITROCHANTERIC...",626.85,250.74,0,1360.15,532.82,SKIPPED,626.85,626.85,532.82,532.82,532.82,1332.95,307.16,307.16,0,188.06,1360.15,1360.15,0
3864146,981,27818,,,,,,,CLOSED TRT TRIMALLEOLAR ANKLE FX,898.28,359.31,0,898.28,763.54,SKIPPED,898.28,898.28,763.54,763.54,763.54,482.07,440.16,440.16,SKIPPED,SKIPPED,491.91,491.91,0
3864147,981,31530,,,,,,,"LARYNHSCOPY, DIRECT, OPERATIVE W/ FOREIG",402.61,161.04,0,402.61,342.22,SKIPPED,402.61,402.61,342.22,342.22,342.22,216.07,197.28,197.28,SKIPPED,SKIPPED,220.48,220.48,0
3864148,981,59025,,,,,,,NST MONITOR,57.06,22.82,0,57.06,48.5,SKIPPED,57.06,57.06,48.5,48.5,48.5,30.62,27.96,27.96,0,17.12,31.25,31.25,0
3864149,981,35207,,,,,,,"RPR BLOOD VESSEL, HAND OR FINGER",1458.98,583.59,0,1458.98,1240.13,SKIPPED,1458.98,1458.98,1240.13,1240.13,1240.13,822.13,714.9,714.9,SKIPPED,SKIPPED,838.91,838.91,0
3870000,762,,,,,,,,ACUTE OBSERVATION,56.16,22.46,0,47.74,47.74,SKIPPED,42.68,42.68,47.74,47.74,47.74,23.67,27.52,27.52,0,16.85,24.15,24.15,47.74
3871000,762,G0378,,,,,,,ACUTE OBSER MIN 4 HR,550.79,220.32,0,550.79,468.17,SKIPPED,550.79,550.79,468.17,468.17,468.17,232.1,269.89,269.89,0,165.24,236.84,236.84,468.17
3871050,762,,,,,,,,OBSERVATION 24 HR,1166.56,466.62,0,991.58,991.58,SKIPPED,886.59,886.59,991.58,991.58,991.58,491.59,571.61,571.61,0,349.97,501.62,501.62,991.58
3872000,762,G0378,,,,,,,ACUTE OBSERVATION P/,56.16,22.46,0,56.16,47.74,SKIPPED,56.16,56.16,47.74,47.74,47.74,23.67,27.52,27.52,0,16.85,24.15,24.15,47.74
3878001,360,50200,,,,,,,RENAL BIOPSY,2955.33,1182.13,414.14,2955.33,2512.03,SKIPPED,2955.33,2955.33,2512.03,2512.03,2512.03,1245.37,414.14,414.14,SKIPPED,SKIPPED,1270.79,1270.79,2512.03
3882000,762,G0378,,,,,,,ICU OBSERVATION P/HR,146.76,58.7,0,146.76,124.75,SKIPPED,146.76,146.76,124.75,124.75,124.75,61.85,71.91,71.91,0,44.03,63.11,63.11,124.75
3930309,270,,,,,,,,TPS POWER SET,297,118.8,0,252.45,252.45,SKIPPED,225.72,225.72,252.45,252.45,252.45,125.16,145.53,145.53,0,89.1,127.71,127.71,252.45
4020001,301,82542,,,,,,,DRUG SCREEN CONFIRM-,283.5,113.4,0,240.98,240.98,SKIPPED,91.54,91.54,240.98,240.98,240.98,119.47,20.24,20.24,0,20.24,121.91,121.91,240.98
4020002,302,84270,,,,,,,SEXHBG,118.32,47.33,0,101.95,100.57,SKIPPED,101.95,101.95,100.57,100.57,100.57,49.86,18.25,18.25,0,20.29,50.88,50.88,100.57
4020003,300,87400,,,,,,,INFLUENZA A/B,125.59,50.24,0,106.75,106.75,SKIPPED,56.24,56.24,106.75,106.75,106.75,52.92,11.87,11.87,0,11.87,54,54,106.75
4020004,302,83520,,,,,,,TRYPTASE,165.54,66.22,0,140.71,140.71,SKIPPED,65.63,65.63,140.71,140.71,140.71,69.76,14.51,14.51,0,14.51,71.18,71.18,140.71
4020005,302,86593,,,,,,,RPR QUANTITATIVE,102,40.8,0,86.7,86.7,SKIPPED,20.67,20.67,86.7,86.7,86.7,42.98,3.7,3.7,0,4.11,43.86,43.86,86.7
4020006,306,87046,,,,,,,CULT STOOL R/O CAMPY,51.42,20.57,0,44.31,43.71,SKIPPED,44.31,44.31,43.71,43.71,43.71,21.67,7.93,7.93,0,8.81,22.11,22.11,43.71
4020007,306,87046,,,,,,,CULT STOOL R/O VIBRI,51.42,20.57,0,44.31,43.71,SKIPPED,44.31,44.31,43.71,43.71,43.71,21.67,7.93,7.93,0,8.81,22.11,22.11,43.71
4020008,306,87046,,,,,,,CULT STOOL R/O YERSI,51.42,20.57,0,44.31,43.71,SKIPPED,44.31,44.31,43.71,43.71,43.71,21.67,7.93,7.93,0,8.81,22.11,22.11,43.71
4020009,306,87335,,,,,,,CULT STOOL E COLI 01,87.18,34.87,0,74.1,74.1,SKIPPED,56.24,56.24,74.1,74.1,74.1,36.74,10.63,10.63,0,11.19,37.49,37.49,74.1
4020010,301,83020,,,,,,,HEMOGLOBIN ELECTROPH,70.08,28.03,0,60.38,59.57,SKIPPED,60.38,60.38,59.57,59.57,59.57,17.48,10.81,10.81,0,12.01,17.84,17.84,59.57
4020012,302,84703,,,,,,,"PREGNANCY TEST, URIN",116.78,46.71,0,99.26,99.26,SKIPPED,35.3,35.3,99.26,99.26,99.26,49.22,6.32,6.32,0,7.02,50.22,50.22,99.26
4020013,306,87272,,,,,,,O&P ROUTINE(GIA/CR),195.01,78,0,165.76,165.76,SKIPPED,56.24,56.24,165.76,165.76,165.76,82.17,10.06,10.06,0,11.19,83.85,83.85,165.76
4020014,306,87206,,,,,,,O&P CYCLOSPORA,103.51,41.4,0,87.98,87.98,SKIPPED,25.27,25.27,87.98,87.98,87.98,43.62,4.53,4.53,0,5.03,44.51,44.51,87.98
4020015,306,87207,,,,,,,O&P MICROSPORIDIA,143.2,57.28,0,121.72,121.72,SKIPPED,28.12,28.12,121.72,121.72,121.72,17.48,5.03,5.03,0,5.59,17.84,17.84,121.72
4020016,391,36430,,,,,,,BLOOD TRANSFUSION/EP,772.65,309.06,0,656.75,656.75,SKIPPED,167.58,167.58,656.75,656.75,656.75,325.6,378.6,378.6,0,231.8,332.24,332.24,656.75
4020017,301,82945,,,,,,,"GLUCOSE,BODY FLUID",110.79,44.32,0,94.17,94.17,SKIPPED,18.43,18.43,94.17,94.17,94.17,46.69,3.3,3.3,0,3.67,47.64,47.64,94.17
4020018,307,81050,,,,,,,VOLUME MEAS TIME URI,32.56,13.02,0,27.68,27.68,SKIPPED,14.1,14.1,27.68,27.68,27.68,13.72,3.06,3.06,0,3.06,14,14,27.68
4020020,301,80170,,,,,,,"GENTAMICIN, TROUGH",258.45,103.38,0,219.68,219.68,SKIPPED,76.84,76.84,219.68,219.68,219.68,108.91,13.76,13.76,0,15.29,111.13,111.13,219.68
4020021,390,P9040,,,,,,,BLOOD LEUKREDUCED IR,747.64,299.06,0,635.49,635.49,SKIPPED,568.21,568.21,635.49,635.49,635.49,315.06,366.34,366.34,0,224.29,321.49,321.49,635.49
4020022,300,86902,,,,,,,ANTIGEN SCREEN/UNIT,128.84,51.54,0,128.84,109.51,SKIPPED,128.84,128.84,109.51,109.51,109.51,54.29,5.33,5.33,0,5.33,55.4,55.4,109.51
4020024,390,P9047,,,,,,,"ALBUMIN,25%,50ML",323.54,129.42,0,275.01,275.01,SKIPPED,62.21,62.21,275.01,275.01,275.01,136.34,158.53,158.53,0,97.06,139.12,139.12,275.01
4020025,305,85384,,,,,,,FIBRINOGEN,109.38,43.75,0,92.97,92.97,SKIPPED,39.86,39.86,92.97,92.97,92.97,46.09,8.16,8.16,0,8.16,47.03,47.03,92.97
4020026,301,83880,,,,,,,B NATRIURETIC(BNP),402.02,160.81,0,341.72,341.72,SKIPPED,159.22,159.22,341.72,341.72,341.72,169.41,32.98,32.98,0,32.98,172.87,172.87,341.72
4020028,301,82747,,,,,,,"FOLATE, RBC",94.29,37.72,0,81.24,80.15,SKIPPED,81.24,81.24,80.15,80.15,80.15,39.73,14.83,14.83,0,16.17,40.54,40.54,80.15
4020029,301,83001,,,,,,,FSH,146.27,58.51,0,124.33,124.33,SKIPPED,87.17,87.17,124.33,124.33,124.33,61.64,15.61,15.61,0,17.35,62.9,62.9,124.33
4020032,306,87070,,,,,,,CULTURE ANY OT SOURC,187.61,75.04,0,159.47,159.47,SKIPPED,40.43,40.43,159.47,159.47,159.47,79.06,7.24,7.24,0,8.04,80.67,80.67,159.47
4020035,302,80074,,,,,,,HEP SURVEY ACUTE,259.35,103.74,0,223.48,220.45,SKIPPED,223.48,223.48,220.45,220.45,220.45,109.29,40.01,40.01,0,44.46,111.52,111.52,220.45
4020036,302,87496,,,,,,,CMV PCR,625.01,250,0,531.26,531.26,SKIPPED,164.65,164.65,531.26,531.26,531.26,263.38,29.48,29.48,0,32.75,268.75,268.75,531.26
4020037,302,87252,,,,,,,VIRAL CULT ENTEROVIR,245.31,98.12,0,208.51,208.51,SKIPPED,122.28,122.28,208.51,208.51,208.51,103.37,21.9,21.9,0,24.33,105.48,105.48,208.51
4020038,302,87254,,,,,,,HERPES CULTURE,106.5,42.6,0,91.77,90.52,SKIPPED,91.77,91.77,90.52,90.52,90.52,44.88,16.43,16.43,0,18.25,45.8,45.8,90.52
4020039,302,87254,,,,,,,VIRAL CULT RESPIRATO,106.5,42.6,0,91.77,90.52,SKIPPED,91.77,91.77,90.52,90.52,90.52,44.88,16.43,16.43,0,18.25,45.8,45.8,90.52
4020040,301,80200,,,,,,,"TOBRAMYCIN, TROUGH",87.8,35.12,0,75.66,74.63,SKIPPED,75.66,75.66,74.63,74.63,74.63,37,13.55,13.55,0,15.05,37.75,37.75,74.63
4020041,302,87254,,,,,,,VIRAL CULT VAR-ZOSTE,106.5,42.6,0,91.77,90.52,SKIPPED,91.77,91.77,90.52,90.52,90.52,44.88,16.43,16.43,0,18.25,45.8,45.8,90.52
4020042,301,83874,,,,,,,MYOGLOBIN,239.31,95.72,0,203.41,203.41,SKIPPED,60.61,60.61,203.41,203.41,203.41,100.84,10.85,10.85,0,12.05,102.9,102.9,203.41
4020045,301,80202,,,,,,,"VANCOMYCIN, TROUGH",141.79,56.72,0,120.52,120.52,SKIPPED,63.54,63.54,120.52,120.52,120.52,59.75,11.37,11.37,0,12.64,60.97,60.97,120.52
4020047,301,82024,,,,,,,ACTH,210.27,84.11,0,181.18,178.73,SKIPPED,181.18,181.18,178.73,178.73,178.73,88.61,32.44,32.44,0,36.04,90.42,90.42,178.73
4020048,301,82105,,,,,,,ALPHA FETO PROTEIN,180.2,72.08,0,153.17,153.17,SKIPPED,78.7,78.7,153.17,153.17,153.17,75.94,14.09,14.09,0,15.66,77.49,77.49,153.17
4020049,301,83090,,,,,,,HOMOCYSTINE LEVEL,195.01,78,0,165.76,165.76,SKIPPED,79.15,79.15,165.76,165.76,165.76,82.17,15.05,15.05,0,15.74,83.85,83.85,165.76
4020050,300,P9604,,,,,,,TRAVEL ALLOWANCE,20.67,8.27,0,17.57,17.57,SKIPPED,15.71,15.71,17.57,17.57,17.57,8.71,10.13,10.13,0,6.2,8.89,8.89,17.57
4020052,301,84484,,,,,,,TROPONION I,239.31,95.72,0,203.41,203.41,SKIPPED,47.39,47.39,203.41,203.41,203.41,100.84,10.47,10.47,0,10.47,102.9,102.9,203.41
4020053,301,80400,,,,,,,ACTH STIM,684.6,273.84,0,581.91,581.91,SKIPPED,153.03,153.03,581.91,581.91,581.91,288.49,27.4,27.4,0,30.44,294.38,294.38,581.91
4020054,301,82627,,,,,,,DHEA SULFATE,121.05,48.42,0,104.31,102.89,SKIPPED,104.31,104.31,102.89,102.89,102.89,51.01,18.67,18.67,0,20.76,52.05,52.05,102.89
4020055,305,85362,,,,,,,FSP,64.97,25.99,0,55.22,55.22,SKIPPED,32.34,32.34,55.22,55.22,55.22,27.38,5.79,5.79,0,6.43,27.94,27.94,55.22
4020056,301,82670,,,,,,,ESTRADIOL,152.1,60.84,0,131.06,129.28,SKIPPED,131.06,131.06,129.28,129.28,129.28,64.09,23.47,23.47,0,26.07,65.4,65.4,129.28
4020059,305,85379,,,,,,,D-DIMER,149.32,59.73,0,126.92,126.92,SKIPPED,47.73,47.73,126.92,126.92,126.92,62.93,8.55,8.55,0,9.5,64.21,64.21,126.92
4020060,305,85025,,,,,,,CBC(AUTO DIFF),147.79,59.12,0,125.62,125.62,SKIPPED,36.44,36.44,125.62,125.62,125.62,62.28,6.53,6.53,0,7.25,63.55,63.55,125.62
4020061,301,83002,,,,,,,LUTEINIZING HORMONE,143.2,57.28,0,121.72,121.72,SKIPPED,86.87,86.87,121.72,121.72,121.72,60.35,15.56,15.56,0,17.28,61.58,61.58,121.72
4020062,301,84702,,,,,,,HCG QUANTITATIVE,239.31,95.72,0,203.41,203.41,SKIPPED,70.64,70.64,203.41,203.41,203.41,100.84,12.64,12.64,0,14.05,102.9,102.9,203.41
4020063,301,83003,,,,,,,HUMAN GROWTH HORMONE,90.76,36.3,0,78.2,77.15,SKIPPED,78.2,78.2,77.15,77.15,77.15,38.25,14,14,0,15.56,39.03,39.03,77.15
4020065,301,82570,,,,,,,CREATININE(URINE),115.26,46.1,0,97.97,97.97,SKIPPED,24.28,24.28,97.97,97.97,97.97,48.57,4.35,4.35,0,4.83,49.56,49.56,97.97
4020066,301,83520,,,,,,,IGF-BP3,79.78,31.91,0,67.81,67.81,SKIPPED,65.63,65.63,67.81,67.81,67.81,33.62,14.51,14.51,0,14.51,34.31,34.31,67.81
4020067,301,86304,,,,,,,CA125,158.14,63.26,0,134.42,134.42,SKIPPED,97.66,97.66,134.42,134.42,134.42,66.64,17.48,17.48,0,19.43,68,68,134.42
4020068,301,84144,,,,,,,PROGESTERONE,166.94,66.78,0,141.9,141.9,SKIPPED,97.89,97.89,141.9,141.9,141.9,70.34,17.52,17.52,0,19.47,71.78,71.78,141.9
4020069,301,84146,,,,,,,PROLACTIN LEVEL,105.48,42.19,0,90.9,89.66,SKIPPED,90.9,90.9,89.66,89.66,89.66,44.45,16.28,16.28,0,18.09,45.36,45.36,89.66
4020072,301,84305,,,,,,,IGF-1,100.57,40.23,0,99.75,85.48,SKIPPED,99.75,99.75,85.48,85.48,85.48,42.38,17.86,17.86,0,19.85,43.25,43.25,85.48
4020073,301,84402,,,,,,,"TESTOSTERONE, FREE",84.11,33.64,0,84.11,71.49,SKIPPED,84.11,84.11,71.49,71.49,71.49,35.45,21.39,21.39,0,23.77,36.17,36.17,71.49
4020074,301,84403,,,,,,,"TESTOSTERONE, TOTAL",103.51,41.4,0,103.51,87.98,SKIPPED,103.51,103.51,87.98,87.98,87.98,43.62,21.68,21.68,0,24.09,44.51,44.51,87.98
4020075,302,86677,,,,,,,HELICOBACTER PYLORI,239.31,95.72,0,203.41,203.41,SKIPPED,68.06,68.06,203.41,203.41,203.41,100.84,14.15,14.15,0,14.15,102.9,102.9,203.41
4020077,301,84588,,,,,,,VASOPRESSIN LEVEL,184.78,73.91,0,159.22,157.06,SKIPPED,159.22,159.22,157.06,157.06,157.06,77.87,28.51,28.51,0,31.68,79.46,79.46,157.06
4020078,306,87116,,,,,,,ACIDFAST CULTURE,93.17,37.27,0,79.19,79.19,SKIPPED,50.69,50.69,79.19,79.19,79.19,39.26,9.07,9.07,0,10.08,40.06,40.06,79.19
4020079,301,82140,,,,,,,AMMONIA,240.84,96.34,0,204.71,204.71,SKIPPED,68.36,68.36,204.71,204.71,204.71,101.49,12.24,12.24,0,13.6,103.56,103.56,204.71
4020080,306,87075,,,,,,,CULTURE ANAEROBIC,72.38,28.95,0,61.52,61.52,SKIPPED,44.42,44.42,61.52,61.52,61.52,30.5,7.95,7.95,0,8.84,31.12,31.12,61.52
4020082,305,85060,,,,,,,PATHOLOGIST BLD SMR EXAM,181.74,72.7,0,154.48,154.48,SKIPPED,96.82,96.82,154.48,154.48,154.48,23.18,89.05,89.05,0,54.52,23.65,23.65,154.48
4020083,301,82375,,,,,,,CARBOXYHEMOGLOBIN,79.78,31.91,0,67.81,67.81,SKIPPED,57.8,57.8,67.81,67.81,67.81,33.62,10.35,10.35,0,11.5,34.31,34.31,67.81
4020084,301,82378,,,,,,,CARCINOEMBRYONIC ANT,103.24,41.3,0,88.96,87.75,SKIPPED,88.96,88.96,87.75,87.75,87.75,43.5,15.93,15.93,0,17.7,44.39,44.39,87.75
4020085,302,87491,,,,,,,CHLAMYDIA PCR,204.44,81.78,0,173.77,173.77,SKIPPED,164.65,164.65,173.77,173.77,173.77,86.15,29.48,29.48,0,32.75,87.91,87.91,173.77
4020086,306,87324,,,,,,,CLOSTRIDIUM DIFFICIL,237.91,95.16,0,202.22,202.22,SKIPPED,56.24,56.24,202.22,202.22,202.22,100.25,10.06,10.06,0,11.19,102.3,102.3,202.22
4020087,301,82533,,,,,,,CORTISOL,88.73,35.49,0,76.46,75.42,SKIPPED,76.46,76.46,75.42,75.42,75.42,37.39,13.69,13.69,0,15.21,38.15,38.15,75.42
4020088,301,82728,,,,,,,FERRITIN,116.78,46.71,0,99.26,99.26,SKIPPED,63.95,63.95,99.26,99.26,99.26,49.22,11.45,11.45,0,12.73,50.22,50.22,99.26
4020089,301,82746,,,,,,,FOLATE SERUM,102,40.8,0,86.7,86.7,SKIPPED,68.97,68.97,86.7,86.7,86.7,42.98,12.35,12.35,0,13.73,43.86,43.86,86.7
4020090,301,83036,,,,,,,HEMOGLOBIN A1C,97.5,39,0,82.88,82.88,SKIPPED,45.56,45.56,82.88,82.88,82.88,41.09,8.16,8.16,0,9.06,41.93,41.93,82.88
4020091,301,86060,,,,,,,ASO TITER,59.09,23.64,0,50.23,50.23,SKIPPED,34.24,34.24,50.23,50.23,50.23,24.9,6.13,6.13,0,6.81,25.41,25.41,50.23
4020092,301,80061,,,,,,,PANEL LIPID,220.17,88.07,0,187.14,187.14,SKIPPED,62.81,62.81,187.14,187.14,187.14,92.78,11.25,11.25,0,12.5,94.67,94.67,187.14
4020093,301,80069,,,,,,,PANEL RENAL FUNCTION,155.19,62.08,0,131.91,131.91,SKIPPED,40.74,40.74,131.91,131.91,131.91,65.4,7.29,7.29,0,8.11,66.73,66.73,131.91
4020094,301,86140,,,,,,,CRP,60.63,24.25,0,51.54,51.54,SKIPPED,24.28,24.28,51.54,51.54,51.54,25.55,4.35,4.35,0,4.83,26.07,26.07,51.54
4020095,302,86762,,,,,,,RUBELLA AB-IGG,78.36,31.34,0,67.53,66.61,SKIPPED,67.53,67.53,66.61,66.61,66.61,33.02,12.09,12.09,0,13.43,33.69,33.69,66.61
4020096,301,86160,,,,,,,C3 COMPLEMENT,65.31,26.12,0,56.28,55.51,SKIPPED,56.28,56.28,55.51,55.51,55.51,27.52,10.08,10.08,0,11.2,28.08,28.08,55.51
4020097,301,80053,,,,,,,PANEL COMP METABO(CM,265.98,106.39,0,226.08,226.08,SKIPPED,49.55,49.55,226.08,226.08,226.08,112.08,8.87,8.87,0,9.86,114.37,114.37,226.08
4020099,301,86235,,,,,,,ANA SCREEN,51.69,20.68,0,51.69,43.94,SKIPPED,51.69,51.69,43.94,43.94,43.94,21.79,15.06,15.06,0,16.74,22.23,22.23,43.94
4020101,301,86256,,,,,,,ENDOMYSIUM IgA,97.5,39,0,82.88,82.88,SKIPPED,56.54,56.54,82.88,82.88,82.88,17.48,10.12,10.12,0,11.25,17.84,17.84,82.88
4020103,301,86317,,,,,,,ROTAVIRUS SCREEN,81.18,32.47,0,70.3,69,SKIPPED,70.3,70.3,69,69,69,34.21,12.59,12.59,0,13.99,34.91,34.91,69
4020106,301,84105,,,,,,,PHOSPHORUS URINE,97.5,39,0,82.88,82.88,SKIPPED,24.28,24.28,82.88,82.88,82.88,41.09,4.86,4.86,0,4.86,41.93,41.93,82.88
4020108,301,86618,,,,,,,LYME IgG&IgM,165.54,66.22,0,140.71,140.71,SKIPPED,79.88,79.88,140.71,140.71,140.71,69.76,14.31,14.31,0,15.89,71.18,71.18,140.71
4020110,302,86803,,,,,,,HEP C ANTIBODY,77.66,31.06,0,66.92,66.01,SKIPPED,66.92,66.92,66.01,66.01,66.01,32.72,11.99,11.99,0,13.31,33.39,33.39,66.01
4020111,301,86668,,,,,,,TULAREMIA,62.44,24.98,0,53.81,53.07,SKIPPED,53.81,53.81,53.07,53.07,53.07,26.31,11.89,11.89,0,11.89,26.85,26.85,53.07
4020112,301,86694,,,,,,,HERPES SIM AB-IgM ACTIVE,81.18,32.47,0,69,69,SKIPPED,67.53,67.53,69,69,69,34.21,12.09,12.09,0,13.43,34.91,34.91,69
4020114,301,86735,,,,,,,"MUMPS, ANTIBODY",71.04,28.42,0,61.22,60.38,SKIPPED,61.22,61.22,60.38,60.38,60.38,29.94,10.96,10.96,0,12.18,30.55,30.55,60.38
4020115,301,86787,,,,,,,"VARICELLA, ZOSTER IgG",87.18,34.87,0,74.1,74.1,SKIPPED,60.42,60.42,74.1,74.1,74.1,36.74,10.82,10.82,0,12.02,37.49,37.49,74.1
4020116,301,86812,,,,,,,HLA B27,226.03,90.41,0,192.13,192.13,SKIPPED,121.07,121.07,192.13,192.13,192.13,95.25,21.68,21.68,0,24.08,97.19,97.19,192.13
4020117,301,87522,,,,,,,HCV QUANTITATIVE,246.72,98.69,0,209.71,209.71,SKIPPED,200.94,200.94,209.71,209.71,209.71,103.97,35.99,35.99,0,39.98,106.09,106.09,209.71
4020119,301,10021,,,,,,,FNA PROCEDURE,285.13,114.05,0,285.13,242.36,SKIPPED,285.13,285.13,242.36,242.36,242.36,97.87,139.71,139.71,0,85.54,99.87,99.87,242.36
4020120,302,86709,,,,,,,"HEP A AB,IGM",61.3,24.52,0,52.82,52.1,SKIPPED,52.82,52.82,52.1,52.1,52.1,25.83,9.46,9.46,0,10.51,26.36,26.36,52.1
4020121,301,80188,,,,,,,PRIMIDONE,84.11,33.64,0,77.82,71.49,SKIPPED,77.82,77.82,71.49,71.49,71.49,35.45,13.94,13.94,0,15.49,36.17,36.17,71.49
4020122,301,84300,,,,,,,"SODIUM, URINE",93.17,37.27,0,79.19,79.19,SKIPPED,22.8,22.8,79.19,79.19,79.19,39.26,4.25,4.25,0,4.54,40.06,40.06,79.19
4020123,301,80307,,,,,,,AMP,36.75,14.7,0,36.75,31.24,SKIPPED,36.75,36.75,31.24,31.24,31.24,15.48,36.75,36.75,0,36.75,15.8,15.8,31.24
4020124,301,80307,,,,,,,BZO,36.75,14.7,0,36.75,31.24,SKIPPED,36.75,36.75,31.24,31.24,31.24,15.48,36.75,36.75,0,36.75,15.8,15.8,31.24
4020125,302,86705,,,,,,,HEP B CORE AB IGM,76.83,30.73,0,65.31,65.31,SKIPPED,55.25,55.25,65.31,65.31,65.31,32.38,9.89,9.89,0,10.99,33.04,33.04,65.31
4020126,301,80307,,,,,,,COC,36.75,14.7,0,36.75,31.24,SKIPPED,36.75,36.75,31.24,31.24,31.24,15.48,36.75,36.75,0,36.75,15.8,15.8,31.24
4020127,301,80307,,,,,,,THC,36.75,14.7,0,36.75,31.24,SKIPPED,36.75,36.75,31.24,31.24,31.24,15.48,36.75,36.75,0,36.75,15.8,15.8,31.24
4020128,306,87102,,,,,,,FUNGUS CULTURE,82.7,33.08,0,70.3,70.3,SKIPPED,39.44,39.44,70.3,70.3,70.3,34.85,7.06,7.06,0,7.85,35.56,35.56,70.3
4020129,301,80307,,,,,,,OPI,36.75,14.7,0,36.75,31.24,SKIPPED,36.75,36.75,31.24,31.24,31.24,15.48,36.75,36.75,0,36.75,15.8,15.8,31.24
4020130,302,86708,,,,,,,"HEP A AB,TOTAL",67.43,26.97,0,58.1,57.32,SKIPPED,58.1,58.1,57.32,57.32,57.32,28.41,10.41,10.41,0,11.56,28.99,28.99,57.32
4020131,301,80307,,,,,,,BAR,36.75,14.7,0,36.75,31.24,SKIPPED,36.75,36.75,31.24,31.24,31.24,15.48,36.75,36.75,0,36.75,15.8,15.8,31.24
4020132,301,80307,,,,,,,TCA,36.75,14.7,0,36.75,31.24,SKIPPED,36.75,36.75,31.24,31.24,31.24,15.48,36.75,36.75,0,36.75,15.8,15.8,31.24
4020133,301,80307,,,,,,,PCP,316.77,126.71,0,272.95,269.25,SKIPPED,272.95,272.95,269.25,269.25,269.25,133.49,52.2,52.2,0,54.31,136.21,136.21,269.25
4020134,306,87206,,,,,,,FUNGUS SMEAR,84.11,33.64,0,71.49,71.49,SKIPPED,25.27,25.27,71.49,71.49,71.49,35.45,4.53,4.53,0,5.03,36.17,36.17,71.49
4020135,302,86706,,,,,,,HEP B SURF ANTIBOD,67.89,27.16,0,57.71,57.71,SKIPPED,50.39,50.39,57.71,57.71,57.71,28.61,9.02,9.02,0,10.02,29.19,29.19,57.71
4020137,301,84133,,,,,,,"POTASSIUM, URINE",93.17,37.27,0,79.19,79.19,SKIPPED,20.22,20.22,79.19,79.19,79.19,39.26,3.97,3.97,0,4.02,40.06,40.06,79.19
4020138,301,82088,,,,,,,ALDOSTERONE,221.87,88.75,0,191.18,188.59,SKIPPED,191.18,191.18,188.59,188.59,188.59,93.49,34.23,34.23,0,38.04,95.4,95.4,188.59
4020139,301,84244,,,,,,,RENIN,119.73,47.89,0,103.17,101.77,SKIPPED,103.17,103.17,101.77,101.77,101.77,50.45,18.47,18.47,0,20.53,51.48,51.48,101.77
4020140,302,87340,,,,,,,HEP B SURF ANTIGEN,76.83,30.73,0,65.31,65.31,SKIPPED,48.45,48.45,65.31,65.31,65.31,32.38,8.68,8.68,0,9.64,33.04,33.04,65.31
4020143,310,88305,,,,,,,LEVEL IV GROSS AND MICRO,197.13,78.85,0,169.86,167.56,SKIPPED,169.86,169.86,167.56,167.56,167.56,68.26,96.59,96.59,0,59.14,69.65,69.65,167.56
4020144,310,88312,,,,,,,SPECIAL STAINS GROUP I,197.13,78.85,0,169.86,167.56,SKIPPED,169.86,169.86,167.56,167.56,167.56,107.78,96.59,96.59,0,59.14,109.98,109.98,167.56
4020145,310,88313,,,,,,,SPECIAL STAINS GROUP II,140.68,56.27,0,120.84,119.58,SKIPPED,120.84,120.84,119.58,119.58,119.58,77.19,68.93,68.93,0,42.2,78.77,78.77,119.58
4020147,301,82436,,,,,,,"CHLORIDE, URINE",100.57,40.23,0,85.48,85.48,SKIPPED,23.6,23.6,85.48,85.48,85.48,42.38,4.83,4.83,0,4.83,43.25,43.25,85.48
4020148,302,87807,,,,,,,RSV,109.38,43.75,0,92.97,92.97,SKIPPED,56.24,56.24,92.97,92.97,92.97,46.09,11,11,0,11.19,47.03,47.03,92.97
4020150,306,87081,,,,,,,CULTURE STREP A,91.64,36.66,0,77.89,77.89,SKIPPED,31.08,31.08,77.89,77.89,77.89,38.62,5.57,5.57,0,6.18,39.41,39.41,77.89
4020151,301,82553,,,,,,,CK-MB,323.54,129.42,0,275.01,275.01,SKIPPED,54.19,54.19,275.01,275.01,275.01,136.34,9.7,9.7,0,10.78,139.12,139.12,275.01
4020154,301,80104,,,,,,,MDMA (ECSTASY),35.48,14.19,0,30.16,30.16,SKIPPED,26.96,26.96,30.16,30.16,30.16,14.95,17.39,17.39,0,10.64,15.26,15.26,30.16
4020155,302,86703,,,,,,,HIV-1 & HIV-2,74.61,29.84,0,64.3,63.42,SKIPPED,64.3,64.3,63.42,63.42,63.42,31.44,11.52,11.52,0,12.79,32.08,32.08,63.42
4020158,310,88323,,,,,,,CONSULT&REPORT CUTTING BL,197.13,78.85,0,169.86,167.56,SKIPPED,169.86,169.86,167.56,167.56,167.56,109.3,96.59,96.59,0,59.14,111.53,111.53,167.56
4020160,301,83655,,,,,,,LEAD,65.93,26.37,0,56.81,56.04,SKIPPED,56.81,56.81,56.04,56.04,56.04,27.78,10.17,10.17,0,11.3,28.35,28.35,56.04
4020161,301,83010,,,,,,,HAPTOGLOBIN,68.49,27.4,0,59.01,58.22,SKIPPED,59.01,59.01,58.22,58.22,58.22,28.86,10.57,10.57,0,11.73,29.45,29.45,58.22
4020162,301,83605,,,,,,,LACTIC ACID,125.59,50.24,0,106.75,106.75,SKIPPED,50.12,50.12,106.75,106.75,106.75,52.92,9.72,9.72,0,9.97,54,54,106.75
4020163,301,83721,,,,,,,LDL CHOLESTEROL,110.79,44.32,0,94.17,94.17,SKIPPED,44.76,44.76,94.17,94.17,94.17,46.69,8.82,8.82,0,8.9,47.64,47.64,94.17
4020164,301,84466,,,,,,,TRANSFERRIN,110.79,44.32,0,94.17,94.17,SKIPPED,59.89,59.89,94.17,94.17,94.17,46.69,10.72,10.72,0,11.91,47.64,47.64,94.17
4020165,301,83690,,,,,,,LIPASE,159.67,63.87,0,135.72,135.72,SKIPPED,32.34,32.34,135.72,135.72,135.72,67.29,5.79,5.79,0,6.43,68.66,68.66,135.72
4020166,301,86141,,,,,,,CRP-HS,72.38,28.95,0,61.52,61.52,SKIPPED,60.72,60.72,61.52,61.52,61.52,30.5,10.88,10.88,0,12.09,31.12,31.12,61.52
4020167,301,82043,,,,,,,MICROALBUMIN,128.53,51.41,0,109.25,109.25,SKIPPED,27.13,27.13,109.25,109.25,109.25,54.16,4.86,4.86,0,5.39,55.27,55.27,109.25
4020168,301,84157,,,,,,,"PROTEIN, BODY FLUID",106.45,42.58,0,90.48,90.48,SKIPPED,17.21,17.21,90.48,90.48,90.48,44.85,3.36,3.36,0,3.42,45.77,45.77,90.48
4020169,302,87449,,,,,,,S PNEUMONIAE URINE Ag,118.18,47.27,0,100.45,100.45,SKIPPED,56.24,56.24,100.45,100.45,100.45,49.8,10.06,10.06,0,11.19,50.82,50.82,100.45
4020170,301,84479,,,,,,,T3 UPTAKE,78.25,31.3,0,66.51,66.51,SKIPPED,30.32,30.32,66.51,66.51,66.51,32.98,5.43,5.43,0,6.03,33.65,33.65,66.51
4020171,301,84439,,,,,,,FREE T4,72.38,28.95,0,61.52,61.52,SKIPPED,42.29,42.29,61.52,61.52,61.52,30.5,7.58,7.58,0,8.42,31.12,31.12,61.52
4020172,301,84156,,,,,,,24 HR URINE TP,103.51,41.4,0,87.98,87.98,SKIPPED,17.21,17.21,87.98,87.98,87.98,43.62,3.08,3.08,0,3.42,44.51,44.51,87.98
4020173,301,82150,,,,,,,AMYLASE URINE U/L,135.92,54.37,0,115.53,115.53,SKIPPED,30.4,30.4,115.53,115.53,115.53,57.28,5.44,5.44,0,6.05,58.45,58.45,115.53
4020174,301,84157,,,,,,,PROTEIN URINE (MTP),106.05,42.42,0,90.14,90.14,SKIPPED,17.21,17.21,90.14,90.14,90.14,44.69,3.36,3.36,0,3.42,45.6,45.6,90.14
4020175,301,80178,,,,,,,LITHIUM,67.89,27.16,0,57.71,57.71,SKIPPED,31.01,31.01,57.71,57.71,57.71,28.61,5.55,5.55,0,6.17,29.19,29.19,57.71
4020176,301,80307,,,,,,,METHADONE,36.75,14.7,0,36.75,31.24,SKIPPED,36.75,36.75,31.24,31.24,31.24,15.48,36.75,36.75,0,36.75,15.8,15.8,31.24
4020177,301,84540,,,,,,,UREA NITROGEN URINE MG/DL,109.38,43.75,0,92.97,92.97,SKIPPED,22.27,22.27,92.97,92.97,92.97,46.09,4.67,4.67,0,4.67,47.03,47.03,92.97
4020178,301,82330,,,,,,,CALCIUM IONIZED,85.64,34.26,0,72.79,72.79,SKIPPED,64.14,64.14,72.79,72.79,72.79,36.09,11.49,11.49,0,12.77,36.83,36.83,72.79
4020179,307,81002,,,,,,,CLINITEST,21,8.4,0,17.85,17.85,SKIPPED,13.22,13.22,17.85,17.85,17.85,8.85,2.92,2.92,0,2.92,9.03,9.03,17.85
4020180,301,82306,,,,,,,VIT D OH25,161.19,64.48,0,138.89,137.01,SKIPPED,138.89,138.89,137.01,137.01,137.01,67.92,24.86,24.86,0,27.63,69.31,69.31,137.01
4020182,301,84260,,,,,,,SERROTONIN,168.68,67.47,0,145.35,143.38,SKIPPED,145.35,145.35,143.38,143.38,143.38,71.08,26.02,26.02,0,28.92,72.53,72.53,143.38
4020183,301,80299,,,,,,,LAMICTAL,82.2,32.88,0,70.83,69.87,SKIPPED,70.83,70.83,69.87,69.87,69.87,34.64,15.66,15.66,0,15.66,35.35,35.35,69.87
4020184,301,84425,,,,,,,VIT B1-THIAMINE,115.63,46.25,0,99.6,98.29,SKIPPED,99.6,99.6,98.29,98.29,98.29,48.73,17.83,17.83,0,19.82,49.72,49.72,98.29
4020185,302,86038,,,,,,,ANTI NUC AB-ANA,65.79,26.32,0,56.7,55.92,SKIPPED,56.7,56.7,55.92,55.92,55.92,27.72,10.16,10.16,0,11.28,28.29,28.29,55.92
4020186,301,84207,,,,,,,VITAMIN B6,152.99,61.2,0,131.82,130.04,SKIPPED,131.82,131.82,130.04,130.04,130.04,64.47,23.6,23.6,0,26.22,65.79,65.79,130.04
4020187,301,86695,,,,,,,HERPES SIMAB 1&2 IgG PAST,81.18,32.47,0,69,69,SKIPPED,61.86,61.86,69,69,69,34.21,11.08,11.08,0,12.31,34.91,34.91,69
4020188,301,86704,,,,,,,"HEP B CORE AB, TOTAL",65.63,26.25,0,56.54,55.79,SKIPPED,56.54,56.54,55.79,55.79,55.79,27.66,10.12,10.12,0,11.25,28.22,28.22,55.79
4020189,301,80197,,,,,,,TACROLIMUS,171.4,68.56,0,145.69,145.69,SKIPPED,64.45,64.45,145.69,145.69,145.69,72.23,11.53,11.53,0,12.82,73.7,73.7,145.69
4020190,301,84436,,,,,,,T4 THYROXINE,67.89,27.16,0,57.71,57.71,SKIPPED,32.22,32.22,57.71,57.71,57.71,28.61,5.77,5.77,0,6.41,29.19,29.19,57.71
4020191,301,82542,,,,,,,"VITAMIN D, 1, 25",116.78,46.71,0,99.26,99.26,SKIPPED,91.54,91.54,99.26,99.26,99.26,49.22,20.24,20.24,0,20.24,50.22,50.22,99.26
4020192,301,82668,,,,,,,ERYTHROPOIETIN,102.31,40.92,0,88.16,86.96,SKIPPED,88.16,88.16,86.96,86.96,86.96,43.11,15.78,15.78,0,17.54,43.99,43.99,86.96
4020193,301,82941,,,,,,,GASTRIN,96,38.4,0,82.73,81.6,SKIPPED,82.73,82.73,81.6,81.6,81.6,40.45,14.81,14.81,0,16.46,41.28,41.28,81.6
4020194,301,82180,,,,,,,ASCORBIC ACID-VIT C,121.12,48.45,0,102.95,102.95,SKIPPED,46.36,46.36,102.95,102.95,102.95,51.04,8.31,8.31,0,9.22,52.08,52.08,102.95
4020195,301,83930,,,,,,,OSMOLALITY SERUM,69.44,27.78,0,59.02,59.02,SKIPPED,31.01,31.01,59.02,59.02,59.02,29.26,5.55,5.55,0,6.17,29.86,29.86,59.02
4020196,302,86592,,,,,,,VDRL,102,40.8,0,86.7,86.7,SKIPPED,20.03,20.03,86.7,86.7,86.7,42.98,3.59,3.59,0,3.99,43.86,43.86,86.7
4020197,306,87081,,,,,,,MRSA SCREEN,102,40.8,0,86.7,86.7,SKIPPED,31.08,31.08,86.7,86.7,86.7,42.98,5.57,5.57,0,6.18,43.86,43.86,86.7
4020198,302,87801,,,,,,,FLU-PRC,382.17,152.87,0,329.31,324.84,SKIPPED,329.31,329.31,324.84,324.84,324.84,161.04,58.97,58.97,0,65.51,164.33,164.33,324.84
4020200,306,87081,,,,,,,MRSA PREV POSTIVE,102,40.8,0,86.7,86.7,SKIPPED,31.08,31.08,86.7,86.7,86.7,42.98,5.57,5.57,0,6.18,43.86,43.86,86.7
4020202,301,84450,,,,,,,AST-SGOT,143.2,57.28,0,121.72,121.72,SKIPPED,24.28,24.28,121.72,121.72,121.72,60.35,4.35,4.35,0,4.83,61.58,61.58,121.72
4020203,301,84481,,,,,,,"T3, FREE",212.76,85.1,0,180.85,180.85,SKIPPED,79.5,79.5,180.85,180.85,180.85,89.66,14.23,14.23,0,15.81,91.49,91.49,180.85
4020204,306,87077,,,,,,,GP ID,134.41,53.76,0,114.25,114.25,SKIPPED,37.89,37.89,114.25,114.25,114.25,56.64,6.79,6.79,0,7.53,57.8,57.8,114.25
4020205,301,83970,,,,,,,PARATHYROID HORMONE,224.73,89.89,0,193.65,191.02,SKIPPED,193.65,193.65,191.02,191.02,191.02,94.7,34.68,34.68,0,38.52,96.63,96.63,191.02
4020206,306,87186,,,,,,,GP SEN,135.04,54.02,0,114.78,114.78,SKIPPED,40.55,40.55,114.78,114.78,114.78,56.91,7.27,7.27,0,8.07,58.07,58.07,114.78
4020207,301,83525,,,,,,,INSULIN,62.22,24.89,0,53.62,52.89,SKIPPED,53.62,53.62,52.89,52.89,52.89,26.22,9.6,9.6,0,10.67,26.75,26.75,52.89
4020208,301,86160,,,,,,,C4 COMPLEMENT,65.31,26.12,0,56.28,55.51,SKIPPED,56.28,56.28,55.51,55.51,55.51,27.52,10.08,10.08,0,11.2,28.08,28.08,55.51
4020209,301,86696,,,,,,,HERPES SIM(HSV1&2)PCR,143.9,57.56,0,122.32,122.32,SKIPPED,90.82,90.82,122.32,122.32,122.32,60.64,16.25,16.25,0,18.07,61.88,61.88,122.32
4020210,301,84134,,,,,,,PREALBUMIN,153.67,61.47,0,130.62,130.62,SKIPPED,68.44,68.44,130.62,130.62,130.62,64.76,12.26,12.26,0,13.62,66.08,66.08,130.62
4020212,301,83935,,,,,,,"OSMOLALITY, URINE",44.42,17.77,0,37.76,37.76,SKIPPED,32,32,37.76,37.76,37.76,18.72,5.73,5.73,0,6.36,19.1,19.1,37.76
4020215,301,84153,,,,,,,PROSTATE SPECIFIC AN( non-medicare),106.45,42.58,0,90.48,90.48,SKIPPED,86.3,86.3,90.48,90.48,90.48,44.85,15.45,15.45,0,17.17,45.77,45.77,90.48
4020216,301,86665,,,,,,,EBVG,98.78,39.51,0,85.12,83.96,SKIPPED,85.12,85.12,83.96,83.96,83.96,41.63,15.24,15.24,0,16.93,42.48,42.48,83.96
4020217,301,86665,,,,,,,EBVM,98.78,39.51,0,85.12,83.96,SKIPPED,85.12,85.12,83.96,83.96,83.96,41.63,15.24,15.24,0,16.93,42.48,42.48,83.96
4020218,301,86663,,,,,,,EBVEA,71.44,28.58,0,61.56,60.72,SKIPPED,61.56,61.56,60.72,60.72,60.72,30.11,11.02,11.02,0,12.25,30.72,30.72,60.72
4020219,301,86664,,,,,,,EBVNA,83.27,33.31,0,71.74,70.78,SKIPPED,71.74,71.74,70.78,70.78,70.78,35.09,12.84,12.84,0,14.27,35.81,35.81,70.78
4020220,301,84165,,,,,,,"PROTEIN ELECTROPH,SE",87.18,34.87,0,74.1,74.1,SKIPPED,50.39,50.39,74.1,74.1,74.1,17.48,9.02,9.02,0,10.02,17.84,17.84,74.1
4020221,301,82175,,,,,,,ARSENIC,103.28,41.31,0,89,87.79,SKIPPED,89,89,87.79,87.79,87.79,43.52,15.93,15.93,0,17.71,44.41,44.41,87.79
4020222,301,82300,,,,,,,CADMIUM,126.04,50.42,0,108.6,107.13,SKIPPED,108.6,108.6,107.13,107.13,107.13,53.12,19.86,19.86,0,21.6,54.2,54.2,107.13
4020223,301,83825,,,,,,,MERCURY QUANTITATIVE,88.5,35.4,0,76.27,75.22,SKIPPED,76.27,76.27,75.22,75.22,75.22,37.3,13.66,13.66,0,15.17,38.06,38.06,75.22
4020226,301,87799,,,,,,,BORDETELLA,233.21,93.28,0,200.94,198.23,SKIPPED,200.94,200.94,198.23,198.23,198.23,98.27,35.99,35.99,0,39.98,100.28,100.28,198.23
4020227,301,87265,,,,,,,BORDET INFECT AGT IMMUNO,65.27,26.11,0,56.24,55.48,SKIPPED,56.24,56.24,55.48,55.48,55.48,27.51,10.06,10.06,0,11.19,28.07,28.07,55.48
4020228,301,86622,,,,,,,BRUCELLA,48.65,19.46,0,41.91,41.35,SKIPPED,41.91,41.91,41.35,41.35,41.35,20.5,7.5,7.5,0,8.33,20.92,20.92,41.35
4020229,301,86644,,,,,,,CMVG,78.36,31.34,0,67.53,66.61,SKIPPED,67.53,67.53,66.61,66.61,66.61,33.02,12.09,12.09,0,13.43,33.69,33.69,66.61
4020230,302,86762,,,,,,,RUBELLA AB-IGM,116.55,46.62,0,99.07,99.07,SKIPPED,67.53,67.53,99.07,99.07,99.07,49.12,12.09,12.09,0,13.43,50.12,50.12,99.07
4020231,301,86235,,,,,,,ANA-DNA1,51.69,20.68,0,51.69,43.94,SKIPPED,51.69,51.69,43.94,43.94,43.94,21.79,15.06,15.06,0,16.74,22.23,22.23,43.94
4020232,301,86235,,,,,,,ANA-ENAB,51.69,20.68,0,51.69,43.94,SKIPPED,51.69,51.69,43.94,43.94,43.94,21.79,15.06,15.06,0,16.74,22.23,22.23,43.94
4020233,301,86235,,,,,,,ANA-SSAB1,76.58,30.63,0,76.58,65.09,SKIPPED,76.58,76.58,65.09,65.09,65.09,32.27,15.06,15.06,0,16.74,32.93,32.93,65.09
4020234,301,86235,,,,,,,ANA-SCL7P,51.69,20.68,0,51.69,43.94,SKIPPED,51.69,51.69,43.94,43.94,43.94,21.79,15.06,15.06,0,16.74,22.23,22.23,43.94
4020235,305,85660,,,,,,,SICKLE CELL SCREEN,29.99,12,0,25.84,25.49,SKIPPED,25.84,25.84,25.49,25.49,25.49,12.64,4.63,4.63,0,5.14,12.9,12.9,25.49
4020236,301,86645,,,,,,,CMVM,91.73,36.69,0,79.04,77.97,SKIPPED,79.04,79.04,77.97,77.97,77.97,38.65,14.15,14.15,0,15.72,39.44,39.44,77.97
4020237,302,86689,,,,,,,WESTERN BLOT,119.71,47.88,0,101.75,101.75,SKIPPED,90.82,90.82,101.75,101.75,101.75,50.45,16.25,16.25,0,18.07,51.48,51.48,101.75
4020238,306,87070,,,,,,,CULTURE SPUTUM,187.61,75.04,0,159.47,159.47,SKIPPED,40.43,40.43,159.47,159.47,159.47,79.06,7.24,7.24,0,8.04,80.67,80.67,159.47
4020239,302,82679,,,,,,,ESTRONE,135.87,54.35,0,117.08,115.49,SKIPPED,117.08,117.08,115.49,115.49,115.49,57.25,20.96,20.96,0,23.29,58.42,58.42,115.49
4020240,301,82355,,,,,,,STONE ANALYSIS,159.67,63.87,0,135.72,135.72,SKIPPED,54.3,54.3,135.72,135.72,135.72,67.29,9.73,9.73,0,10.8,68.66,68.66,135.72
4020242,310,88360,,,,,,,ESTROG/PROGEST RECEPT,429.85,171.94,0,429.85,365.37,SKIPPED,429.85,429.85,365.37,365.37,365.37,115.7,210.63,210.63,0,128.96,118.06,118.06,365.37
4020243,301,82085,,,,,,,ALDOLASE,78.75,31.5,0,66.94,66.94,SKIPPED,45.56,45.56,66.94,66.94,66.94,33.18,8.16,8.16,0,9.06,33.86,33.86,66.94
4020244,302,84166,,,,,,,UIFX,97.06,38.82,0,83.64,82.5,SKIPPED,83.64,83.64,82.5,82.5,82.5,17.48,14.98,14.98,0,16.64,17.84,17.84,82.5
4020245,306,87045,,,,,,,CULT STOOL R/OSS ROU,132.98,53.19,0,113.03,113.03,SKIPPED,44.31,44.31,113.03,113.03,113.03,56.04,7.93,7.93,0,8.81,57.18,57.18,113.03
4020246,305,85025,,,,,,,CBC SEND OUT,42.29,16.92,0,36.44,35.95,SKIPPED,36.44,36.44,35.95,35.95,35.95,17.82,6.53,6.53,0,7.25,18.18,18.18,35.95
4020247,302,86334,,,,,,,SIEP,121.67,48.67,0,104.84,103.42,SKIPPED,104.84,104.84,103.42,103.42,103.42,17.48,18.77,18.77,0,20.86,17.84,17.84,103.42
4020248,306,87070,,,,,,,CULTURE THROAT/NOSE,187.61,75.04,0,159.47,159.47,SKIPPED,40.43,40.43,159.47,159.47,159.47,79.06,7.24,7.24,0,8.04,80.67,80.67,159.47
4020249,306,87077,,,,,,,AEROBIC ID/SENS,43.96,17.58,0,37.89,37.37,SKIPPED,37.89,37.89,37.37,37.37,37.37,18.52,6.79,6.79,0,7.53,18.9,18.9,37.37
4020250,301,84443,,,,,,,THYROID STIMULAT HOR,153.67,61.47,0,130.62,130.62,SKIPPED,78.85,78.85,130.62,130.62,130.62,64.76,14.11,14.11,0,15.68,66.08,66.08,130.62
4020251,301,82950,,,,,,,GLUCOLA 2HR-PP,128.53,51.41,0,109.25,109.25,SKIPPED,22.27,22.27,109.25,109.25,109.25,54.16,3.99,3.99,0,4.43,55.27,55.27,109.25
4020252,301,82947,,,,,,,GLUCOSE 2HR-PP,110.79,44.32,0,94.17,94.17,SKIPPED,18.43,18.43,94.17,94.17,94.17,46.69,3.3,3.3,0,3.67,47.64,47.64,94.17
4020253,301,82951,,,,,,,GLUCOSE-FASTING,70.08,28.03,0,60.38,59.57,SKIPPED,60.38,60.38,59.57,59.57,59.57,29.53,10.81,10.81,0,12.01,30.13,30.13,59.57
4020254,301,82951,,,,,,,GLUCOSE-1 HOUR,70.08,28.03,0,60.38,59.57,SKIPPED,60.38,60.38,59.57,59.57,59.57,29.53,10.81,10.81,0,12.01,30.13,30.13,59.57
4020255,301,80164,,,,,,,VALPORIC ACID-DEPAKE,100.57,40.23,0,85.48,85.48,SKIPPED,63.54,63.54,85.48,85.48,85.48,42.38,11.37,11.37,0,12.64,43.25,43.25,85.48
4020256,301,82951,,,,,,,GLUCOSE 2 HOUR,70.08,28.03,0,60.38,59.57,SKIPPED,60.38,60.38,59.57,59.57,59.57,29.53,10.81,10.81,0,12.01,30.13,30.13,59.57
4020259,301,82952,,,,,,,GLUCOSE 3HR EA ADD'L,56.16,22.46,0,47.74,47.74,SKIPPED,18.39,18.39,47.74,47.74,47.74,23.67,3.29,3.29,0,3.66,24.15,24.15,47.74
4020260,301,80202,,,,,,,VANCOMYCIN /PEAK,141.79,56.72,0,120.52,120.52,SKIPPED,63.54,63.54,120.52,120.52,120.52,59.75,11.37,11.37,0,12.64,60.97,60.97,120.52
4020261,305,89060,,,,,,,CRYSTAL ID,60.63,24.25,0,51.54,51.54,SKIPPED,33.55,33.55,51.54,51.54,51.54,17.48,6.16,6.16,0,6.68,17.84,17.84,51.54
4020262,301,87512,,,,,,,HEP B-PCR,227.34,90.94,0,195.89,193.24,SKIPPED,195.89,195.89,193.24,193.24,193.24,95.8,35.08,35.08,0,38.98,97.76,97.76,193.24
4020263,301,84480,,,,,,,T3 TOTAL,77.22,30.89,0,66.54,65.64,SKIPPED,66.54,66.54,65.64,65.64,65.64,32.54,11.91,11.91,0,13.23,33.2,33.2,65.64
4020264,301,88141,,,,,,,CYTOPATH CERVICAL,145.61,58.24,0,125.48,123.77,SKIPPED,125.48,125.48,123.77,123.77,123.77,21.32,71.35,71.35,0,43.68,21.76,21.76,123.77
4020265,301,82607,,,,,,,VITAMIN B12,82.07,32.83,0,70.72,69.76,SKIPPED,70.72,70.72,69.76,69.76,69.76,34.58,12.67,12.67,0,14.07,35.29,35.29,69.76
4020266,301,86800,,,,,,,ANTITHYROID ANTIBODIES,90.24,36.1,0,76.7,76.7,SKIPPED,74.63,74.63,76.7,76.7,76.7,38.02,13.36,13.36,0,14.84,38.8,38.8,76.7
4020267,301,83921,,,,,,,METHYLMALORIC ACID-FS,104.92,41.97,0,89.18,89.18,SKIPPED,80.6,80.6,89.18,89.18,89.18,44.22,17.82,17.82,0,17.82,45.12,45.12,89.18
4020268,301,83520,,,,,,,C1 ESTERASE INHIBITOR,155.19,62.08,0,131.91,131.91,SKIPPED,65.63,65.63,131.91,131.91,131.91,65.4,14.51,14.51,0,14.51,66.73,66.73,131.91
4020269,301,86376,,,,,,,TPO-AB,166.94,66.78,0,141.9,141.9,SKIPPED,68.25,68.25,141.9,141.9,141.9,70.34,12.22,12.22,0,13.58,71.78,71.78,141.9
4020270,301,84630,,,,,,,"ZINC, SERUM",91.64,36.66,0,77.89,77.89,SKIPPED,53.43,53.43,77.89,77.89,77.89,38.62,9.57,9.57,0,10.63,39.41,39.41,77.89
4020272,301,83735,,,,,,,MAGNESIUM URINE MG/DL,146.27,58.51,0,124.33,124.33,SKIPPED,31.43,31.43,124.33,124.33,124.33,61.64,5.63,5.63,0,6.25,62.9,62.9,124.33
4020273,301,84560,,,,,,,URIC ACID URINE MG/DL,109.38,43.75,0,92.97,92.97,SKIPPED,22.27,22.27,92.97,92.97,92.97,46.09,4.27,4.27,0,4.43,47.03,47.03,92.97
4020274,301,82271,,,,,,,GASTROCCULT,73.9,29.56,0,62.82,62.82,SKIPPED,20.22,20.22,62.82,62.82,62.82,31.14,4.47,4.47,0,4.47,31.78,31.78,62.82
4020275,301,86160,,,,,,,COMPLEMENT CIQ,143.2,57.28,0,121.72,121.72,SKIPPED,56.28,56.28,121.72,121.72,121.72,60.35,10.08,10.08,0,11.2,61.58,61.58,121.72
4020276,301,86200,,,,,,,CCP AB,130.06,52.02,0,110.55,110.55,SKIPPED,60.72,60.72,110.55,110.55,110.55,54.81,10.88,10.88,0,12.09,55.93,55.93,110.55
4020277,310,88173,,,,,,,FNA INTERP&REPORT,285.13,114.05,0,242.36,242.36,SKIPPED,169.86,169.86,242.36,242.36,242.36,150.42,139.71,139.71,0,85.54,153.49,153.49,242.36
4020278,301,86300,,,,,,,CA 15.3,147.79,59.12,0,125.62,125.62,SKIPPED,97.66,97.66,125.62,125.62,125.62,62.28,17.48,17.48,0,19.43,63.55,63.55,125.62
4020279,301,87529,,,,,,,HERPES SIMPLEX(HSVO),456.53,182.61,0,388.05,388.05,SKIPPED,164.65,164.65,388.05,388.05,388.05,192.38,29.48,29.48,0,32.75,196.31,196.31,388.05
4020280,301,86215,,,,,,,DNASE AB,64.97,25.99,0,62.13,55.22,SKIPPED,62.13,62.13,55.22,55.22,55.22,27.38,11.13,11.13,0,12.36,27.94,27.94,55.22
4020281,301,83516,,,,,,,GLIADIN IgG,134.41,53.76,0,114.25,114.25,SKIPPED,54.11,54.11,114.25,114.25,114.25,56.64,9.69,9.69,0,10.76,57.8,57.8,114.25
4020282,301,83516,,,,,,,TTGIG,132.98,53.19,0,113.03,113.03,SKIPPED,54.11,54.11,113.03,113.03,113.03,56.04,9.69,9.69,0,10.76,57.18,57.18,113.03
4020283,301,83516,,,,,,,TTGIA,132.98,53.19,0,113.03,113.03,SKIPPED,54.11,54.11,113.03,113.03,113.03,56.04,9.69,9.69,0,10.76,57.18,57.18,113.03
4020284,301,86300,,,,,,,CA 27-29,113.34,45.34,0,97.66,96.34,SKIPPED,97.66,97.66,96.34,96.34,96.34,47.77,17.48,17.48,0,19.43,48.74,48.74,96.34
4020285,301,82523,,,,,,,URINE NTX-TELOPEPTIDE,128.1,51.24,0,108.88,108.88,SKIPPED,87.67,87.67,108.88,108.88,108.88,53.98,15.69,15.69,0,17.44,55.08,55.08,108.88
4020286,301,84585,,,,,,,VMA,84.37,33.75,0,72.69,71.71,SKIPPED,72.69,72.69,71.71,71.71,71.71,35.55,13.02,13.02,0,14.46,36.28,36.28,71.71
4020287,301,83835,,,,,,,METEP UR,92.25,36.9,0,79.5,78.41,SKIPPED,79.5,79.5,78.41,78.41,78.41,38.88,14.23,14.23,0,15.81,39.67,39.67,78.41
4020288,301,82384,,,,,,,CATCOL UR,137.51,55,0,118.48,116.88,SKIPPED,118.48,118.48,116.88,116.88,116.88,57.95,21.21,21.21,0,23.57,59.13,59.13,116.88
4020289,310,88348,,,,,,,ELCTRON MICROSCOPY,2385.63,954.25,0,2055.65,2027.79,SKIPPED,2055.65,2055.65,2027.79,2027.79,2027.79,434.47,1168.96,1168.96,0,715.69,443.34,443.34,2027.79
4020290,971,88300,,,,,,,PROF COMPONENT-88300,10.5,4.2,0,10.5,8.92,SKIPPED,10.5,10.5,8.92,8.92,8.92,4.83,5.14,5.14,0,3.15,4.93,4.93,0
4020291,971,88302,,,,,,,PROF COMPONENT-88302,16.8,6.72,0,16.8,14.28,SKIPPED,16.8,16.8,14.28,14.28,14.28,7.53,8.23,8.23,0,5.04,7.68,7.68,0
4020292,971,88304,,,,,,,PROF COMPONENT-88304,27.34,10.94,0,27.34,23.24,SKIPPED,27.34,27.34,23.24,23.24,23.24,12.53,13.4,13.4,0,8.2,12.79,12.79,0
4020293,971,88305,,,,,,,PROF COMPONENT-88305,89.61,35.84,0,89.61,76.17,SKIPPED,89.61,89.61,76.17,76.17,76.17,41.4,43.91,43.91,0,26.88,42.24,42.24,0
4020294,971,88307,,,,,,,PROF COMPONENT-88307,196.71,78.68,0,196.71,167.2,SKIPPED,196.71,196.71,167.2,167.2,167.2,90.86,96.39,96.39,0,59.01,92.71,92.71,0
4020295,971,88309,,,,,,,PROF COMPONENT-88309,348.98,139.59,0,348.98,296.63,SKIPPED,348.98,348.98,296.63,296.63,296.63,159.88,171,171,0,104.69,163.14,163.14,0
4020296,971,88311,,,,,,,PROF COMPONENT-88311,29.78,11.91,0,29.78,25.31,SKIPPED,29.78,29.78,25.31,25.31,25.31,13.68,14.59,14.59,0,8.93,13.96,13.96,0
4020297,971,88312,,,,,,,PROF COMPONENT-88312,63.08,25.23,0,63.08,53.62,SKIPPED,63.08,63.08,53.62,53.62,53.62,29.11,30.91,30.91,0,18.92,29.7,29.7,0
4020298,971,88313,,,,,,,PROF COMPONENT-88313,28.22,11.29,0,28.22,23.99,SKIPPED,28.22,28.22,23.99,23.99,23.99,13.31,13.83,13.83,0,8.47,13.58,13.58,0
4020302,971,88331,,,,,,,PROF COMPONENT-88331,184.7,73.88,0,184.7,157,SKIPPED,184.7,184.7,157,157,157,68.46,90.5,90.5,0,55.41,69.86,69.86,0
4020303,971,88332,,,,,,,PROF COMPONENT-88332,73.4,29.36,0,73.4,62.39,SKIPPED,73.4,73.4,62.39,62.39,62.39,33.66,35.97,35.97,0,22.02,34.35,34.35,0
4020304,301,84460,,,,,,,ALT-SGPT,81.63,32.65,0,69.39,69.39,SKIPPED,24.85,24.85,69.39,69.39,69.39,34.4,4.45,4.45,0,4.95,35.1,35.1,69.39
4020305,301,82172,,,,,,,LIP.A SERUM,144.72,57.89,0,123.01,123.01,SKIPPED,80.14,80.14,123.01,123.01,123.01,60.99,17.72,17.72,0,17.72,62.23,62.23,123.01
4020307,971,88348,,,,,,,PROF COMPONENT-88348,179.36,71.74,0,179.36,152.46,SKIPPED,179.36,179.36,152.46,152.46,152.46,85.5,87.89,87.89,0,53.81,87.25,87.25,0
4020308,301,,,,,,,,ACETONE/KETONE URINE,50.28,20.11,0,42.74,42.74,SKIPPED,38.21,38.21,42.74,42.74,42.74,21.19,24.64,24.64,0,15.08,21.62,21.62,42.74
4020309,301,G0103,,,,,,,PSA SCREENING(Medicare Only),236.37,94.55,0,200.91,200.91,SKIPPED,86.3,86.3,200.91,200.91,200.91,99.61,115.82,115.82,0,70.91,101.64,101.64,200.91
4020310,301,80198,,,,,,,THEOPHYLLINE LEVEL,127.62,51.05,0,108.48,108.48,SKIPPED,66.35,66.35,108.48,108.48,108.48,53.78,11.88,11.88,0,13.2,54.88,54.88,108.48
4020311,306,84376,,,,,,,REDUCING SUBSTANCE,50.28,20.11,0,42.74,42.74,SKIPPED,25.8,25.8,42.74,42.74,42.74,21.19,4.62,4.62,0,5.13,21.62,21.62,42.74
4020312,301,82525,,,,,,,"COPPER, SERUM",67.56,27.02,0,58.22,57.43,SKIPPED,58.22,58.22,57.43,57.43,57.43,28.47,10.42,10.42,0,11.58,29.05,29.05,57.43
4020315,301,80170,,,,,,,"GENTAMICIN, PEAK",258.45,103.38,0,219.68,219.68,SKIPPED,76.84,76.84,219.68,219.68,219.68,108.91,13.76,13.76,0,15.29,111.13,111.13,219.68
4020316,301,83520,,,,,,,C12 AUTOANTIBODY,132.98,53.19,0,113.03,113.03,SKIPPED,65.63,65.63,113.03,113.03,113.03,56.04,14.51,14.51,0,14.51,57.18,57.18,113.03
4020317,301,86161,,,,,,,C1 ESTERASE FUNT ASSAY,161.08,64.43,0,136.92,136.92,SKIPPED,56.28,56.28,136.92,136.92,136.92,67.87,10.08,10.08,0,11.2,69.26,69.26,136.92
4020318,301,84681,,,,,,,C-PEPTIDE,113.34,45.34,0,97.66,96.34,SKIPPED,97.66,97.66,96.34,96.34,96.34,47.77,17.48,17.48,0,19.43,48.74,48.74,96.34
4020319,301,87798,,,,,,,BORDETELLA PERTUSIS PCR,191.09,76.44,0,164.65,162.43,SKIPPED,164.65,164.65,162.43,162.43,162.43,80.53,29.48,29.48,0,32.75,82.17,82.17,162.43
4020320,306,87591,,,,,,,GC URINE,204.44,81.78,0,173.77,173.77,SKIPPED,164.65,164.65,173.77,173.77,173.77,86.15,29.48,29.48,0,32.75,87.91,87.91,173.77
4020321,302,87491,,,,,,,CHLAMYDIA URINE,204.44,81.78,0,173.77,173.77,SKIPPED,164.65,164.65,173.77,173.77,173.77,86.15,29.48,29.48,0,32.75,87.91,87.91,173.77
4020322,302,83498,,,,,,,HYDROPROG,147.91,59.16,0,127.45,125.72,SKIPPED,127.45,127.45,125.72,125.72,125.72,62.33,22.82,22.82,0,25.36,63.6,63.6,125.72
4020323,302,83020,,,,,,,HEMELOC,70.08,28.03,0,60.38,59.57,SKIPPED,60.38,60.38,59.57,59.57,59.57,17.48,10.81,10.81,0,12.01,17.84,17.84,59.57
4020324,302,82776,,,,,,,GALACTOSE,51.78,20.71,0,44.61,44.01,SKIPPED,44.61,44.61,44.01,44.01,44.01,21.82,9.86,9.86,0,9.86,22.27,22.27,44.01
4020325,302,84437,,,,,,,THYROXINE NEO,35.2,14.08,0,30.32,29.92,SKIPPED,30.32,30.32,29.92,29.92,29.92,14.84,5.43,5.43,0,6.03,15.14,15.14,29.92
4020327,301,86788,,,,,,,WEST NILE IgM Ab,148.05,59.22,0,125.84,125.84,SKIPPED,79.04,79.04,125.84,125.84,125.84,62.39,14.15,14.15,0,15.72,63.66,63.66,125.84
4020328,301,89321,,,,,,,SPERM CNT POST VASECTOMY,65.63,26.25,0,56.54,55.79,SKIPPED,56.54,56.54,55.79,55.79,55.79,27.66,32.16,32.16,0,19.69,28.22,28.22,55.79
4020329,302,83789,,,,,,,MASS SPEC,106.32,42.53,0,91.62,90.37,SKIPPED,91.62,91.62,90.37,90.37,90.37,44.81,20.25,20.25,0,20.25,45.72,45.72,90.37
4020330,302,82261,,,,,,,BIOTINIDASE,91.86,36.74,0,79.15,78.08,SKIPPED,79.15,79.15,78.08,78.08,78.08,38.71,14.17,14.17,0,15.74,39.5,39.5,78.08
4020331,302,83520,,,,,,,IMMUNO ANALY,76.16,30.46,0,65.63,64.74,SKIPPED,65.63,65.63,64.74,64.74,64.74,32.1,14.51,14.51,0,14.51,32.75,32.75,64.74
4020332,305,85610,,,,,,,PT/INR (WAIVED),103.51,41.4,0,87.98,87.98,SKIPPED,18.43,18.43,87.98,87.98,87.98,43.62,3.6,3.6,0,3.67,44.51,44.51,87.98
4020333,301,82955,,,,,,,G6PD,106.45,42.58,0,90.48,90.48,SKIPPED,45.49,45.49,90.48,90.48,90.48,44.85,8.15,8.15,0,9.05,45.77,45.77,90.48
4020334,301,86677,,,,,,,H PYLORI AB,87.18,34.87,0,74.1,74.1,SKIPPED,68.06,68.06,74.1,74.1,74.1,36.74,14.15,14.15,0,14.15,37.49,37.49,74.1
4020335,302,0241U,,,,,,,INFLUENZA A&B PCR,463.31,185.32,0,393.81,393.81,SKIPPED,352.12,352.12,393.81,393.81,393.81,195.24,227.02,227.02,0,138.99,199.22,199.22,393.81
4020338,300,36415,,,,,,,VENIPUNCTURE,31.14,12.46,0,26.47,26.47,SKIPPED,0,0,26.47,26.47,26.47,13.12,15.26,15.26,0,9.34,13.39,13.39,26.47
4020339,301,86162,,,,,,,COMPLEMENT TOTAL(CH50),110.65,44.26,0,95.34,94.05,SKIPPED,95.34,95.34,94.05,94.05,94.05,46.63,17.07,17.07,0,18.97,47.58,47.58,94.05
4020340,301,82009,,,,,,,ACETONE/KETONE SERUM,50.28,20.11,0,42.74,42.74,SKIPPED,21.2,21.2,42.74,42.74,42.74,21.19,3.8,3.8,0,4.22,21.62,21.62,42.74
4020345,301,80329,,,,,,,ACETAMINOPHEN,329.54,131.82,0,280.11,280.11,SKIPPED,0,0,280.11,280.11,280.11,138.87,9.63,9.63,0,9.63,141.7,141.7,280.11
4020346,301,86301,,,,,,,CARBOHYDRATE Ag 19-9,155.19,62.08,0,131.91,131.91,SKIPPED,97.66,97.66,131.91,131.91,131.91,65.4,17.48,17.48,0,19.43,66.73,66.73,131.91
4020360,306,87206,,,,,,,AFB SMEAR,56.16,22.46,0,47.74,47.74,SKIPPED,25.27,25.27,47.74,47.74,47.74,23.67,4.53,4.53,0,5.03,24.15,24.15,47.74
4020365,301,83718,,,,,,,CHOLESTEROL HDL,178.82,71.53,0,152,152,SKIPPED,38.46,38.46,152,152,152,75.35,6.88,6.88,0,7.64,76.89,76.89,152
4020393,301,82040,,,,,,,ALBUMIN,37.8,15.12,0,32.13,32.13,SKIPPED,23.22,23.22,32.13,32.13,32.13,15.92,4.16,4.16,0,4.62,16.25,16.25,32.13
4020394,301,80307,,,,,,,ACETAMINOPHEN/PARACETAMOL,316.77,126.71,0,272.95,269.25,SKIPPED,272.95,272.95,269.25,269.25,269.25,133.49,52.2,52.2,0,54.31,136.21,136.21,269.25
4020395,301,80307,,,,,,,METHAMPHETAMINES,316.77,126.71,0,272.95,269.25,SKIPPED,272.95,272.95,269.25,269.25,269.25,133.49,52.2,52.2,0,54.31,136.21,136.21,269.25
4020396,301,82784,,,,,,,IGGAM,50.63,20.25,0,43.62,43.04,SKIPPED,43.62,43.62,43.04,43.04,43.04,21.33,7.81,7.81,0,8.69,21.77,21.77,43.04
4020397,301,87338,,,,,,,"H PYLORI, STOOL",171.4,68.56,0,145.69,145.69,SKIPPED,67.49,67.49,145.69,145.69,145.69,72.23,12.08,12.08,0,13.42,73.7,73.7,145.69
4020400,305,85027,,,,,,,CBC(NO DIFF),79.78,31.91,0,67.81,67.81,SKIPPED,30.32,30.32,67.81,67.81,67.81,33.62,5.43,5.43,0,6.03,34.31,34.31,67.81
4020402,306,87077,,,,,,,SENDOUT ID/SENS,127,50.8,0,107.95,107.95,SKIPPED,37.89,37.89,107.95,107.95,107.95,53.52,6.79,6.79,0,7.53,54.61,54.61,107.95
4020404,305,85007,,,,,,,"SMEAR, MANUAL WBC DIFF",85.67,34.27,0,72.82,72.82,SKIPPED,16.11,16.11,72.82,72.82,72.82,36.1,3.19,3.19,0,3.21,36.84,36.84,72.82
4020451,301,84075,,,,,,,ALK PHOSPHATASE,37.8,15.12,0,32.13,32.13,SKIPPED,24.28,24.28,32.13,32.13,32.13,15.92,4.35,4.35,0,4.83,16.25,16.25,32.13
4020484,301,82150,,,,,,,AMYLASE,153.67,61.47,0,130.62,130.62,SKIPPED,30.4,30.4,130.62,130.62,130.62,64.76,5.44,5.44,0,6.05,66.08,66.08,130.62
4020508,301,84478,,,,,,,TRIGLYCERIDES,199.35,79.74,0,169.45,169.45,SKIPPED,26.94,26.94,169.45,169.45,169.45,84.01,4.82,4.82,0,5.36,85.72,85.72,169.45
4020553,301,84520,,,,,,,UREANITROGEN-BUN,109.38,43.75,0,92.97,92.97,SKIPPED,18.54,18.54,92.97,92.97,92.97,46.09,3.32,3.32,0,3.69,47.03,47.03,92.97
4020633,301,82247,,,,,,,BILIRUBIN TOTAL,39.9,15.96,0,33.92,33.92,SKIPPED,23.52,23.52,33.92,33.92,33.92,16.82,4.22,4.22,0,4.68,17.16,17.16,33.92
4020666,301,82248,,,,,,,BILIRUBIN DIRECT,75.6,30.24,0,64.26,64.26,SKIPPED,23.52,23.52,64.26,64.26,64.26,31.86,4.22,4.22,0,4.68,32.51,32.51,64.26
4020705,272,,,,,,,,BLOOD FILTER,49.8,19.92,0,42.33,42.33,SKIPPED,37.85,37.85,42.33,42.33,42.33,20.98,24.4,24.4,0,14.94,21.41,21.41,42.33
4020715,390,P9016,,,,,,,"BLOOD, LEUKOREDUCED",552.51,221,0,469.63,469.63,SKIPPED,419.91,419.91,469.63,469.63,469.63,232.83,270.73,270.73,0,165.75,237.58,237.58,469.63
4020724,306,87040,,,,,,,CULTURE BLOOD,211.35,84.54,0,179.65,179.65,SKIPPED,48.41,48.41,179.65,179.65,179.65,89.06,8.67,8.67,0,9.63,90.88,90.88,179.65
4020726,306,87040,,,,,,,CULTURE BLOOD W/ARD,264.44,105.78,0,224.77,224.77,SKIPPED,48.41,48.41,224.77,224.77,224.77,111.44,8.67,8.67,0,9.63,113.71,113.71,224.77
4020755,301,83735,,,,,,,MAGNESIUM,146.27,58.51,0,124.33,124.33,SKIPPED,31.43,31.43,124.33,124.33,124.33,61.64,5.63,5.63,0,6.25,62.9,62.9,124.33
4020785,302,86900,,,,,,,BLOOD ABO,64.97,25.99,0,64.97,55.22,SKIPPED,64.97,64.97,55.22,55.22,55.22,27.38,2.51,2.51,0,2.79,27.94,27.94,55.22
4020790,302,86901,,,,,,,BLOOD RH,64.97,25.99,0,64.97,55.22,SKIPPED,64.97,64.97,55.22,55.22,55.22,27.38,2.51,2.51,0,2.79,27.94,27.94,55.22
4020815,301,82310,,,,,,,CALCIUM SERUM,70.64,28.26,0,60.04,60.04,SKIPPED,24.21,24.21,60.04,60.04,60.04,29.77,4.33,4.33,0,4.81,30.38,30.38,60.04
4020826,301,82340,,,,,,,CALCIUM URINE,135.92,54.37,0,115.53,115.53,SKIPPED,28.27,28.27,115.53,115.53,115.53,57.28,5.07,5.07,0,5.63,58.45,58.45,115.53
4020848,301,82374,,,,,,,CARBON DIOXIDE,93.17,37.27,0,79.19,79.19,SKIPPED,22.91,22.91,79.19,79.19,79.19,39.26,4.1,4.1,0,4.56,40.06,40.06,79.19
4020850,301,80156,,,,,,,CARBAMAZEPINE-TEGRET,234.98,93.99,0,199.73,199.73,SKIPPED,68.32,68.32,199.73,199.73,199.73,99.02,12.24,12.24,0,13.59,101.04,101.04,199.73
4020860,306,87077,,,,,,,GN ID,134.41,53.76,0,114.25,114.25,SKIPPED,37.89,37.89,114.25,114.25,114.25,56.64,6.79,6.79,0,7.53,57.8,57.8,114.25
4020868,302,86308,,,,,,,MONOSPOT,102,40.8,0,86.7,86.7,SKIPPED,24.28,24.28,86.7,86.7,86.7,42.98,4.35,4.35,0,4.83,43.86,43.86,86.7
4020875,309,89051,,,,,,,CELL CT BDY FL W/DIF,152.27,60.91,0,129.43,129.43,SKIPPED,25.84,25.84,129.43,129.43,129.43,64.17,4.7,4.7,0,5.14,65.48,65.48,129.43
4020904,301,82270,,,,,,,OCCULT BLOOD STOOL,73.9,29.56,0,62.82,62.82,SKIPPED,16.64,16.64,62.82,62.82,62.82,31.14,3.68,3.68,0,3.68,31.78,31.78,62.82
4020939,301,82435,,,,,,,CHLORIDE SERUM,109.38,43.75,0,92.97,92.97,SKIPPED,21.58,21.58,92.97,92.97,92.97,46.09,3.86,3.86,0,4.29,47.03,47.03,92.97
4020995,301,82465,,,,,,,CHOLESTEROL,115.26,46.1,0,97.97,97.97,SKIPPED,20.41,20.41,97.97,97.97,97.97,48.57,3.65,3.65,0,4.07,49.56,49.56,97.97
4021009,301,84550,,,,,,,URIC ACID,40.95,16.38,0,34.81,34.81,SKIPPED,21.2,21.2,34.81,34.81,34.81,17.26,3.8,3.8,0,4.22,17.61,17.61,34.81
4021052,301,82271,,,,,,,OCCULT BLOOD URINE,72.38,28.95,0,61.52,61.52,SKIPPED,20.22,20.22,61.52,61.52,61.52,30.5,4.47,4.47,0,4.47,31.12,31.12,61.52
4021054,307,81000,,,,,,,URINALYSIS W/MICRO,96.11,38.44,0,81.69,81.69,SKIPPED,15.28,15.28,81.69,81.69,81.69,40.5,3.38,3.38,0,3.38,41.33,41.33,81.69
4021058,306,87210,,,,,,,SMEAR WET PREP,84.11,33.64,0,71.49,71.49,SKIPPED,22.12,22.12,71.49,71.49,71.49,35.45,4.89,4.89,0,4.89,36.17,36.17,71.49
4021410,306,87172,,,,,,,PINWORM PREP,23.24,9.3,0,20.03,19.75,SKIPPED,20.03,20.03,19.75,19.75,19.75,9.79,3.59,3.59,0,3.99,9.99,9.99,19.75
4021450,305,85730,,,,,,,PTT,132.98,53.19,0,113.03,113.03,SKIPPED,28.2,28.2,113.03,113.03,113.03,56.04,5.05,5.05,0,5.6,57.18,57.18,113.03
4021455,301,84100,,,,,,,PHOSPHORUS SERUM,37.8,15.12,0,32.13,32.13,SKIPPED,22.23,22.23,32.13,32.13,32.13,15.92,3.98,3.98,0,4.43,16.25,16.25,32.13
4021503,302,86880,,,,,,,COOMBS DIRECT,115.26,46.1,0,115.26,97.97,SKIPPED,115.26,115.26,97.97,97.97,97.97,48.57,4.53,4.53,0,5.03,49.56,49.56,97.97
4021555,301,80184,,,,,,,PHENOBARBITAL,234.98,93.99,0,199.73,199.73,SKIPPED,58.14,58.14,199.73,199.73,199.73,99.02,12.85,12.85,0,12.85,101.04,101.04,199.73
4021654,305,85049,,,,,,,"PLATELET COUNT,AUTO",96.11,38.44,0,81.69,81.69,SKIPPED,21.01,21.01,81.69,81.69,81.69,40.5,3.76,3.76,0,4.17,41.33,41.33,81.69
4021803,301,84132,,,,,,,"POTASSIUM,SERUM",88.7,35.48,0,75.4,75.4,SKIPPED,21.58,21.58,75.4,75.4,75.4,37.38,4,4,0,4.29,38.14,38.14,75.4
4021858,302,84703,,,,,,,"PREGNANCY TEST, SERU",116.78,46.71,0,99.26,99.26,SKIPPED,35.3,35.3,99.26,99.26,99.26,49.22,6.32,6.32,0,7.02,50.22,50.22,99.26
4022406,301,84156,,,,,,,PROTEIN URINE,103.51,41.4,0,87.98,87.98,SKIPPED,17.21,17.21,87.98,87.98,87.98,43.62,3.08,3.08,0,3.42,44.51,44.51,87.98
4022435,302,86885,,,,,,,COOMBS INDIRECT,569.69,227.88,0,490.88,484.24,SKIPPED,490.88,490.88,484.24,484.24,484.24,240.07,4.8,4.8,0,5.34,244.97,244.97,484.24
4022504,301,82550,,,,,,,CPK,159.67,63.87,0,135.72,135.72,SKIPPED,30.55,30.55,135.72,135.72,135.72,67.29,5.47,5.47,0,6.07,68.66,68.66,135.72
4022655,301,84155,,,,,,,PROTEIN SERUM,37.8,15.12,0,32.13,32.13,SKIPPED,17.21,17.21,32.13,32.13,32.13,15.92,3.08,3.08,0,3.42,16.25,16.25,32.13
4022951,301,82042,,,,,,,PROTEIN CSF(MTP),95.55,38.22,0,81.22,81.22,SKIPPED,29.56,29.56,81.22,81.22,81.22,40.27,6.54,6.54,0,6.54,41.09,41.09,81.22
4023009,305,85610,,,,,,,PROTHROMBIN TIME,103.51,41.4,0,87.98,87.98,SKIPPED,18.43,18.43,87.98,87.98,87.98,43.62,3.6,3.6,0,3.67,44.51,44.51,87.98
4023107,301,82565,,,,,,,CREATININE,115.26,46.1,0,97.97,97.97,SKIPPED,24.05,24.05,97.97,97.97,97.97,48.57,4.3,4.3,0,4.78,49.56,49.56,97.97
4023110,301,82575,,,,,,,CREATININE CLEARANCE,211.35,84.54,0,179.65,179.65,SKIPPED,44.35,44.35,179.65,179.65,179.65,89.06,7.95,7.95,0,8.83,90.88,90.88,179.65
4023403,306,87086,,,,,,,CULTURE URINE,82.7,33.08,0,70.3,70.3,SKIPPED,37.85,37.85,70.3,70.3,70.3,34.85,6.78,6.78,0,7.53,35.56,35.56,70.3
4023407,302,86592,,,,,,,RPR,54.63,21.85,0,46.44,46.44,SKIPPED,20.03,20.03,46.44,46.44,46.44,23.02,3.59,3.59,0,3.99,23.49,23.49,46.44
4023441,305,85045,,,,,,,RETICULOCYTE COUNT,21.75,8.7,0,18.73,18.49,SKIPPED,18.73,18.73,18.49,18.49,18.49,9.16,3.35,3.35,0,3.73,9.35,9.35,18.49
4023454,305,85048,,,,,,,"WBC COUNT,AUTO",87.18,34.87,0,74.1,74.1,SKIPPED,11.89,11.89,74.1,74.1,74.1,36.74,2.13,2.13,0,2.37,37.49,37.49,74.1
4023910,301,80076,,,,,,,PANEL LIVER,220.17,88.07,0,187.14,187.14,SKIPPED,38.34,38.34,187.14,187.14,187.14,92.78,6.86,6.86,0,7.63,94.67,94.67,187.14
4023940,306,89055,,,,,,,SMEAR FECAL LEUKOCYT,84.11,33.64,0,71.49,71.49,SKIPPED,20.03,20.03,71.49,71.49,71.49,35.45,3.59,3.59,0,3.99,36.17,36.17,71.49
4024459,301,82948,,,,,,,ACCU-CHECK BG,56.16,22.46,0,47.74,47.74,SKIPPED,19.15,19.15,47.74,47.74,47.74,23.67,4.23,4.23,0,4.23,24.15,24.15,47.74
4024555,302,86430,,,,,,,RA LATEX,78.25,31.3,0,66.51,66.51,SKIPPED,26.6,26.6,66.51,66.51,66.51,32.98,5.16,5.16,0,5.29,33.65,33.65,66.51
4024560,306,87880,,,,,,,STREP RAPID,102,40.8,0,86.7,86.7,SKIPPED,62.81,62.81,86.7,86.7,86.7,42.98,13.89,13.89,0,13.89,43.86,43.86,86.7
4024655,306,87205,,,,,,,SMEAR GRAM STAIN,84.11,33.64,0,71.49,71.49,SKIPPED,20.03,20.03,71.49,71.49,71.49,35.45,3.59,3.59,0,3.99,36.17,36.17,71.49
4024663,301,80162,,,,,,,DIGOXIN,249.64,99.86,0,212.19,212.19,SKIPPED,62.28,62.28,212.19,212.19,212.19,105.2,11.16,11.16,0,12.39,107.35,107.35,212.19
4024683,301,80185,,,,,,,PHENYTOIN-DILANTIN,212.76,85.1,0,180.85,180.85,SKIPPED,62.17,62.17,180.85,180.85,180.85,89.66,11.13,11.13,0,12.37,91.49,91.49,180.85
4024759,305,85651,,,,,,,SEDIMENTATION RATE,88.7,35.48,0,75.4,75.4,SKIPPED,16.64,16.64,75.4,75.4,75.4,37.38,3.59,3.59,0,3.59,38.14,38.14,75.4
4024917,305,85014,,,,,,,HEMATOCRIT,62.02,24.81,0,52.72,52.72,SKIPPED,11.13,11.13,52.72,52.72,52.72,26.14,1.99,1.99,0,2.21,26.67,26.67,52.72
4025407,305,85018,,,,,,,HEMOGLOBIN,62.02,24.81,0,52.72,52.72,SKIPPED,11.13,11.13,52.72,52.72,52.72,26.14,1.99,1.99,0,2.21,26.67,26.67,52.72
4025529,301,80051,,,,,,,ELECTROLYTES,189.15,75.66,0,160.78,160.78,SKIPPED,32.91,32.91,160.78,160.78,160.78,79.7,5.89,5.89,0,6.54,81.33,81.33,160.78
4025550,301,80320,,,,,,,ETOH,186.08,74.43,0,158.17,158.17,SKIPPED,0,0,158.17,158.17,158.17,78.41,9.42,9.42,0,9.42,80.01,80.01,158.17
4025551,306,87186,,,,,,,GN SEN,141.79,56.72,0,120.52,120.52,SKIPPED,40.55,40.55,120.52,120.52,120.52,59.75,7.27,7.27,0,8.07,60.97,60.97,120.52
4025760,306,87591,,,,,,,GC-PCR,204.44,81.78,0,173.77,173.77,SKIPPED,164.65,164.65,173.77,173.77,173.77,86.15,29.48,29.48,0,32.75,87.91,87.91,173.77
4025780,301,80329,,,,,,,SALICYLATE,175.88,70.35,0,149.5,149.5,SKIPPED,0,0,149.5,149.5,149.5,74.12,9.63,9.63,0,9.63,75.63,75.63,149.5
4025783,301,84295,,,,,,,"SODIUM,SERUM",88.7,35.48,0,75.4,75.4,SKIPPED,22.57,22.57,75.4,75.4,75.4,37.38,4.04,4.04,0,4.49,38.14,38.14,75.4
4025786,301,80048,,,,,,,PANEL BASIC METABO(B,220.17,88.07,0,187.14,187.14,SKIPPED,39.67,39.67,187.14,187.14,187.14,92.78,7.11,7.11,0,7.9,94.67,94.67,187.14
4025815,307,81002,,,,,,,URINALYSIS ROUT(DIP),21,8.4,0,17.85,17.85,SKIPPED,13.22,13.22,17.85,17.85,17.85,8.85,2.92,2.92,0,2.92,9.03,9.03,17.85
4025820,307,81015,,,,,,,URINALYSIS MICRO ONL,62.02,24.81,0,52.72,52.72,SKIPPED,14.29,14.29,52.72,52.72,52.72,26.14,2.56,2.56,0,2.85,26.67,26.67,52.72
4026204,301,83540,,,,,,,IRON,96.11,38.44,0,81.69,81.69,SKIPPED,30.36,30.36,81.69,81.69,81.69,40.5,5.43,5.43,0,6.04,41.33,41.33,81.69
4026231,390,86920,,,,,,,CROSSMATCH IMM SPIN,153.67,61.47,0,153.67,130.62,SKIPPED,153.67,153.67,130.62,130.62,130.62,64.76,75.3,75.3,0,46.1,66.08,66.08,130.62
4026235,390,86921,,,,,,,CROSSMATCH 37 DEGREE,569.69,227.88,0,490.88,484.24,SKIPPED,490.88,490.88,484.24,484.24,484.24,240.07,279.15,279.15,0,170.91,244.97,244.97,484.24
4026240,390,86922,,,,,,,CROSSMATCH AHG,569.69,227.88,0,490.88,484.24,SKIPPED,490.88,490.88,484.24,484.24,484.24,240.07,279.15,279.15,0,170.91,244.97,244.97,484.24
4026259,301,83550,,,,,,,TIBC,152.27,60.91,0,129.43,129.43,SKIPPED,41,41,129.43,129.43,129.43,64.17,7.34,7.34,0,8.16,65.48,65.48,129.43
4026264,306,87220,,,,,,,"SMEAR KOH,SKIN SCRAP",84.11,33.64,0,71.49,71.49,SKIPPED,20.03,20.03,71.49,71.49,71.49,35.45,3.59,3.59,0,3.99,36.17,36.17,71.49
4026402,390,P9021,,,,,,,"BLOOD, PRBC PER UNIT",258.83,103.53,0,220.01,220.01,SKIPPED,196.71,196.71,220.01,220.01,220.01,109.07,126.83,126.83,0,77.65,111.3,111.3,220.01
4026504,390,P9017,,,,,,,FRESH FROZEN PLASMA,221.7,88.68,0,188.44,188.44,SKIPPED,168.49,168.49,188.44,188.44,188.44,93.42,108.63,108.63,0,66.51,95.33,95.33,188.44
4026908,301,83615,,,,,,,LDH,37.8,15.12,0,32.13,32.13,SKIPPED,28.31,28.31,32.13,32.13,32.13,15.92,5.07,5.07,0,5.64,16.25,16.25,32.13
4026911,310,88172,,,,,,,CYTOPATHOLOGY EVAL OF FNA,68.04,27.22,0,68.04,57.83,SKIPPED,68.04,68.04,57.83,57.83,57.83,52.3,33.34,33.34,0,20.41,53.37,53.37,57.83
4026922,310,88300,,,,,,,LEVEL I GROSS EXAM ONLY,77.04,30.82,0,66.39,65.48,SKIPPED,66.39,66.39,65.48,65.48,65.48,14.45,37.75,37.75,0,23.11,14.74,14.74,65.48
4026923,310,88302,,,,,,,LEVEL II GROSS AND MICRO,140.24,56.1,0,120.84,119.2,SKIPPED,120.84,120.84,119.2,119.2,119.2,30.07,68.72,68.72,0,42.07,30.68,30.68,119.2
4026924,310,88304,,,,,,,LEVEL III GROSS AND MICRO,197.13,78.85,0,169.86,167.56,SKIPPED,169.86,169.86,167.56,167.56,167.56,39.6,96.59,96.59,0,59.14,40.41,40.41,167.56
4026926,310,88305,,,,,,,CELL BLOCK/NON-GYN OR FNA,197.13,78.85,0,169.86,167.56,SKIPPED,169.86,169.86,167.56,167.56,167.56,68.26,96.59,96.59,0,59.14,69.65,69.65,167.56
4026928,310,88307,,,,,,,LEVEL V GROSS AND MICRO,950.05,380.02,0,818.63,807.54,SKIPPED,818.63,818.63,807.54,807.54,807.54,273.48,465.52,465.52,0,285.02,279.06,279.06,807.54
4026929,310,88309,,,,,,,LEVEL VI GROSS AND MICRO,2385.63,954.25,0,2055.65,2027.79,SKIPPED,2055.65,2055.65,2027.79,2027.79,2027.79,416.41,1168.96,1168.96,0,715.69,424.91,424.91,2027.79
4026930,310,88311,,,,,,,DECALCIFICATION PROCEDURE,47.37,18.95,0,40.26,40.26,SKIPPED,35.45,35.45,40.26,40.26,40.26,19.87,23.21,23.21,0,14.21,20.28,20.28,40.26
4026936,310,88331,,,,,,,PATHOLOGY CONSULT W/FROZE,569.69,227.88,0,490.88,484.24,SKIPPED,490.88,490.88,484.24,484.24,484.24,98.27,279.15,279.15,0,170.91,100.28,100.28,484.24
4026937,310,88332,,,,,,,PATH CONSULT SURG W/FROZE,94.95,37.98,0,81.81,80.71,SKIPPED,81.81,81.81,80.71,80.71,80.71,52.15,46.53,46.53,0,28.48,53.21,53.21,80.71
4027078,300,87328,,,,,,,CRYPTOSPORIDIUM AG IA,65.27,26.11,0,56.24,55.48,SKIPPED,56.24,56.24,55.48,55.48,55.48,27.51,11.61,11.61,0,11.61,28.07,28.07,55.48
4027301,390,P9035,,,,,,,"PLATELETAPHERESIS, LR",1546.85,618.74,0,1314.82,1314.82,SKIPPED,1175.61,1175.61,1314.82,1314.82,1314.82,651.85,757.96,757.96,0,464.06,665.15,665.15,1314.82
4028277,307,81002,,,,,,,LEUCOCYTE/NITRITE,21,8.4,0,17.85,17.85,SKIPPED,13.22,13.22,17.85,17.85,17.85,8.85,2.92,2.92,0,2.92,9.03,9.03,17.85
4029250,301,82977,,,,,,,GGT,159.67,63.87,0,135.72,135.72,SKIPPED,33.78,33.78,135.72,135.72,135.72,67.29,6.05,6.05,0,6.72,68.66,68.66,135.72
4029589,301,82947,,,,,,,GLUCOSE,110.79,44.32,0,94.17,94.17,SKIPPED,18.43,18.43,94.17,94.17,94.17,46.69,3.3,3.3,0,3.67,47.64,47.64,94.17
4029590,302,87801,,,,,,,STOOL PATHOGEN,543.7,217.48,0,462.14,462.14,SKIPPED,329.31,329.31,462.14,462.14,462.14,229.11,58.97,58.97,0,65.51,233.79,233.79,462.14
4029591,301,84154,,,,,,,PSA FT2,109.38,43.75,0,92.97,92.97,SKIPPED,86.3,86.3,92.97,92.97,92.97,46.09,15.45,15.45,0,17.17,47.03,47.03,92.97
4029592,301,84300,,,,,,,SODIUM 24 HR UR,93.17,37.27,0,79.19,79.19,SKIPPED,22.8,22.8,79.19,79.19,79.19,39.26,4.25,4.25,0,4.54,40.06,40.06,79.19
4029593,301,84133,,,,,,,POTASSIUM 24 HR UR,93.17,37.27,0,79.19,79.19,SKIPPED,20.22,20.22,79.19,79.19,79.19,39.26,3.97,3.97,0,4.02,40.06,40.06,79.19
4029594,301,82436,,,,,,,CHLORIDE 24 HR UR,100.57,40.23,0,85.48,85.48,SKIPPED,23.6,23.6,85.48,85.48,85.48,42.38,4.83,4.83,0,4.83,43.25,43.25,85.48
4029595,301,84156,,,,,,,TOTAL PROTEIN 24 HR UR,103.51,41.4,0,87.98,87.98,SKIPPED,17.21,17.21,87.98,87.98,87.98,43.62,3.08,3.08,0,3.42,44.51,44.51,87.98
4029597,301,84105,,,,,,,PHOSPHORUS 24 HR UR,97.5,39,0,82.88,82.88,SKIPPED,24.28,24.28,82.88,82.88,82.88,41.09,4.86,4.86,0,4.86,41.93,41.93,82.88
4029598,301,82340,,,,,,,CALCIUM 24 HR UR,135.92,54.37,0,115.53,115.53,SKIPPED,28.27,28.27,115.53,115.53,115.53,57.28,5.07,5.07,0,5.63,58.45,58.45,115.53
4029599,301,82103,,,,,,,ALPHA-1 ANTITRYPSIN,73.16,29.26,0,63.04,62.19,SKIPPED,63.04,63.04,62.19,62.19,62.19,30.83,11.29,11.29,0,12.54,31.46,31.46,62.19
4029601,301,82785,,,,,,,IgE,89.61,35.84,0,77.22,76.17,SKIPPED,77.22,77.22,76.17,76.17,76.17,37.76,13.83,13.83,0,15.36,38.53,38.53,76.17
4029604,301,82784,,,,,,,IgG,50.63,20.25,0,43.62,43.04,SKIPPED,43.62,43.62,43.04,43.04,43.04,21.33,7.81,7.81,0,8.69,21.77,21.77,43.04
4029605,301,82232,,,,,,,BETA W MICROGLOBUBIN,96.11,38.44,0,81.69,81.69,SKIPPED,75.89,75.89,81.69,81.69,81.69,40.5,13.59,13.59,0,15.09,41.33,41.33,81.69
4029608,301,84145,,,,,,,PROCALCITONIN,271.85,108.74,0,231.07,231.07,SKIPPED,125.7,125.7,231.07,231.07,231.07,114.56,22.86,22.86,0,25.01,116.9,116.9,231.07
4029610,301,83835,,,,,,,"METANEPHRINES, PLASMA",177.28,70.91,0,150.69,150.69,SKIPPED,79.5,79.5,150.69,150.69,150.69,74.71,14.23,14.23,0,15.81,76.23,76.23,150.69
4029611,301,83520,,,,,,,COLLEGAN II AB,134.41,53.76,0,114.25,114.25,SKIPPED,65.63,65.63,114.25,114.25,114.25,56.64,14.51,14.51,0,14.51,57.8,57.8,114.25
4029612,301,85610,,,,,,,LUPUS ANTICOAG EVAL W/REFLEX,51.69,20.68,0,43.94,43.94,SKIPPED,18.43,18.43,43.94,43.94,43.94,21.79,3.6,3.6,0,3.67,22.23,22.23,43.94
4029613,301,85613,,,,,,,LUPUS ANTICOAG EVAL W/REFLEX,52.17,20.87,0,44.95,44.34,SKIPPED,44.95,44.95,44.34,44.34,44.34,21.98,8.05,8.05,0,8.94,22.43,22.43,44.34
4029614,301,85670,,,,,,,LUPUS ANTICOAG EVAL W/REFLEX,51.69,20.68,0,43.94,43.94,SKIPPED,27.06,27.06,43.94,43.94,43.94,21.79,4.85,4.85,0,5.38,22.23,22.23,43.94
4029615,301,85730,,,,,,,LUPUS ANTICOAG EVAL W/RELEX,51.69,20.68,0,43.94,43.94,SKIPPED,28.2,28.2,43.94,43.94,43.94,21.79,5.05,5.05,0,5.6,22.23,22.23,43.94
4029616,301,83518,,,,,,,HISTONE AB,46.17,18.47,0,39.79,39.24,SKIPPED,39.79,39.79,39.24,39.24,39.24,19.45,8.1,8.1,0,8.1,19.85,19.85,39.24
4029617,301,85130,,,,,,,ANTI-FACTOR XA,103.51,41.4,0,87.98,87.98,SKIPPED,55.78,55.78,87.98,87.98,87.98,43.62,9.99,9.99,0,11.1,44.51,44.51,87.98
4029618,301,88344,,,,,,,IMMUNOHISTO ANTIBOD ADD SLID,950.05,380.02,0,818.63,807.54,SKIPPED,818.63,818.63,807.54,807.54,807.54,162.87,465.52,465.52,0,285.02,166.19,166.19,807.54
4029619,971,88344,,,,,,,IMMUNOHISTO ANTIBOD ADD SLID PROF,92.02,36.81,0,92.02,78.22,SKIPPED,92.02,92.02,78.22,78.22,78.22,42.17,45.09,45.09,0,27.61,43.03,43.03,0
4029620,301,88342,,,,,,,IMMUNOHISTO/CYTO CHEM 1ST,950.05,380.02,0,818.63,807.54,SKIPPED,818.63,818.63,807.54,807.54,807.54,96.69,465.52,465.52,0,285.02,98.66,98.66,807.54
4029621,971,88342,,,,,,,IMMUNOHISTO/CYTO CHEM 1ST PROF,83.92,33.57,0,83.92,71.33,SKIPPED,83.92,83.92,71.33,71.33,71.33,38.33,41.12,41.12,0,25.18,39.11,39.11,0
4029622,301,36416,,,,,,,CAPILLARY STICK,26.54,10.62,0,22.56,22.56,SKIPPED,0,0,22.56,22.56,22.56,11.18,13,13,0,7.96,11.41,11.41,22.56
4029625,302,,,,,,,,MISC LAB,14.81,5.92,0,12.59,12.59,SKIPPED,11.26,11.26,12.59,12.59,12.59,6.24,7.26,7.26,0,4.44,6.37,6.37,12.59
4029627,301,86481,,,,,,,T-SPOT,169.88,67.95,0,169.88,144.4,SKIPPED,169.88,169.88,144.4,144.4,144.4,71.59,84,84,0,84,73.05,73.05,144.4
4029628,301,82542,,,,,,,OMEGACHECK,106.24,42.5,0,91.54,90.3,SKIPPED,91.54,91.54,90.3,90.3,90.3,44.77,20.24,20.24,0,20.24,45.68,45.68,90.3
4029632,301,85576,,,,,,,PLATELET FUNCTION SCREEN,116.95,46.78,0,100.78,99.41,SKIPPED,100.78,100.78,99.41,99.41,99.41,17.48,20.92,20.92,0,20.92,17.84,17.84,99.41
4029633,301,88112,,,,,,,URINE CYTOLOGY,197.13,78.85,0,169.86,167.56,SKIPPED,169.86,169.86,167.56,167.56,167.56,63.76,96.59,96.59,0,59.14,65.06,65.06,167.56
4029634,301,87449,,,,,,,URINE LEGIONELLA AB,65.27,26.11,0,56.24,55.48,SKIPPED,56.24,56.24,55.48,55.48,55.48,27.51,10.06,10.06,0,11.19,28.07,28.07,55.48
4029635,301,82164,,,,,,,ANGIOTENSION CONVERTING ENZYME ACES,79.52,31.81,0,68.51,67.59,SKIPPED,68.51,68.51,67.59,67.59,67.59,33.51,12.26,12.26,0,13.62,34.19,34.19,67.59
4029636,301,80307,,,,,,,SERUM DRUG SCREEN,316.77,126.71,0,272.95,269.25,SKIPPED,272.95,272.95,269.25,269.25,269.25,133.49,52.2,52.2,0,54.31,136.21,136.21,269.25
4029637,301,82784,,,,,,,IgG,50.63,20.25,0,43.62,43.04,SKIPPED,43.62,43.62,43.04,43.04,43.04,21.33,7.81,7.81,0,8.69,21.77,21.77,43.04
4029638,301,82784,,,,,,,IgM,50.63,20.25,0,43.62,43.04,SKIPPED,43.62,43.62,43.04,43.04,43.04,21.33,7.81,7.81,0,8.69,21.77,21.77,43.04
4029639,301,82103,,,,,,,ALPHA 1 ANTITRYPSIN,73.16,29.26,0,63.04,62.19,SKIPPED,63.04,63.04,62.19,62.19,62.19,30.83,11.29,11.29,0,12.54,31.46,31.46,62.19
4029640,301,86765,,,,,,,MEASLES IgG,70.12,28.05,0,60.42,59.6,SKIPPED,60.42,60.42,59.6,59.6,59.6,29.55,10.82,10.82,0,12.02,30.15,30.15,59.6
4029641,301,86765,,,,,,,MEASLES IgM TITER,70.12,28.05,0,60.42,59.6,SKIPPED,60.42,60.42,59.6,59.6,59.6,29.55,10.82,10.82,0,12.02,30.15,30.15,59.6
4029643,301,86747,,,,,,,PARVO VIRUS B19 IgM IgG AB,121.8,48.72,0,103.53,103.53,SKIPPED,70.53,70.53,103.53,103.53,103.53,51.32,12.63,12.63,0,14.03,52.37,52.37,103.53
4029644,301,86147,,,,,,,ANTICARDIOLIPIN,138.56,55.42,0,119.4,117.78,SKIPPED,119.4,119.4,117.78,117.78,117.78,58.39,21.38,21.38,0,23.76,59.58,59.58,117.78
4029645,301,88189,,,,,,,FLOW CYTOMETRY/READ 16 & >,390.95,156.38,0,336.87,332.31,SKIPPED,336.87,336.87,332.31,332.31,332.31,80.49,191.57,191.57,0,117.28,82.13,82.13,332.31
4029646,301,88185,,,,,,,FLOW CYTOMETRY/ TC ADD-ON,243.78,97.51,0,207.21,207.21,SKIPPED,115.94,115.94,207.21,207.21,207.21,20.73,119.45,119.45,0,73.13,21.15,21.15,207.21
4029647,301,88184,,,,,,,FLOW CYTOMETRY/ TC 1 MARKER,950.05,380.02,0,818.63,807.54,SKIPPED,818.63,818.63,807.54,807.54,807.54,64.52,465.52,465.52,0,285.02,65.84,65.84,807.54
4029649,301,83930,,,,,,,OSMOLALITY SERUM,104.14,41.66,0,88.52,88.52,SKIPPED,31.01,31.01,88.52,88.52,88.52,43.88,5.55,5.55,0,6.17,44.78,44.78,88.52
4029650,301,83935,,,,,,,OSMOLALITY URINE,104.14,41.66,0,88.52,88.52,SKIPPED,32,32,88.52,88.52,88.52,43.88,5.73,5.73,0,6.36,44.78,44.78,88.52
4029653,301,88346,,,,,,,IMMUNOFLUORESCENT,949.65,379.86,0,818.63,807.2,SKIPPED,818.63,818.63,807.2,807.2,807.2,146.63,465.33,465.33,0,284.9,149.62,149.62,807.2
4029654,971,88346,,,,,,,IMMUNOFLUORESCENT-PROF,85.03,34.01,0,85.03,72.28,SKIPPED,85.03,85.03,72.28,72.28,72.28,39.89,41.66,41.66,0,25.51,40.7,40.7,0
4029655,302,83883,,,,,,,FREE LIGHT CHAIN ASSAY,161.84,64.74,0,137.56,137.56,SKIPPED,63.8,63.8,137.56,137.56,137.56,68.2,11.42,11.42,0,12.69,69.59,69.59,137.56
4029656,310,88360,,,,,,,TUMOR IMMUNOHISTOCHEM TECH,950.05,380.02,0,818.63,807.54,SKIPPED,818.63,818.63,807.54,807.54,807.54,115.7,465.52,465.52,0,285.02,118.06,118.06,807.54
4029657,310,88360,,,,,,,TUMOR IMMUNOHISTOCHEM PROF,950.05,380.02,0,818.63,807.54,SKIPPED,818.63,818.63,807.54,807.54,807.54,115.7,465.52,465.52,0,285.02,118.06,118.06,807.54
4029662,301,87338,,,,,,,H-PYLORI STOOL AG,147.79,59.12,0,125.62,125.62,SKIPPED,67.49,67.49,125.62,125.62,125.62,62.28,12.08,12.08,0,13.42,63.55,63.55,125.62
4029663,301,86255,,,,,,,C-ANCA,65.63,26.25,0,56.54,55.79,SKIPPED,56.54,56.54,55.79,55.79,55.79,17.48,10.12,10.12,0,11.25,17.84,17.84,55.79
4029666,301,80183,,,,,,,TRILEPTAL,70.33,28.13,0,62.17,59.78,SKIPPED,62.17,62.17,59.78,59.78,59.78,29.64,11.13,11.13,0,12.37,30.24,30.24,59.78
4029668,301,88185,,,,,,,"FLOW CYTOMETRY,ADDITIONAL MARKERS",230.76,92.3,0,196.15,196.15,SKIPPED,115.94,115.94,196.15,196.15,196.15,20.73,113.07,113.07,0,69.23,21.15,21.15,196.15
4029669,301,88184,,,,,,,"FLOW CYTOMETRY, INTREPRETATION 16+MARKER",950.05,380.02,0,818.63,807.54,SKIPPED,818.63,818.63,807.54,807.54,807.54,64.52,465.52,465.52,0,285.02,65.84,65.84,807.54
4029670,301,88184,,,,,,,"FLOW CYTOMETRY,FIRST MARKER",950.05,380.02,0,818.63,807.54,SKIPPED,818.63,818.63,807.54,807.54,807.54,64.52,465.52,465.52,0,285.02,65.84,65.84,807.54
4029671,300,82306,,,,,,,VIT D 25 OH,161.19,64.48,0,138.89,137.01,SKIPPED,138.89,138.89,137.01,137.01,137.01,67.92,24.86,24.86,0,27.63,69.31,69.31,137.01
4029672,310,88341,,,,,,,IMMUNOHISTO AN SLIDE,284.89,113.96,0,245.48,242.16,SKIPPED,245.48,245.48,242.16,242.16,242.16,84.61,139.6,139.6,0,85.47,86.34,86.34,242.16
4029673,971,88341,,,,,,,IMMUNOHISTO AB SLIDE PROF,84.49,33.8,0,84.49,71.82,SKIPPED,84.49,84.49,71.82,71.82,71.82,31.01,41.4,41.4,0,25.35,31.64,31.64,0
4029674,310,88271,,,,,,,G-HER2 CISH(1),270.27,108.11,0,229.73,229.73,SKIPPED,100.47,100.47,229.73,229.73,229.73,113.9,17.99,17.99,0,19.99,116.22,116.22,229.73
4029675,310,88274,,,,,,,G-HER2 CISH(2),311.85,124.74,0,265.07,265.07,SKIPPED,163.32,163.32,265.07,265.07,265.07,131.42,35.6,35.6,0,35.6,134.1,134.1,265.07
4029676,310,88291,,,,,,,G-HER2 CISH(3),182.89,73.16,0,155.46,155.46,SKIPPED,128.21,128.21,155.46,155.46,155.46,31.7,89.62,89.62,0,54.87,32.35,32.35,155.46
4029684,301,88184,,,,,,,LEUKEMIA / LYMPHOMA PATH PANEL,93.81,37.52,0,93.81,79.74,SKIPPED,93.81,93.81,79.74,79.74,79.74,64.52,45.97,45.97,0,28.14,65.84,65.84,79.74
4029685,310,88361,,,,,,,CORE NEEDLE BIOPSY(TC),281.43,112.57,0,281.43,239.22,SKIPPED,281.43,281.43,239.22,239.22,239.22,115.53,137.9,137.9,0,84.43,117.89,117.89,239.22
4029686,971,88361,,,,,,,CORE NEEDLE BIOPSY(PC),140.77,56.31,0,140.77,119.65,SKIPPED,140.77,140.77,119.65,119.65,119.65,48.45,68.98,68.98,0,42.23,49.44,49.44,0
4029687,301,82530,,,,,,,24 HR. URINE CORTISOL,120.61,48.24,0,102.52,102.52,SKIPPED,78.39,78.39,102.52,102.52,102.52,50.82,14.04,14.04,0,15.6,51.86,51.86,102.52
4029688,300,80307,,,,,,,PRE-COLLEGE DRUG SCREEN,36.75,14.7,0,36.75,31.24,SKIPPED,36.75,36.75,31.24,31.24,31.24,15.48,36.75,36.75,0,36.75,15.8,15.8,31.24
4029689,300,85810,,,,,,,VISCOSITY WHOLE BLOOD,63.55,25.42,0,54.76,54.02,SKIPPED,54.76,54.76,54.02,54.02,54.02,26.78,9.8,9.8,0,10.89,27.33,27.33,54.02
4029690,300,80157,,,,,,,FREE CARBAMAZEPINE,75.04,30.02,0,63.78,63.78,SKIPPED,62.17,62.17,63.78,63.78,63.78,31.62,11.13,11.13,0,12.37,32.27,32.27,63.78
4029691,300,86146,,,,,,,BETA-2 GLYCOPROTEIN IgG,107.21,42.88,0,107.21,91.13,SKIPPED,107.21,107.21,91.13,91.13,91.13,45.18,21.38,21.38,0,23.76,46.1,46.1,91.13
4029692,300,86146,,,,,,,BETA-2 GLYCOPROTEIN IgM,107.21,42.88,0,107.21,91.13,SKIPPED,107.21,107.21,91.13,91.13,91.13,45.18,21.38,21.38,0,23.76,46.1,46.1,91.13
4029693,300,84080,,,,,,,BONE SPECIFIC ALKALINE PHOSPHATASE,80.48,32.19,0,69.35,68.41,SKIPPED,69.35,69.35,68.41,68.41,68.41,33.92,12.42,12.42,0,13.8,34.61,34.61,68.41
4029694,301,83516,,,,,,,GLIADIN IgA,134.41,53.76,0,114.25,114.25,SKIPPED,54.11,54.11,114.25,114.25,114.25,56.64,9.69,9.69,0,10.76,57.8,57.8,114.25
4029696,300,85220,,,,,,,FACTOR V,96.1,38.44,0,82.8,81.68,SKIPPED,82.8,82.8,81.68,81.68,81.68,40.49,14.83,14.83,0,16.47,41.32,41.32,81.68
4029697,300,85210,,,,,,,FACTOR II,147.42,58.97,0,125.31,125.31,SKIPPED,60.91,60.91,125.31,125.31,125.31,62.12,10.9,10.9,0,12.12,63.39,63.39,125.31
4029698,300,85303,,,,,,,PROTEIN C ACTIVITY,75.33,30.13,0,64.9,64.03,SKIPPED,64.9,64.9,64.03,64.03,64.03,31.74,11.63,11.63,0,12.91,32.39,32.39,64.03
4029699,300,85306,,,,,,,PROTEIN S ACTIVITY,83.43,33.37,0,71.9,70.92,SKIPPED,71.9,71.9,70.92,70.92,70.92,35.15,12.87,12.87,0,14.31,35.87,35.87,70.92
4029700,300,85300,,,,,,,ANTITHROMBIN III ACTIVITY,64.52,25.81,0,55.59,54.84,SKIPPED,55.59,55.59,54.84,54.84,54.84,27.19,9.95,9.95,0,11.06,27.74,27.74,54.84
4029701,300,83516,,,,,,,ANTI-MITOCHONDIAL AB M2,62.8,25.12,0,54.11,53.38,SKIPPED,54.11,54.11,53.38,53.38,53.38,26.46,9.69,9.69,0,10.76,27,27,53.38
4029702,300,83516,,,,,,,ANTI-SMOOTH MUSCLE/ F-ACTION,62.8,25.12,0,54.11,53.38,SKIPPED,54.11,54.11,53.38,53.38,53.38,26.46,9.69,9.69,0,10.76,27,27,53.38
4029703,300,82139,,,,,,,URINE PHOSPHOETHANOLAMIN(PEA)TEST,189,75.6,0,160.65,160.65,SKIPPED,79.15,79.15,160.65,160.65,160.65,79.64,14.17,14.17,0,15.74,81.27,81.27,160.65
4029704,300,86003,,,,,,,ALPHA-Gal IgE,40.2,16.08,0,34.17,34.17,SKIPPED,24.47,24.47,34.17,34.17,34.17,16.94,4.38,4.38,0,4.87,17.29,17.29,34.17
4029705,300,86160,,,,,,,C2-COMPLEMENT,71.09,28.44,0,60.43,60.43,SKIPPED,56.28,56.28,60.43,60.43,60.43,29.96,10.08,10.08,0,11.2,30.57,30.57,60.43
4029706,300,83516,,,,,,,GAD 65 AB,93.81,37.52,0,79.74,79.74,SKIPPED,54.11,54.11,79.74,79.74,79.74,39.53,9.69,9.69,0,10.76,40.34,40.34,79.74
4029707,300,87902,,,,,,,HEP C GENOTYPE,1401.68,560.67,0,1207.79,1191.43,SKIPPED,1207.79,1207.79,1191.43,1191.43,1191.43,590.67,216.26,216.26,0,240.28,602.72,602.72,1191.43
4029709,300,87337,,,,,,,ENTAMOEB HIST GROUP AG IA,65.27,26.11,0,56.24,55.48,SKIPPED,56.24,56.24,55.48,55.48,55.48,27.51,10.06,10.06,0,11.19,28.07,28.07,55.48
4029710,300,87329,,,,,,,GIARDIA AG IA,65.27,26.11,0,56.24,55.48,SKIPPED,56.24,56.24,55.48,55.48,55.48,27.51,10.06,10.06,0,11.19,28.07,28.07,55.48
4029711,300,G0480,,,,,,,OXYCODONE,504.64,201.86,0,434.83,428.94,SKIPPED,434.83,434.83,428.94,428.94,428.94,212.66,96.12,96.12,0,96.12,217,217,428.94
4029712,300,86757,,,,,,,RICKETTSIA IgG,116.66,46.66,0,99.16,99.16,SKIPPED,90.82,90.82,99.16,99.16,99.16,49.16,16.25,16.25,0,18.07,50.16,50.16,99.16
4029713,300,87088,,,,,,,ID/SENS URINE ISOLATE CULT,44.06,17.62,0,37.96,37.45,SKIPPED,37.96,37.96,37.45,37.45,37.45,18.57,6.8,6.8,0,7.55,18.95,18.95,37.45
4029714,300,84482,,,,,,,T3 REVERSE,85.82,34.33,0,73.95,72.95,SKIPPED,73.95,73.95,72.95,72.95,72.95,36.16,13.24,13.24,0,14.71,36.9,36.9,72.95
4029716,300,86757,,,,,,,RICKETTSIA IgM,116.66,46.66,0,99.16,99.16,SKIPPED,90.82,90.82,99.16,99.16,99.16,49.16,16.25,16.25,0,18.07,50.16,50.16,99.16
4029719,301,88333,,,,,,,INTRAOP CYTO PATH CONSULT 1,2385.63,954.25,0,2055.65,2027.79,SKIPPED,2055.65,2055.65,2027.79,2027.79,2027.79,89.88,1168.96,1168.96,0,715.69,91.71,91.71,2027.79
4029721,300,85240,,,,,,,BLOOD CLOT FACTOR VIII,156.35,62.54,0,132.9,132.9,SKIPPED,83.98,83.98,132.9,132.9,132.9,65.89,15.04,15.04,0,16.71,67.23,67.23,132.9
4029722,300,85245,,,,,,,BLOOD CLOT FACTOR VIII,156.35,62.54,0,132.9,132.9,SKIPPED,107.62,107.62,132.9,132.9,132.9,65.89,19.27,19.27,0,21.41,67.23,67.23,132.9
4029723,300,85246,,,,,,,BLOOD CLOT FACTOR VIII,156.35,62.54,0,132.9,132.9,SKIPPED,107.62,107.62,132.9,132.9,132.9,65.89,19.27,19.27,0,21.41,67.23,67.23,132.9
4029728,300,80195,,,,,,,SIROLIMUS(RAPAMUNE),316.26,126.5,0,268.82,268.82,SKIPPED,64.45,64.45,268.82,268.82,268.82,133.27,11.53,11.53,0,12.82,135.99,135.99,268.82
4029729,300,83497,,,,,,,5-HIAA/ HYDROXYINDOLEACUTIC ACID,70.2,28.08,0,60.5,59.67,SKIPPED,60.5,60.5,59.67,59.67,59.67,29.59,10.84,10.84,0,12.04,30.19,30.19,59.67
4029730,300,81270,,,,,,,JAK2 V617F MUTATION DETECTION,681.45,272.58,0,579.23,579.23,SKIPPED,430.05,430.05,579.23,579.23,579.23,287.16,76.99,76.99,0,85.55,293.02,293.02,579.23
4029731,300,83516,,,,,,,ANTIPHOSPHOLIPID ANTIBODY,62.8,25.12,0,54.11,53.38,SKIPPED,54.11,54.11,53.38,53.38,53.38,26.46,9.69,9.69,0,10.76,27,27,53.38
4029732,300,86148,,,,,,,PHOSPHOLIPID ANTIBODY,87.5,35,0,75.39,74.38,SKIPPED,75.39,75.39,74.38,74.38,74.38,36.88,13.5,13.5,0,14.99,37.63,37.63,74.38
4029733,300,80050,,,,,,,GENERAL HEALTH PANEL,193.2,77.28,0,164.22,164.22,SKIPPED,133.65,133.65,164.22,164.22,164.22,81.42,94.67,94.67,0,57.96,83.08,83.08,164.22
4029734,300,80158,,,,,,,CYCLOSPORINE LEVEL,98.26,39.3,0,84.66,83.52,SKIPPED,84.66,84.66,83.52,83.52,83.52,41.4,15.16,15.16,0,16.85,42.25,42.25,83.52
4029735,300,87507,,,,,,,GI PANEL,2269.17,907.67,0,1955.29,1928.79,SKIPPED,1955.29,1955.29,1928.79,1928.79,1928.79,956.23,350.1,350.1,0,389,975.74,975.74,1928.79
4029736,300,87150,,,,,,,BLOOD CX ID PANEL,191.09,76.44,0,164.65,162.43,SKIPPED,164.65,164.65,162.43,162.43,162.43,80.53,29.48,29.48,0,32.75,82.17,82.17,162.43
4029737,300,87633,,,,,,,RESPIRATORY PANEL,1009.53,403.81,0,1009.53,858.1,SKIPPED,1009.53,1009.53,858.1,858.1,858.1,425.42,350.1,350.1,0,389,434.1,434.1,858.1
4029738,300,80305,,,,,,,URINE DRUG SCREEN-POCT,59.36,23.74,0,51.15,50.46,SKIPPED,51.15,51.15,50.46,50.46,50.46,25.01,10.58,10.58,0,10.58,25.52,25.52,50.46
4029739,250,J2790,,,,,,,RHIG-RHOGRAM 300MG,250.14,100.06,0,212.62,212.62,SKIPPED,75.52,75.52,212.62,212.62,212.62,105.41,122.57,122.57,0,75.04,107.56,107.56,212.62
4029740,300,82373,,,,,,,CARB DEFICIENT TRANSFERRIN,98.3,39.32,0,84.7,83.56,SKIPPED,84.7,84.7,83.56,83.56,83.56,41.42,15.17,15.17,0,16.85,42.27,42.27,83.56
4029741,300,,,,,,,,FRAGILE X SCREEN W/REFLEX,530.93,212.37,0,451.29,451.29,SKIPPED,403.51,403.51,451.29,451.29,451.29,223.73,260.16,260.16,0,159.28,228.3,228.3,451.29
4029742,300,80183,,,,,,,TRILEPTAL (OXCARBAZEPINE),81.68,32.67,0,69.43,69.43,SKIPPED,62.17,62.17,69.43,69.43,69.43,34.42,11.13,11.13,0,12.37,35.12,35.12,69.43
4029743,300,82784,,,,,,,IMMUNOGLOBULIN A QN,50.63,20.25,0,43.62,43.04,SKIPPED,43.62,43.62,43.04,43.04,43.04,21.33,7.81,7.81,0,8.69,21.77,21.77,43.04
4029744,300,81240,,,,,,,PROTHROMBIN GENE MUTATION,289.7,115.88,0,249.62,246.24,SKIPPED,249.62,249.62,246.24,246.24,246.24,122.08,55.18,55.18,0,55.18,124.57,124.57,246.24
4029745,300,85240,,,,,,,FACTOR VIII,97.46,38.98,0,83.98,82.84,SKIPPED,83.98,83.98,82.84,82.84,82.84,41.07,15.04,15.04,0,16.71,41.91,41.91,82.84
4029746,300,85597,,,,,,,LUPUS ANTICOAGULANT EVAL.,97.86,39.14,0,84.32,83.18,SKIPPED,84.32,84.32,83.18,83.18,83.18,41.24,15.1,15.1,0,16.77,42.08,42.08,83.18
4029747,300,82595,,,,,,,CRYOGLBULIN QUANT.,35.2,14.08,0,30.32,29.92,SKIPPED,30.32,30.32,29.92,29.92,29.92,14.84,5.43,5.43,0,6.03,15.14,15.14,29.92
4029748,300,86704,,,,,,,HEP B CORE AB REFLEX Igm,65.63,26.25,0,56.54,55.79,SKIPPED,56.54,56.54,55.79,55.79,55.79,27.66,10.12,10.12,0,11.25,28.22,28.22,55.79
4029749,300,88271,,,,,,,"FISH, BCR/ABL",270.27,108.11,0,229.73,229.73,SKIPPED,100.47,100.47,229.73,229.73,229.73,113.9,17.99,17.99,0,19.99,116.22,116.22,229.73
4029750,300,88312,,,,,,,PAS STAIN,197.13,78.85,0,169.86,167.56,SKIPPED,169.86,169.86,167.56,167.56,167.56,107.78,96.59,96.59,0,59.14,109.98,109.98,167.56
4029751,301,83013,,,,,,,H PYLORI BREATH TEST,366.73,146.69,0,316.01,311.72,SKIPPED,316.01,316.01,311.72,311.72,311.72,154.54,56.58,56.58,0,62.87,157.69,157.69,311.72
4029752,301,78267,,,,,,,H PYLORI BREATH COLLECTION,31.91,12.76,0,31.91,27.12,SKIPPED,31.91,31.91,27.12,27.12,27.12,13.45,9.29,9.29,0,9.29,13.72,13.72,27.12
4029754,301,99195,,,,,,,THERAPEUTIC PHLEBOTOMY,245.04,98.02,0,245.04,208.28,SKIPPED,245.04,245.04,208.28,208.28,208.28,96.61,120.07,120.07,0,73.51,98.58,98.58,208.28
4029755,300,87385,,,,,,,HISTOPLASMOSIS URINARY ANTIGEN,229.73,91.89,0,195.27,195.27,SKIPPED,56.24,56.24,195.27,195.27,195.27,96.8,11.13,11.13,0,11.19,98.78,98.78,195.27
4029756,300,86021,,,,,,,MYELOPEROXIDASE AB,81.98,32.79,0,70.64,69.68,SKIPPED,70.64,70.64,69.68,69.68,69.68,34.54,12.64,12.64,0,14.05,35.25,35.25,69.68
4029757,300,86606,,,,,,,ASPERGILLUS AB,81.98,32.79,0,70.64,69.68,SKIPPED,70.64,70.64,69.68,69.68,69.68,34.54,12.64,12.64,0,14.05,35.25,35.25,69.68
4029758,360,,,,,,,,FUNGAL SEROLOGY,216.97,86.79,0,184.42,184.42,SKIPPED,164.9,164.9,184.42,184.42,184.42,91.43,0,0,0,65.09,93.3,93.3,184.42
4029760,300,86698,,,,,,,HISTOPALASMOSIS SERUM AB,68.05,27.22,0,58.63,57.84,SKIPPED,58.63,58.63,57.84,57.84,57.84,28.67,11.58,11.58,0,11.66,29.26,29.26,57.84
4029761,300,88334,,,,,,,INTRAOPERATIVE TOUCH PREP,71.22,28.49,0,61.37,60.54,SKIPPED,61.37,61.37,60.54,60.54,60.54,54.11,34.9,34.9,0,21.37,55.21,55.21,60.54
4029762,300,88173,,,,,,,FNA INTERP & REPORT,197.13,78.85,0,169.86,167.56,SKIPPED,169.86,169.86,167.56,167.56,167.56,150.42,96.59,96.59,0,59.14,153.49,153.49,167.56
4029763,300,81291,,,,,,,METHYLFOLATE REDUCTASE,257.69,103.08,0,248.29,219.04,SKIPPED,248.29,248.29,219.04,219.04,219.04,108.59,54.89,54.89,0,54.89,110.81,110.81,219.04
4029764,300,81401,,,,,,,TPMT,604.17,241.67,0,520.6,513.54,SKIPPED,520.6,520.6,513.54,513.54,513.54,254.59,115.08,115.08,0,115.08,259.79,259.79,513.54
4029765,300,87798,,,,,,,MUMPS VIRUS RNA QUAL PCR,191.09,76.44,0,164.65,162.43,SKIPPED,164.65,164.65,162.43,162.43,162.43,80.53,29.48,29.48,0,32.75,82.17,82.17,162.43
4029766,310,81225,,,,,,,CYP2C19 GENE,1284.9,513.96,0,1107.17,1092.16,SKIPPED,1107.17,1107.17,1092.16,1092.16,1092.16,541.46,244.74,244.74,0,244.74,552.51,552.51,1092.16
4029767,310,81226,,,,,,,CYP2D6 GENE,1988.51,795.4,0,1713.46,1690.23,SKIPPED,1713.46,1713.46,1690.23,1690.23,1690.23,837.96,378.76,378.76,0,378.76,855.06,855.06,1690.23
4029768,310,81227,,,,,,,CYP2C9 GENE,770.91,308.36,0,664.28,655.27,SKIPPED,664.28,664.28,655.27,655.27,655.27,324.86,146.84,146.84,0,146.84,331.49,331.49,655.27
4029769,310,81355,,,,,,,VKORC1 GENE,388.96,155.58,0,335.16,330.62,SKIPPED,335.16,335.16,330.62,330.62,330.62,163.9,74.09,74.09,0,74.09,167.25,167.25,330.62
4029770,310,81240,,,,,,,F2 GENE,282,112.8,0,249.62,239.7,SKIPPED,249.62,249.62,239.7,239.7,239.7,118.83,55.18,55.18,0,55.18,121.26,121.26,239.7
4029771,310,81241,,,,,,,F5 GENE,332.69,133.08,0,286.67,282.79,SKIPPED,286.67,286.67,282.79,282.79,282.79,140.2,61.63,61.63,0,61.63,143.06,143.06,282.79
4029772,310,81291,,,,,,,MHTFR GENE,254.04,101.62,0,248.29,215.93,SKIPPED,248.29,248.29,215.93,215.93,215.93,107.06,54.89,54.89,0,54.89,109.24,109.24,215.93
4029773,310,81479,,,,,,,UNLISTED MOLECULAR PATH,911.63,364.65,0,774.89,774.89,SKIPPED,97.47,97.47,774.89,774.89,774.89,384.16,446.7,446.7,0,273.49,392,392,774.89
4029774,310,81401,,,,,,,MOLECULAR PATH PROC LVL. 2,606.88,242.75,0,520.6,515.85,SKIPPED,520.6,520.6,515.85,515.85,515.85,255.74,115.08,115.08,0,115.08,260.96,260.96,515.85
4029776,300,86612,,,,,,,BLASTOMYCES,70.26,28.1,0,60.53,59.72,SKIPPED,60.53,60.53,59.72,59.72,59.72,29.61,10.84,10.84,0,12.05,30.21,30.21,59.72
4029777,300,86635,,,,,,,COCCIDIOIDES ANTIBODY,62.49,25,0,53.85,53.12,SKIPPED,53.85,53.85,53.12,53.12,53.12,26.33,9.63,9.63,0,10.71,26.87,26.87,53.12
4029779,301,80051,,,,,,,EPOC CHEM PANEL,66.85,26.74,0,56.82,56.82,SKIPPED,32.91,32.91,56.82,56.82,56.82,28.18,5.89,5.89,0,6.54,28.75,28.75,56.82
4029785,301,80320,,,,,,,OCCUPATIONAL HEALTH-ETOH,14.7,5.88,0,12.5,12.5,SKIPPED,0,0,12.5,12.5,12.5,6.19,9.42,9.42,0,9.42,6.32,6.32,12.5
4029786,301,80307,,,,,,,OCCOUPATIONAL HEALTH-AMP,13.23,5.29,0,13.23,11.25,SKIPPED,13.23,13.23,11.25,11.25,11.25,5.58,13.23,13.23,0,13.23,5.69,5.69,11.25
4029787,301,80307,,,,,,,OCCUPATIONAL HEALTH-BARB,12.6,5.04,0,12.6,10.71,SKIPPED,12.6,12.6,10.71,10.71,10.71,5.31,12.6,12.6,0,12.6,5.42,5.42,10.71
4029788,301,80307,,,,,,,OCCUPATIONAL HEALTH-BENZO,12.6,5.04,0,12.6,10.71,SKIPPED,12.6,12.6,10.71,10.71,10.71,5.31,12.6,12.6,0,12.6,5.42,5.42,10.71
4029789,301,80307,,,,,,,OCCUPATIONAL HEALTH-COC,12.6,5.04,0,12.6,10.71,SKIPPED,12.6,12.6,10.71,10.71,10.71,5.31,12.6,12.6,0,12.6,5.42,5.42,10.71
4029790,301,80307,,,,,,,OCCUPATIONAL HEALTH-OPI,12.6,5.04,0,12.6,10.71,SKIPPED,12.6,12.6,10.71,10.71,10.71,5.31,12.6,12.6,0,12.6,5.42,5.42,10.71
4029791,301,80307,,,,,,,OCCUPATIONAL HEALTH-THC,12.6,5.04,0,12.6,10.71,SKIPPED,12.6,12.6,10.71,10.71,10.71,5.31,12.6,12.6,0,12.6,5.42,5.42,10.71
4029792,302,86757,,,,,,,ROCKY MOUNTAIN SPOTTED FEVER IgG & IgM,105.4,42.16,0,90.82,89.59,SKIPPED,90.82,90.82,89.59,89.59,89.59,44.41,16.25,16.25,0,18.07,45.32,45.32,89.59
4029793,302,86757,,,,,,,TYPHUS FEVER AB/RICKETTSIA IgG,105.4,42.16,0,90.82,89.59,SKIPPED,90.82,90.82,89.59,89.59,89.59,44.41,16.25,16.25,0,18.07,45.32,45.32,89.59
4029794,302,86757,,,,,,,ROCKY MNT.SPOTTED FEVER/TYPHUS FEVER AB,105.4,42.16,0,90.82,89.59,SKIPPED,90.82,90.82,89.59,89.59,89.59,44.41,16.25,16.25,0,18.07,45.32,45.32,89.59
4029795,300,87799,,,,,,,EBV PCR QNT,233.21,93.28,0,200.94,198.23,SKIPPED,200.94,200.94,198.23,198.23,198.23,98.27,35.99,35.99,0,39.98,100.28,100.28,198.23
4029796,300,87799,,,,,,,BK VIRUS PCR QNT,300.98,120.39,0,255.83,255.83,SKIPPED,200.94,200.94,255.83,255.83,255.83,126.83,35.99,35.99,0,39.98,129.42,129.42,255.83
4029797,300,36591,,,,,,,DRAW BLOOD OFF VENOUS DEVICE,463.23,185.29,0,399.15,393.75,SKIPPED,399.15,399.15,393.75,393.75,393.75,25.46,226.98,226.98,0,138.97,25.98,25.98,393.75
4029798,300,36592,,,,,,,COLLECT BLOOD FROM PICC,463.23,185.29,0,463.23,393.75,SKIPPED,463.23,463.23,393.75,393.75,393.75,28.37,226.98,226.98,0,138.97,28.95,28.95,393.75
4029800,302,86800,,,,,,,THYROGLOBULIN AB,86.61,34.64,0,74.63,73.62,SKIPPED,74.63,74.63,73.62,73.62,73.62,36.5,13.36,13.36,0,14.84,37.24,37.24,73.62
4029802,300,87502,,,,,,,FLU A/B RAPID PCR,192.94,77.18,0,192.94,164,SKIPPED,192.94,192.94,164,164,164,81.3,80.47,80.47,0,80.47,82.96,82.96,164
4029803,302,87631,,,,,,,FLU A/B & RSV RAPID PCR,196.25,78.5,0,196.25,166.81,SKIPPED,196.25,196.25,166.81,166.81,166.81,82.7,119.81,119.81,0,119.81,84.39,84.39,166.81
4029804,302,87651,,,,,,,STREP RAPID PCR,105.84,42.34,0,105.84,89.96,SKIPPED,105.84,105.84,89.96,89.96,89.96,44.6,29.48,29.48,0,32.75,45.51,45.51,89.96
4029805,300,86360,,,,,,,CD4/CD8 LYMPHOCYTE ENUMERATION,88.2,35.28,0,88.2,74.97,SKIPPED,88.2,88.2,74.97,74.97,74.97,37.17,39.46,39.46,0,43.85,37.93,37.93,74.97
4029806,300,86356,,,,,,,NATURAL KILLER CELL,606.38,242.55,0,515.42,515.42,SKIPPED,125.63,125.63,515.42,515.42,515.42,255.53,22.5,22.5,0,24.99,260.74,260.74,515.42
4029807,300,86359,,,,,,,TOTAL T AND B CELL COUNT,233.73,93.49,0,198.67,198.67,SKIPPED,177,177,198.67,198.67,198.67,98.49,31.69,31.69,0,35.21,100.5,100.5,198.67
4029808,300,82390,,,,,,,CERULOPLASMIN,88.2,35.28,0,74.97,74.97,SKIPPED,50.39,50.39,74.97,74.97,74.97,37.17,9.02,9.02,0,10.02,37.93,37.93,74.97
4029809,300,83516,,,,,,,MAG 1GM ANTIBODIES,187.43,74.97,0,159.32,159.32,SKIPPED,54.11,54.11,159.32,159.32,159.32,78.98,9.69,9.69,0,10.76,80.59,80.59,159.32
4029810,300,84590,,,,,,,VITAMIN A,66.15,26.46,0,56.23,56.23,SKIPPED,54.45,54.45,56.23,56.23,56.23,27.87,9.75,9.75,0,10.84,28.44,28.44,56.23
4029811,300,84446,,,,,,,VITAMIN E,39.69,15.88,0,39.69,33.74,SKIPPED,39.69,39.69,33.74,33.74,33.74,16.73,11.91,11.91,0,13.23,17.07,17.07,33.74
4029812,302,86757,,,,,,,Rickettsia Typhus AB IgG / IgM,154.35,61.74,0,131.2,131.2,SKIPPED,90.82,90.82,131.2,131.2,131.2,65.04,16.25,16.25,0,18.07,66.37,66.37,131.2
4029813,306,U0004,,,,,,,COVID-19 SCREENING,157.5,63,0,133.88,133.88,SKIPPED,119.7,119.7,133.88,133.88,133.88,66.38,75,75,0,47.25,67.73,67.73,133.88
4029814,302,87635,,,,,,,COVID-19 ANTIBODIES SCREENING,52.5,21,0,52.5,51.31,SKIPPED,52.5,52.5,44.62,44.62,44.62,22.13,51.33,51.33,0,15.75,22.58,22.58,44.62
4029815,302,83516,,,,,,,ANTI SRP AB,288.75,115.5,0,245.44,245.44,SKIPPED,54.11,54.11,245.44,245.44,245.44,121.68,9.69,9.69,0,10.76,124.16,124.16,245.44
4029816,302,83516,,,,,,,M 1-2 AB,220.5,88.2,0,187.42,187.42,SKIPPED,54.11,54.11,187.42,187.42,187.42,92.92,9.69,9.69,0,10.76,94.82,94.82,187.42
4029817,302,86235,,,,,,,RNP AB,31.5,12.6,0,31.5,26.78,SKIPPED,31.5,31.5,26.78,26.78,26.78,13.28,15.06,15.06,0,16.74,13.55,13.55,26.78
4029818,302,86235,,,,,,,SMITH AB,17.85,7.14,0,17.85,15.17,SKIPPED,17.85,17.85,15.17,15.17,15.17,7.53,15.06,15.06,0,16.74,7.68,7.68,15.17
4029819,301,80307,,,,,,,ETHANOL(URINE),32.55,13.02,0,32.55,27.67,SKIPPED,32.55,32.55,27.67,27.67,27.67,13.72,32.55,32.55,0,32.55,14,14,27.67
4029820,301,80323,,,,,,,NICOTINE,168,67.2,0,142.8,142.8,SKIPPED,0,0,142.8,142.8,142.8,70.8,17.09,17.09,0,17.09,72.24,72.24,142.8
4029821,302,82784,,,,,,,IMMUNOGLOULIN PROFILE,337.58,135.03,0,286.94,286.94,SKIPPED,43.62,43.62,286.94,286.94,286.94,142.26,7.81,7.81,0,8.69,145.16,145.16,286.94
4029822,302,86235,,,,,,,ANTI-JP AB,42,16.8,0,42,35.7,SKIPPED,42,42,35.7,35.7,35.7,17.7,15.06,15.06,0,16.74,18.06,18.06,35.7
4029823,301,83498,,,,,,,17-HYDROXY PROGESTERONE,34.13,13.65,0,34.13,29.01,SKIPPED,34.13,34.13,29.01,29.01,29.01,14.39,22.82,22.82,0,25.36,14.68,14.68,29.01
4029824,302,84445,,,,,,,THYROID STIMULATING IMM.,126,50.4,0,126,107.1,SKIPPED,126,126,107.1,107.1,107.1,53.1,42.72,42.72,0,47.47,54.18,54.18,107.1
4029825,301,84591,,,,,,,VITAMIN B3(NIACIN),443.1,177.24,0,376.64,376.64,SKIPPED,64.83,64.83,376.64,376.64,376.64,186.72,14.33,14.33,0,14.33,190.53,190.53,376.64
4029826,301,83018,,,,,,,IODINE(SERUM),128.63,51.45,0,109.34,109.34,SKIPPED,103.06,103.06,109.34,109.34,109.34,54.2,18.45,18.45,0,20.5,55.31,55.31,109.34
4029827,302,83516,,,,,,,MITOCHONDRIAL M2 AB,33.6,13.44,0,33.6,28.56,SKIPPED,33.6,33.6,28.56,28.56,28.56,14.16,9.69,9.69,0,10.76,14.45,14.45,28.56
4029828,302,86376,,,,,,,LKM AB (LIVER-KIDNEY MITOCHONDRIAL AB),83.37,33.35,0,70.86,70.86,SKIPPED,68.25,68.25,70.86,70.86,70.86,35.13,12.22,12.22,0,13.58,35.85,35.85,70.86
4029829,300,U0005,,,,,,,COVID-19 SCREENING< 2 DAYS,52.5,21,0,44.62,44.62,SKIPPED,39.9,39.9,44.62,44.62,44.62,22.13,25,25,0,15.75,22.58,22.58,44.62
4029831,301,83921,,,,,,,"METHYMALONIC ACID, SERUM",69.3,27.72,0,69.3,58.9,SKIPPED,69.3,69.3,58.9,58.9,58.9,29.2,17.82,17.82,0,17.82,29.8,29.8,58.9
4029832,302,86978,,,,,,,PHENOTYPE ADSORPTION TEST,162.75,65.1,0,138.34,138.34,SKIPPED,120.84,120.84,138.34,138.34,138.34,68.58,79.75,79.75,0,48.82,69.98,69.98,138.34
4029833,302,0084U,,,,,,,MOLECULAR RBC GENOTYPE,279.3,111.72,0,237.4,237.4,SKIPPED,71.63,71.63,237.4,237.4,237.4,117.7,136.86,136.86,0,83.79,120.1,120.1,237.4
4029834,302,86972,,,,,,,PRETREAT RBCS,64.05,25.62,0,64.05,54.44,SKIPPED,64.05,64.05,54.44,54.44,54.44,26.99,31.38,31.38,0,19.22,27.54,27.54,54.44
4029835,302,86870,,,,,,,ABID PANEL,162.75,65.1,0,162.75,138.34,SKIPPED,162.75,162.75,138.34,138.34,138.34,68.58,79.75,79.75,0,48.82,69.98,69.98,138.34
4029836,302,84597,,,,,,,VITAMIN K1,172.2,68.88,0,146.37,146.37,SKIPPED,64.37,64.37,146.37,146.37,146.37,72.57,11.52,11.52,0,12.8,74.05,74.05,146.37
4029837,300,87811,,,,,,,COVID ANTIGEN,120.75,48.3,0,102.64,102.64,SKIPPED,91.77,91.77,102.64,102.64,102.64,50.88,41.38,41.38,0,36.22,51.92,51.92,102.64
4029838,300,88377,,,,,,,FLUORESCENCE IN SITU HYBRIDIZATION(FISH),661.5,264.6,0,562.28,562.28,SKIPPED,490.88,490.88,562.28,562.28,562.28,387.05,324.14,324.14,0,198.45,394.95,394.95,562.28
4029839,302,86255,,,,,,,PHOSPHOLIPASE A2 RECEPTOR AB (IgG & TIT,569.1,227.64,0,483.74,483.74,SKIPPED,56.54,56.54,483.74,483.74,483.74,17.48,10.12,10.12,0,11.25,17.84,17.84,483.74
4029841,300,87536,,,,,,,HIV RNA QUANT,210,84,0,210,178.5,SKIPPED,210,210,178.5,178.5,178.5,88.49,71.48,71.48,0,79.42,90.3,90.3,178.5
4029842,300,80201,,,,,,,TOPIRAMATE,136.5,54.6,0,116.02,116.02,SKIPPED,55.94,55.94,116.02,116.02,116.02,57.53,10.01,10.01,0,11.12,58.7,58.7,116.02
4029843,300,88381,,,,,,,MICRODISSECTION MANUAL,189.58,75.83,0,204.43,161.14,SKIPPED,189.58,189.58,161.14,161.14,161.14,200.34,92.89,92.89,0,56.87,204.43,204.43,161.14
4060000,272,,,,,,,,"INFLATION DEVICE 13.5MM,14.5MM,15.5MM",89.28,35.71,0,75.89,75.89,SKIPPED,67.85,67.85,75.89,75.89,75.89,37.62,43.75,43.75,0,26.78,38.39,38.39,75.89
4060001,272,,,,,,,,WIRE GUIDED BALLOON CATH 8.5MM-20MM,479.93,191.97,0,407.94,407.94,SKIPPED,364.75,364.75,407.94,407.94,407.94,202.24,235.17,235.17,0,143.98,206.37,206.37,407.94
4060002,272,,,,,,,,EVERCROSS BALLOONS,290,116,0,246.5,246.5,SKIPPED,220.4,220.4,246.5,246.5,246.5,122.21,142.1,142.1,0,87,124.7,124.7,246.5
4060003,278,,,,,,,,NANOCROSS BALLOONS,695,278,0,590.75,590.75,SKIPPED,528.2,528.2,590.75,590.75,590.75,292.87,340.55,340.55,0,208.5,298.85,298.85,590.75
4060004,272,,,,,,,,CHOCOLATE BALLOONS,1937.5,775,0,1646.88,1646.88,SKIPPED,1472.5,1472.5,1646.88,1646.88,1646.88,816.47,949.38,949.38,0,581.25,833.13,833.13,1646.88
4060005,272,,,,,,,,IN PACT ADMIRAL DRUG COATED BALLOON,4900,1960,0,4165,4165,SKIPPED,3724,3724,4165,4165,4165,2064.86,2401,2401,0,1470,2107,2107,4165
4060006,272,,,,,,,,IN PACT AV DRUG COATED BALLOON,5975,2390,0,5078.75,5078.75,SKIPPED,4541,4541,5078.75,5078.75,5078.75,2517.86,2927.75,2927.75,0,1792.5,2569.25,2569.25,5078.75
4060007,278,C1876,,,,,,,EVERFLEX SELF EXPANDING STENTS,5375,2150,0,4568.75,4568.75,SKIPPED,4085,4085,4568.75,4568.75,4568.75,2265.02,2633.75,2633.75,0,1612.5,2311.25,2311.25,4568.75
4060008,272,,,,,,,,EVERFLEX ENTRUST SELF EXPANDING BALLOON,4147.5,1659,0,3525.38,3525.38,SKIPPED,3152.1,3152.1,3525.38,3525.38,3525.38,1747.76,2032.28,2032.28,0,1244.25,1783.43,1783.43,3525.38
4060009,278,C1876,,,,,,,VISPRO BALLOON EXPANDABLE STENTS,2647.5,1059,0,2250.38,2250.38,SKIPPED,2012.1,2012.1,2250.38,2250.38,2250.38,1115.66,1297.28,1297.28,0,794.25,1138.43,1138.43,2250.38
4060010,278,C1876,,,,,,,PROTEGE GPS SELF EXPANDING STENTS,2660,1064,0,2261,2261,SKIPPED,2021.6,2021.6,2261,2261,2261,1120.92,1303.4,1303.4,0,798,1143.8,1143.8,2261
4060011,278,,,,,,,,TRAAILBLAZER SUPPORT CATH,360,144,0,306,306,SKIPPED,273.6,273.6,306,306,306,151.7,176.4,176.4,0,108,154.8,154.8,306
4060012,272,C1726,,,,,,,ANGLED TRAILBLAZER SUPPORT CATH,467.5,187,0,397.38,397.38,SKIPPED,355.3,355.3,397.38,397.38,397.38,197.01,229.08,229.08,0,140.25,201.03,201.03,397.38
4060013,272,,,,,,,,AMP LAZY GOOSE NECK SNARES,767.5,307,0,652.38,652.38,SKIPPED,583.3,583.3,652.38,652.38,652.38,323.43,376.08,376.08,0,230.25,330.03,330.03,652.38
4060014,272,,,,,,,,CRAIG-MCNAMARA INFUSION CATH,187.5,75,0,159.38,159.38,SKIPPED,142.5,142.5,159.38,159.38,159.38,79.02,91.88,91.88,0,56.25,80.63,80.63,159.38
4060015,272,,,,,,,,NITREX GUIDEWIRE,145,58,0,123.25,123.25,SKIPPED,110.2,110.2,123.25,123.25,123.25,61.1,71.05,71.05,0,43.5,62.35,62.35,123.25
4060016,272,,,,,,,,WHOLEY GUIDEWIRES,342.5,137,0,291.12,291.12,SKIPPED,260.3,260.3,291.12,291.12,291.12,144.33,167.82,167.82,0,102.75,147.28,147.28,291.12
4060017,272,,,,,,,,VIANCE CROSSING CATH,4195,1678,0,3565.75,3565.75,SKIPPED,3188.2,3188.2,3565.75,3565.75,3565.75,1767.77,2055.55,2055.55,0,1258.5,1803.85,1803.85,3565.75
4060018,272,,,,,,,,SPIDER FX EMBOLIC PROTECTION DEVICE,3452.5,1381,0,2934.62,2934.62,SKIPPED,2623.9,2623.9,2934.62,2934.62,2934.62,1454.89,1691.72,1691.72,0,1035.75,1484.58,1484.58,2934.62
4060019,272,,,,,,,,HAWKONE DIRECTIONAL ATHERECTOMY,9050,3620,0,7692.5,7692.5,SKIPPED,6878,6878,7692.5,7692.5,7692.5,3813.67,4434.5,4434.5,0,2715,3891.5,3891.5,7692.5
4060020,272,,,,,,,,EVEREST 30 SURVIVAL KIT,100,40,0,85,85,SKIPPED,76,76,85,85,85,42.14,49,49,0,30,43,43,85
4060021,272,,,,,,,,ANGIO PACK,125,50,0,106.25,106.25,SKIPPED,95,95,106.25,106.25,106.25,52.68,61.25,61.25,0,37.5,53.75,53.75,106.25
4060022,481,75630,,,,,,,AORTOGRAPHY ABDL BI LOW EXTRM CATH RS&I,6030.43,2412.17,0,6030.43,5125.87,SKIPPED,6030.43,6030.43,5125.87,5125.87,5125.87,2541.22,3605.69,3605.69,0,1600.34,2593.08,2593.08,5125.87
4060023,975,75630,,,,,,,AORTOGRAPHY ABDL BI LOW EXTRM CATH RS&I,210.78,84.31,0,210.78,179.16,SKIPPED,210.78,210.78,179.16,179.16,179.16,104.01,210.78,210.78,0,210.78,106.13,106.13,0
4060024,975,36569,,,,,,,PICC LINE PLACEMENT,207.43,82.97,0,207.43,176.32,SKIPPED,207.43,207.43,176.32,176.32,176.32,101.91,101.64,101.64,SKIPPED,SKIPPED,103.99,103.99,0
4060025,272,,,,,,,,PACIFIC PULSE,581.63,232.65,0,494.39,494.39,SKIPPED,442.04,442.04,494.39,494.39,494.39,245.1,285,285,0,174.49,250.1,250.1,494.39
4060026,272,,,,,,,,PACIFIC EXTREME,594,237.6,0,504.9,504.9,SKIPPED,451.44,451.44,504.9,504.9,504.9,250.31,291.06,291.06,0,178.2,255.42,255.42,504.9
4060027,272,,,,,,,,FORTREX,433.13,173.25,0,368.16,368.16,SKIPPED,329.18,329.18,368.16,368.16,368.16,182.52,212.23,212.23,0,129.94,186.25,186.25,368.16
4060028,272,,,,,,,,300CM INT MODIFIED GUIDEWIRE,1024.8,409.92,0,871.08,871.08,SKIPPED,778.85,778.85,871.08,871.08,871.08,431.85,502.15,502.15,0,307.44,440.66,440.66,871.08
4060029,272,,,,,,,,MEDTRONIC INFINITI,30,12,0,25.5,25.5,SKIPPED,22.8,22.8,25.5,25.5,25.5,12.64,14.7,14.7,0,9,12.9,12.9,25.5
4060030,272,,,,,,,,CATH LAB MULTIPAC,86,34.4,0,73.1,73.1,SKIPPED,65.36,65.36,73.1,73.1,73.1,36.24,42.14,42.14,0,25.8,36.98,36.98,73.1
4060031,272,,,,,,,,OUTBACK ELITE,6300,2520,0,5355,5355,SKIPPED,4788,4788,5355,5355,5355,2654.82,3087,3087,0,1890,2709,2709,5355
4060032,272,,,,,,,,VISTABRITE TIP,262,104.8,0,222.7,222.7,SKIPPED,199.12,199.12,222.7,222.7,222.7,110.41,128.38,128.38,0,78.6,112.66,112.66,222.7
4060033,272,,,,,,,,WHOLEY MOD GUIDEWIRE .035,479,191.6,0,407.15,407.15,SKIPPED,364.04,364.04,407.15,407.15,407.15,201.85,234.71,234.71,0,143.7,205.97,205.97,407.15
4060034,272,,,,,,,,GR GS GUIDEWIRE,196,78.4,0,166.6,166.6,SKIPPED,148.96,148.96,166.6,166.6,166.6,82.59,96.04,96.04,0,58.8,84.28,84.28,166.6
4060035,272,,,,,,,,DIRECT ATHER 7/6 DEVICE,12670,5068,0,10769.5,10769.5,SKIPPED,9629.2,9629.2,10769.5,10769.5,10769.5,5339.14,6208.3,6208.3,0,3801,5448.1,5448.1,10769.5
4060036,272,,,,,,,,SPIDER FX PROTECTION DEVICE,4834,1933.6,0,4108.9,4108.9,SKIPPED,3673.84,3673.84,4108.9,4108.9,4108.9,2037.05,2368.66,2368.66,0,1450.2,2078.62,2078.62,4108.9
4060037,272,,,,,,,,GORE-VBCR0607,10668,4267.2,0,9067.8,9067.8,SKIPPED,8107.68,8107.68,9067.8,9067.8,9067.8,4495.5,5227.32,5227.32,0,3200.4,4587.24,4587.24,9067.8
4060038,272,,,,,,,,VIANCE VNC FXCD,5873,2349.2,0,4992.05,4992.05,SKIPPED,4463.48,4463.48,4992.05,4992.05,4992.05,2474.88,2877.77,2877.77,0,1761.9,2525.39,2525.39,4992.05
4060039,272,,,,,,,,POWER PULSE-BOSTON SCIENTIFIC,126,50.4,0,107.1,107.1,SKIPPED,95.76,95.76,107.1,107.1,107.1,53.1,61.74,61.74,0,37.8,54.18,54.18,107.1
4060040,272,,,,,,,,AVX CONTRAST INJ,2719.5,1087.8,0,2311.58,2311.58,SKIPPED,2066.82,2066.82,2311.58,2311.58,2311.58,1146,1332.56,1332.56,0,815.85,1169.39,1169.39,2311.58
4060041,272,,,,,,,,SOLENT CATHETER,7367,2946.8,0,6261.95,6261.95,SKIPPED,5598.92,5598.92,6261.95,6261.95,6261.95,3104.45,3609.83,3609.83,0,2210.1,3167.81,3167.81,6261.95
4060042,272,,,,,,,,ZELANTE DVT,7637,3054.8,0,6491.45,6491.45,SKIPPED,5804.12,5804.12,6491.45,6491.45,6491.45,3218.23,3742.13,3742.13,0,2291.1,3283.91,3283.91,6491.45
4060043,272,,,,,,,,V-18 CONTROL WIRE,392,156.8,0,333.2,333.2,SKIPPED,297.92,297.92,333.2,333.2,333.2,165.19,192.08,192.08,0,117.6,168.56,168.56,333.2
4060044,272,,,,,,,,TERUMO ASVIP6,7525,3010,0,6396.25,6396.25,SKIPPED,5719,5719,6396.25,6396.25,6396.25,3171.04,3687.25,3687.25,0,2257.5,3235.75,3235.75,6396.25
4060045,272,,,,,,,,TERUMO ASVIP8,7525,3010,0,6396.25,6396.25,SKIPPED,5719,5719,6396.25,6396.25,6396.25,3171.04,3687.25,3687.25,0,2257.5,3235.75,3235.75,6396.25
4060046,272,,,,,,,,TERUMO ASEVO6,7700,3080,0,6545,6545,SKIPPED,5852,5852,6545,6545,6545,3244.78,3773,3773,0,2310,3311,3311,6545
4060047,272,,,,,,,,TERUMO ASEVO8,7700,3080,0,6545,6545,SKIPPED,5852,5852,6545,6545,6545,3244.78,3773,3773,0,2310,3311,3311,6545
4060048,272,,,,,,,,TERUMO FINE CROSS GUIDE,1855,742,0,1576.75,1576.75,SKIPPED,1409.8,1409.8,1576.75,1576.75,1576.75,781.7,908.95,908.95,0,556.5,797.65,797.65,1576.75
4060049,272,,,,,,,,TERUMO HEART TRAIL 3,343,137.2,0,291.55,291.55,SKIPPED,260.68,260.68,291.55,291.55,291.55,144.54,168.07,168.07,0,102.9,147.49,147.49,291.55
4060050,272,,,,,,,,TERUMO OP2,578,231.2,0,491.3,491.3,SKIPPED,439.28,439.28,491.3,491.3,491.3,243.57,283.22,283.22,0,173.4,248.54,248.54,491.3
4060051,272,,,,,,,,TERUMO OP1,833,333.2,0,708.05,708.05,SKIPPED,633.08,633.08,708.05,708.05,708.05,351.03,408.17,408.17,0,249.9,358.19,358.19,708.05
4060052,272,,,,,,,,TERUMO GR16,2450,980,0,2082.5,2082.5,SKIPPED,1862,1862,2082.5,2082.5,2082.5,1032.43,1200.5,1200.5,0,735,1053.5,1053.5,2082.5
4060053,272,,,,,,,,TERUMO GR14,371,148.4,0,315.35,315.35,SKIPPED,281.96,281.96,315.35,315.35,315.35,156.34,181.79,181.79,0,111.3,159.53,159.53,315.35
4060054,272,,,,,,,,TERUMO GR13,1855,742,0,1576.75,1576.75,SKIPPED,1409.8,1409.8,1576.75,1576.75,1576.75,781.7,908.95,908.95,0,556.5,797.65,797.65,1576.75
4060055,278,,,,,,,,DUAL TEMPORARY PACEMAKER,24238,9695.2,0,20602.3,20602.3,SKIPPED,18420.88,18420.88,20602.3,20602.3,20602.3,10213.89,11876.62,11876.62,0,7271.4,10422.34,10422.34,20602.3
4060056,278,,,,,,,,SINGLE TEMPORARY PACEMAKER,12722,5088.8,0,10813.7,10813.7,SKIPPED,9668.72,9668.72,10813.7,10813.7,10813.7,5361.05,6233.78,6233.78,0,3816.6,5470.46,5470.46,10813.7
4060057,278,C1876,,,,,,,MEDTRONIC STENTS,4865,1946,0,4135.25,4135.25,SKIPPED,3697.4,3697.4,4135.25,4135.25,4135.25,2050.11,2383.85,2383.85,0,1459.5,2091.95,2091.95,4135.25
4060058,278,C1876,,,,,,,BAREMETAL STENTS,4865,1946,0,4135.25,4135.25,SKIPPED,3697.4,3697.4,4135.25,4135.25,4135.25,2050.11,2383.85,2383.85,0,1459.5,2091.95,2091.95,4135.25
4060059,272,,,,,,,,SPRINTER BALLONS,490,196,0,416.5,416.5,SKIPPED,372.4,372.4,416.5,416.5,416.5,206.49,240.1,240.1,0,147,210.7,210.7,416.5
4060060,272,,,,,,,,GUIDE CATH,158,63.2,0,134.3,134.3,SKIPPED,120.08,120.08,134.3,134.3,134.3,66.58,77.42,77.42,0,47.4,67.94,67.94,134.3
4060061,272,,,,,,,,CORO GUIDEWIRES,263,105.2,0,223.55,223.55,SKIPPED,199.88,199.88,223.55,223.55,223.55,110.83,128.87,128.87,0,78.9,113.09,113.09,223.55
4060062,272,,,,,,,,MEDTRONIC EXPORT CATH,2013,805.2,0,1711.05,1711.05,SKIPPED,1529.88,1529.88,1711.05,1711.05,1711.05,848.28,986.37,986.37,0,603.9,865.59,865.59,1711.05
4060063,272,,,,,,,,MEDTRONIC INFLATION DEVICE,263,105.2,0,223.55,223.55,SKIPPED,199.88,199.88,223.55,223.55,223.55,110.83,128.87,128.87,0,78.9,113.09,113.09,223.55
4060064,272,,,,,,,,MEDTRONIC PTCA-Y-ADAPTOR KIT,928,371.2,0,788.8,788.8,SKIPPED,705.28,705.28,788.8,788.8,788.8,391.06,454.72,454.72,0,278.4,399.04,399.04,788.8
4060065,272,,,,,,,,MEDTRONIC PTCA AC4002,1663,665.2,0,1413.55,1413.55,SKIPPED,1263.88,1263.88,1413.55,1413.55,1413.55,700.79,814.87,814.87,0,498.9,715.09,715.09,1413.55
4060066,272,,,,,,,,MEDTRONIC PTCA INFLATION,140,56,0,119,119,SKIPPED,106.4,106.4,119,119,119,59,68.6,68.6,0,42,60.2,60.2,119
4060067,272,,,,,,,,DIAG. CATH,875,350,0,743.75,743.75,SKIPPED,665,665,743.75,743.75,743.75,368.72,428.75,428.75,0,262.5,376.25,376.25,743.75
4060068,272,,,,,,,,MEDTRONIC N/S ANGIOWIRES,3850,1540,0,3272.5,3272.5,SKIPPED,2926,2926,3272.5,3272.5,3272.5,1622.39,1886.5,1886.5,0,1155,1655.5,1655.5,3272.5
4060069,272,,,,,,,,MEDTRONIC ANGIO GUIDEWIRES,536,214.4,0,455.6,455.6,SKIPPED,407.36,407.36,455.6,455.6,455.6,225.87,262.64,262.64,0,160.8,230.48,230.48,455.6
4060070,272,,,,,,,,MEDTRONIC CORONARY INTRODUCERS,263,105.2,0,223.55,223.55,SKIPPED,199.88,199.88,223.55,223.55,223.55,110.83,128.87,128.87,0,78.9,113.09,113.09,223.55
4060071,481,93320,,,,,,,DOPPLER ECHO EXAM HEART,810.12,324.05,0,688.6,688.6,SKIPPED,173.9,173.9,688.6,688.6,688.6,341.38,396.96,396.96,0,243.04,348.35,348.35,688.6
4060072,972,93320,,,,,,,DOPPLER ECHO EXAM HEART,115,46,0,115,97.75,SKIPPED,115,115,97.75,97.75,97.75,19.89,56.35,56.35,0,34.5,20.3,20.3,0
4060073,481,93325,,,,,,,DOPPLER COLOR FLOW ADD-ON,718.83,287.53,0,611.01,611.01,SKIPPED,109.11,109.11,611.01,611.01,611.01,302.92,352.23,352.23,0,215.65,309.1,309.1,611.01
4060074,972,93325,,,,,,,DOPPLER COLOR FLOW ADD-ON,53.06,21.22,0,53.06,45.1,SKIPPED,53.06,53.06,45.1,45.1,45.1,3.47,26,26,0,15.92,3.54,3.54,0
4060075,481,36200,,,,,,,INTRO CATH AORTA,2566.62,1026.65,0,2181.63,2181.63,SKIPPED,0,0,2181.63,2181.63,2181.63,1081.58,1257.64,1257.64,0,769.99,1103.65,1103.65,2181.63
4060076,972,36200,,,,,,,INTRO CATH AORTA,305.37,122.15,0,259.56,259.56,SKIPPED,0,0,259.56,259.56,259.56,147.77,149.63,149.63,0,91.61,150.79,150.79,0
4060077,270,,,,,,,,PHILLIPS CO2/O2 NC,25,10,0,21.25,21.25,SKIPPED,19,19,21.25,21.25,21.25,10.54,12.25,12.25,0,7.5,10.75,10.75,21.25
4060078,272,,,,,,,,SOFT-UV OMNI FLUSH 5F X 65 CM,30,12,0,25.5,25.5,SKIPPED,22.8,22.8,25.5,25.5,25.5,12.64,14.7,14.7,0,9,12.9,12.9,25.5
4060079,270,,,,,,,,BAG DECANTER,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,8.5,4.21,4.9,4.9,0,3,4.3,4.3,8.5
4060080,270,,,,,,,,SINGLE USE LIGHT SHIELD,20,8,0,17,17,SKIPPED,15.2,15.2,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4060081,272,,,,,,,,MERIT HIGH PRESSURE TUBING,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,8.5,4.21,4.9,4.9,0,3,4.3,4.3,8.5
4060082,272,,,,,,,,MERIT DISPOSABLE DEPOT 1400,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,8.5,4.21,4.9,4.9,0,3,4.3,4.3,8.5
4060083,272,,,,,,,,ABBOTT PERCLISE 6FR,350,140,0,297.5,297.5,SKIPPED,266,266,297.5,297.5,297.5,147.49,171.5,171.5,0,105,150.5,150.5,297.5
4060084,272,,,,,,,,MERIT MEDICAL CUSTOM MANIFOLD KIT,15,6,0,12.75,12.75,SKIPPED,11.4,11.4,12.75,12.75,12.75,6.32,7.35,7.35,0,4.5,6.45,6.45,12.75
4060085,272,,,,,,,,TERUMO NAVI CROSS 4 FR 135 CM,30,12,0,25.5,25.5,SKIPPED,22.8,22.8,25.5,25.5,25.5,12.64,14.7,14.7,0,9,12.9,12.9,25.5
4060086,272,,,,,,,,TERUMO TORQYUE DEVICE,282,112.8,0,239.7,239.7,SKIPPED,214.32,214.32,239.7,239.7,239.7,118.83,138.18,138.18,0,84.6,121.26,121.26,239.7
4060087,272,,,,,,,,VOLCANO 5FR IVUS CATH,938,375.2,0,797.3,797.3,SKIPPED,712.88,712.88,797.3,797.3,797.3,395.27,459.62,459.62,0,281.4,403.34,403.34,797.3
4060088,278,,,,,,,,AbreEx90120,3987.5,1595,0,3389.38,3389.38,SKIPPED,3030.5,3030.5,3389.38,3389.38,3389.38,1680.34,1953.88,1953.88,0,1196.25,1714.63,1714.63,3389.38
4060089,278,,,,,,,,AbreEx150,4562.5,1825,0,3878.12,3878.12,SKIPPED,3467.5,3467.5,3878.12,3878.12,3878.12,1922.64,2235.62,2235.62,0,1368.75,1961.88,1961.88,3878.12
4060090,481,36247,,,,,,,"SELECTIVE CATH PLACEMENT, INITIAL 3RD",3904.09,1561.64,0,3318.48,3318.48,SKIPPED,0,0,3318.48,3318.48,3318.48,1645.18,1913,1913,0,1171.23,1678.76,1678.76,3318.48
4060091,972,36247,,,,,,,"SELECTIVE CATH PLACEMENT, INITIAL 3RD",664.01,265.6,0,564.41,564.41,SKIPPED,0,0,564.41,564.41,564.41,319.52,325.36,325.36,0,199.2,326.04,326.04,0
4060092,272,,,,,,,,BDEXP BALLOON,1366.25,546.5,0,1161.31,1161.31,SKIPPED,1038.35,1038.35,1161.31,1161.31,1161.31,575.74,669.46,669.46,0,409.88,587.49,587.49,1161.31
4060093,481,37220,,,,,,,ILIAC REVASC ANGIOPLAST 1ST VSL,14236.32,5694.53,5999.19,14236.32,12100.87,SKIPPED,14236.32,14236.32,12100.87,12100.87,12100.87,5999.19,6975.8,6975.8,SKIPPED,SKIPPED,6121.62,6121.62,12100.87
4060094,972,37220,,,,,,,ILIAC REVASC ANGIOPLAST 1ST VSL,877.26,350.9,0,877.26,745.67,SKIPPED,877.26,877.26,745.67,745.67,745.67,423.89,429.86,429.86,SKIPPED,SKIPPED,432.54,432.54,0
4060095,481,37225,,,,,,,FEM/POP REVASC W/ATHER,25463.15,10185.26,10730.17,25463.15,21643.68,SKIPPED,25463.15,25463.15,21643.68,21643.68,21643.68,10730.17,12476.94,12476.94,SKIPPED,SKIPPED,10949.15,10949.15,21643.68
4060096,481,37226,,,,,,,FEM/POP REVASC W/STENT,23912.12,9564.85,10076.57,23912.12,20325.3,SKIPPED,23912.12,23912.12,20325.3,20325.3,20325.3,10076.57,11716.94,11716.94,SKIPPED,SKIPPED,10282.21,10282.21,20325.3
4060097,272,,,,,,,,SOLENT OMNI CATHETER US,5263.13,2105.25,0,4473.66,4473.66,SKIPPED,3999.98,3999.98,4473.66,4473.66,4473.66,2217.89,2578.93,2578.93,0,1578.94,2263.15,2263.15,4473.66
4060098,272,,,,,,,,SOLENT PROXI CATHETER US,5000.63,2000.25,0,4250.54,4250.54,SKIPPED,3800.48,3800.48,4250.54,4250.54,4250.54,2107.26,2450.31,2450.31,0,1500.19,2150.27,2150.27,4250.54
4060099,272,,,,,,,,ZELANTE DVT US,9350,3740,0,7947.5,7947.5,SKIPPED,7106,7106,7947.5,7947.5,7947.5,3940.09,4581.5,4581.5,0,2805,4020.5,4020.5,7947.5
4060100,272,,,,,,,,AMPLATZ S/S XCH 035/260/CBX/5,562.5,225,0,478.12,478.12,SKIPPED,427.5,427.5,478.12,478.12,478.12,237.04,275.62,275.62,0,168.75,241.88,241.88,478.12
4060101,481,36902,,,,,,,INTRO CATH DIALYSIS CIRCUIT W/ TRLUML,13657.56,5463.02,5755.3,13657.56,11608.93,SKIPPED,13657.56,13657.56,11608.93,11608.93,11608.93,5755.3,6692.2,6692.2,SKIPPED,SKIPPED,5872.75,5872.75,11608.93
4060102,272,,,,,,,,RIGHT HEART SET,2500,1000,0,2125,2125,SKIPPED,1900,1900,2125,2125,2125,1053.5,1225,1225,0,750,1075,1075,2125
4060103,272,,,,,,,,ACIST KIT WITH ACIST SYRINGE,1500,600,0,1275,1275,SKIPPED,1140,1140,1275,1275,1275,632.1,735,735,0,450,645,645,1275
4060104,272,,,,,,,,SYRINGE KIT,890,356,0,756.5,756.5,SKIPPED,676.4,676.4,756.5,756.5,756.5,375.05,436.1,436.1,0,267,382.7,382.7,756.5
4060105,481,37228,,,,,,,REVSC OPN/PRQ TIB/PER W/ ANGIO,15399.72,6159.89,6489.44,15399.72,13089.76,SKIPPED,15399.72,15399.72,13089.76,13089.76,13089.76,6489.44,7545.86,7545.86,SKIPPED,SKIPPED,6621.88,6621.88,13089.76
4060106,972,37228,,,,,,,REVSC OPN/PRQ TIB/PER W/ ANGIO,1129.12,451.65,0,1129.12,959.75,SKIPPED,1129.12,1129.12,959.75,959.75,959.75,573.2,553.27,553.27,SKIPPED,SKIPPED,584.9,584.9,0
4060107,272,,,,,,,,OXYGEN EXT TUBING,1.65,0.66,0,1.4,1.4,SKIPPED,1.25,1.25,1.4,1.4,1.4,0.7,0.81,0.81,0,0.5,0.71,0.71,1.4
4060108,272,,,,,,,,CONDOM CATH,4.05,1.62,0,3.44,3.44,SKIPPED,3.08,3.08,3.44,3.44,3.44,1.71,1.98,1.98,0,1.22,1.74,1.74,3.44
4060109,278,,,,,,,,PURWICK,46.88,18.75,0,39.85,39.85,SKIPPED,35.63,35.63,39.85,39.85,39.85,19.76,22.97,22.97,0,14.06,20.16,20.16,39.85
4060110,272,,,,,,,,NEEDLESS CONNECTOR,3.38,1.35,0,2.87,2.87,SKIPPED,2.57,2.57,2.87,2.87,2.87,1.42,1.66,1.66,0,1.01,1.45,1.45,2.87
4060111,272,,,,,,,,C-ARM BONNET,8.4,3.36,0,7.14,7.14,SKIPPED,6.38,6.38,7.14,7.14,7.14,3.54,4.12,4.12,0,2.52,3.61,3.61,7.14
4060112,272,,,,,,,,ALARIS PUMP TUBING,11.68,4.67,0,9.93,9.93,SKIPPED,8.88,8.88,9.93,9.93,9.93,4.92,5.72,5.72,0,3.5,5.02,5.02,9.93
4060113,272,,,,,,,,BAG DECANTER,2.93,1.17,0,2.49,2.49,SKIPPED,2.23,2.23,2.49,2.49,2.49,1.23,1.44,1.44,0,0.88,1.26,1.26,2.49
4060114,272,,,,,,,,DRESSING SPONGE,3.18,1.27,0,2.7,2.7,SKIPPED,2.42,2.42,2.7,2.7,2.7,1.34,1.56,1.56,0,0.95,1.37,1.37,2.7
4060115,481,37224,,,,,,,FEM/POP REVSC ANGIOPLASTY,14131.79,5652.72,5955.14,14131.79,12012.02,SKIPPED,14131.79,14131.79,12012.02,12012.02,12012.02,5955.14,6924.58,6924.58,SKIPPED,SKIPPED,6076.67,6076.67,12012.02
4060116,481,75710,,,,,,,ANGIOGRAPHY EXT UNI,5358.15,2143.26,0,5358.15,4554.43,SKIPPED,5358.15,5358.15,4554.43,4554.43,4554.43,2257.92,3605.69,3605.69,0,1600.34,2304,2304,4554.43
4060117,481,75825,,,,,,,VENOGRAPY EXT UNI,2006.99,802.8,0,2006.99,1705.94,SKIPPED,2006.99,2006.99,1705.94,1705.94,1705.94,845.75,2006.99,2006.99,0,1600.34,863.01,863.01,1705.94
4060118,972,75825,,,,,,,VENOGRAPY EXT UNI,254.28,101.71,0,254.28,216.14,SKIPPED,254.28,254.28,216.14,216.14,216.14,58,254.28,254.28,0,254.28,59.18,59.18,0
4060119,972,36585,,,,,,,REPLACE PICVAD CATH,577.49,231,0,577.49,490.87,SKIPPED,577.49,577.49,490.87,490.87,490.87,306.51,282.97,282.97,SKIPPED,SKIPPED,312.77,312.77,0
4060120,481,75820,,,,,,,VENOGRAPHY EXT UNI,2006.99,802.8,0,2006.99,1705.94,SKIPPED,2006.99,2006.99,1705.94,1705.94,1705.94,845.75,1771.74,1771.74,0,393.27,863.01,863.01,1705.94
4060121,972,75820,,,,,,,VENOGRAPHY EXT UNI,144.47,57.79,0,144.47,122.8,SKIPPED,144.47,144.47,122.8,122.8,122.8,55.29,144.47,144.47,0,144.47,56.42,56.42,0
4060122,272,,,,,,,,BOSTON SCIENTIFIC BALLOONS,637.5,255,0,541.88,541.88,SKIPPED,484.5,484.5,541.88,541.88,541.88,268.65,312.38,312.38,0,191.25,274.13,274.13,541.88
4060123,272,,,,,,,,BOSTON EMERGE BALLOONS,687.5,275,0,584.38,584.38,SKIPPED,522.5,522.5,584.38,584.38,584.38,289.72,336.88,336.88,0,206.25,295.63,295.63,584.38
4060124,278,C1876,,,,,,,BOSTON SCIENTIFIC STENTS,5875,2350,0,4993.75,4993.75,SKIPPED,4465,4465,4993.75,4993.75,4993.75,2475.72,2878.75,2878.75,0,1762.5,2526.25,2526.25,4993.75
4060125,272,,,,,,,,WOLVERINE CUTTING BALLOONS,2187.5,875,0,1859.38,1859.38,SKIPPED,1662.5,1662.5,1859.38,1859.38,1859.38,921.82,1071.88,1071.88,0,656.25,940.63,940.63,1859.38
4060126,272,,,,,,,,CHOICE PT ES WIRES,1030,412,0,875.5,875.5,SKIPPED,782.8,782.8,875.5,875.5,875.5,434.04,504.7,504.7,0,309,442.9,442.9,875.5
4060128,272,,,,,,,,EUPHORA BALLOONS,350,140,0,297.5,297.5,SKIPPED,266,266,297.5,297.5,297.5,147.49,171.5,171.5,0,105,150.5,150.5,297.5
4060129,272,,,,,,,,ASAHI WAIRES,362.5,145,0,308.12,308.12,SKIPPED,275.5,275.5,308.12,308.12,308.12,152.76,177.62,177.62,0,108.75,155.88,155.88,308.12
4060130,278,C1876,,,,,,,PK PAPYRUS COVERED STENTS,6875,2750,0,5843.75,5843.75,SKIPPED,5225,5225,5843.75,5843.75,5843.75,2897.12,3368.75,3368.75,0,2062.5,2956.25,2956.25,5843.75
4060131,272,,,,,,,,MERIT INFLATION KIT,87.5,35,0,74.38,74.38,SKIPPED,66.5,66.5,74.38,74.38,74.38,36.88,42.88,42.88,0,26.25,37.63,37.63,74.38
4060132,272,,,,,,,,DEFIBRILLATOR PADS(RADIOLUCENT),136.5,54.6,0,116.02,116.02,SKIPPED,103.74,103.74,116.02,116.02,116.02,57.53,66.88,66.88,0,40.95,58.7,58.7,116.02
4060133,272,,,,,,,,30 CC IABP CATHETER,2622.9,1049.16,0,2229.46,2229.46,SKIPPED,1993.4,1993.4,2229.46,2229.46,2229.46,1105.29,1285.22,1285.22,0,786.87,1127.85,1127.85,2229.46
4060134,278,,,,,,,,40/50 CC IABP CATHETER,5489.9,2195.96,0,4666.42,4666.42,SKIPPED,4172.32,4172.32,4666.42,4666.42,4666.42,2313.45,2690.05,2690.05,0,1646.97,2360.66,2360.66,4666.42
4060135,272,,,,,,,,EAGLE EYE IVUS CATHETER,1875,750,0,1593.75,1593.75,SKIPPED,1425,1425,1593.75,1593.75,1593.75,790.12,918.75,918.75,0,562.5,806.25,806.25,1593.75
4060136,272,,,,,,,,OMNIWIRE PRESSURE WIRE,1687.5,675,0,1434.38,1434.38,SKIPPED,1282.5,1282.5,1434.38,1434.38,1434.38,711.12,826.88,826.88,0,506.25,725.63,725.63,1434.38
4060137,272,,,,,,,,ARROW T-PACER WIRE,482.5,193,0,410.12,410.12,SKIPPED,366.7,366.7,410.12,410.12,410.12,203.33,236.42,236.42,0,144.75,207.48,207.48,410.12
4060138,272,,,,,,,,ANGIOSEAL CLOSURE DEVICE,537.5,215,0,456.88,456.88,SKIPPED,408.5,408.5,456.88,456.88,456.88,226.51,263.38,263.38,0,161.25,231.13,231.13,456.88
4060139,272,,,,,,,,VASCADE CLOSURE DEVICE,600,240,0,510,510,SKIPPED,456,456,510,510,510,252.84,294,294,0,180,258,258,510
4060140,272,,,,,,,,PERCLOSE CLOSURE DEVICE,650,260,0,552.5,552.5,SKIPPED,494,494,552.5,552.5,552.5,273.91,318.5,318.5,0,195,279.5,279.5,552.5
4060141,272,,,,,,,,MANUAL PRESSURE CLOSURE,375,150,0,318.75,318.75,SKIPPED,285,285,318.75,318.75,318.75,158.02,183.75,183.75,0,112.5,161.25,161.25,318.75
4060142,272,,,,,,,,MERIT ENSNARE,790.5,316.2,0,671.92,671.92,SKIPPED,600.78,600.78,671.92,671.92,671.92,333.12,387.34,387.34,0,237.15,339.92,339.92,671.92
4060143,272,,,,,,,,MERIT ONE SNARE,678.05,271.22,0,576.34,576.34,SKIPPED,515.32,515.32,576.34,576.34,576.34,285.73,332.24,332.24,0,203.42,291.56,291.56,576.34
4060144,270,,,,,,,,SAFEGUARD PRESSURE DEVICE,150,60,0,127.5,127.5,SKIPPED,114,114,127.5,127.5,127.5,63.21,73.5,73.5,0,45,64.5,64.5,127.5
4060145,481,37248,,,,,,,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1,11889.97,4755.99,5010.44,11889.97,10106.47,SKIPPED,11889.97,11889.97,10106.47,10106.47,10106.47,5010.44,5826.09,5826.09,SKIPPED,SKIPPED,5112.69,5112.69,10106.47
4060146,481,93458,,,,,,,CATH PLMT L HRT & ARTS W/ NJX & ANGIO,15823.01,6329.2,0,13449.56,13449.56,SKIPPED,13364.6,13364.6,13449.56,13449.56,13449.56,6667.81,7753.27,7753.27,0,4746.9,6803.89,6803.89,13449.56
4060147,972,93458,,,,,,,CATH PLMT L HRT & ARTS W/ NJX & ANGIO,2382,952.8,0,2382,2024.7,SKIPPED,2382,2382,2024.7,2024.7,2024.7,315.4,1167.18,1167.18,0,714.6,321.84,321.84,0
4060148,481,93567,,,,,,,NJX SUPRAVAL AORTAG HRT CATH W/ S&I,1652.65,661.06,0,1404.75,1404.75,SKIPPED,0,0,1404.75,1404.75,1404.75,696.43,809.8,809.8,0,495.8,710.64,710.64,1404.75
4060149,972,93567,,,,,,,NJX SUPRAVAL AORTAG HRT CATH W/ S&I,109.06,43.62,0,92.7,92.7,SKIPPED,0,0,92.7,92.7,92.7,55.51,53.44,53.44,0,32.72,56.64,56.64,0
4060150,481,93460,,,,,,,R&L HRT CATH /INJX HRT ART&L VENTR IMG,17309.25,6923.7,0,14712.86,14712.86,SKIPPED,13364.6,13364.6,14712.86,14712.86,14712.86,7294.12,8481.53,8481.53,0,5192.78,7442.98,7442.98,14712.86
4060151,972,93460,,,,,,,R&L HRT CATH /INJX HRT ART&L VENTR IMG,2856.38,1142.55,0,2856.38,2427.92,SKIPPED,2856.38,2856.38,2427.92,2427.92,2427.92,400.48,1399.63,1399.63,0,856.91,408.65,408.65,0
4060152,272,,,,,,,,BIOMONITOR IIIm Ref# 450218,10750,4300,0,9137.5,9137.5,SKIPPED,8170,8170,9137.5,9137.5,9137.5,4530.05,5267.5,5267.5,0,3225,4622.5,4622.5,9137.5
4060153,272,,,,,,,,VISIPAQUE 320,3.78,1.51,0,3.21,3.21,SKIPPED,2.87,2.87,3.21,3.21,3.21,1.6,1.85,1.85,0,1.13,1.63,1.63,3.21
4060154,481,37227,,,,,,,REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIO,36963.52,14785.41,15576.42,36963.52,31418.99,SKIPPED,36963.52,36963.52,31418.99,31418.99,31418.99,15576.42,18112.12,18112.12,SKIPPED,SKIPPED,15894.31,15894.31,31418.99
4060155,972,36593,,,,,,,DECLOT BY THROMBOLYTIC VASC DEVICE,69.96,27.98,0,69.96,59.47,SKIPPED,69.96,69.96,59.47,59.47,59.47,35.84,34.28,34.28,0,20.99,36.57,36.57,0
4060156,481,36582,,,,,,,REPLACEMENT TUNNELED CV CATH,6853.35,2741.34,2888,6853.35,5825.35,SKIPPED,6853.35,6853.35,5825.35,5825.35,5825.35,2888,3358.14,3358.14,SKIPPED,SKIPPED,2946.94,2946.94,5825.35
4060157,972,36582,,,,,,,REPLACEMENT TUNNELED CV CATH,583.65,233.46,0,583.65,496.1,SKIPPED,583.65,583.65,496.1,496.1,496.1,311.79,285.99,285.99,SKIPPED,SKIPPED,318.15,318.15,0
4060158,481,92928,,,,,,,PERCUTANEOUS TRANSCATHETER PLACEMENT,2008.65,803.46,0,2008.65,1707.35,SKIPPED,2008.65,2008.65,1707.35,1707.35,1707.35,846.45,984.24,984.24,0,602.6,863.72,863.72,1707.35
4060159,972,92928,,,,,,,PERCUTANEOUS TRANSCATHETER PLACEMENT,1173.27,469.31,0,1173.27,997.28,SKIPPED,1173.27,1173.27,997.28,997.28,997.28,626.53,574.9,574.9,0,351.98,639.32,639.32,0
4060160,481,93454,,,,,,,CATH PLACEMENT CORONARY ATERIES,12340.65,4936.26,0,12340.65,10489.55,SKIPPED,12340.65,12340.65,10489.55,10489.55,10489.55,5200.35,6046.92,6046.92,0,3702.2,5306.48,5306.48,10489.55
4060161,972,93454,,,,,,,CATH PLACEMENT CORONARY ATERIES,1963.73,785.49,0,1963.73,1669.17,SKIPPED,1963.73,1963.73,1669.17,1669.17,1669.17,256.19,962.23,962.23,0,589.12,261.42,261.42,0
4060162,481,36598,,,,,,,CONTRAST INJ RAD EVAL FLURO,763.35,305.34,321.68,648.85,648.85,SKIPPED,405.27,405.27,648.85,648.85,648.85,321.68,374.04,374.04,SKIPPED,SKIPPED,328.24,328.24,648.85
4060163,972,36598,,,,,,,CONTRAST INJ RAD EVAL FLURO,73.58,29.43,0,73.58,62.54,SKIPPED,73.58,73.58,62.54,62.54,62.54,39.62,36.05,36.05,SKIPPED,SKIPPED,40.43,40.43,0
4060164,481,33274,,,,,,,INSERT/REPLACE PERM LEADLESS PACEMAKER,33649.18,13459.67,0,33649.18,28601.8,SKIPPED,33649.18,33649.18,28601.8,28601.8,28601.8,14179.77,16488.1,16488.1,0,10094.75,14469.15,14469.15,28601.8
4060165,972,33274,,,,,,,INSERT/REPLACE PERM LEADLESS PACEMAKER,974.21,389.68,0,974.21,828.08,SKIPPED,974.21,974.21,828.08,828.08,828.08,518.77,477.36,477.36,0,292.26,529.36,529.36,0
4060166,481,36905,,,,,,,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO,23872.8,9549.12,10059.99,23872.8,20291.88,SKIPPED,23872.8,23872.8,20291.88,20291.88,20291.88,10059.99,11697.67,11697.67,SKIPPED,SKIPPED,10265.3,10265.3,20291.88
4060167,481,37223,,,,,,,OPN/PRQ ART W/STENT & ANGIO,12368.3,4947.32,0,10513.06,10513.06,SKIPPED,0,0,10513.06,10513.06,10513.06,5212,6060.47,6060.47,0,3710.49,5318.37,5318.37,10513.06
4060168,481,36904,,,,,,,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX,11395.31,4558.12,4801.98,11395.31,9686.01,SKIPPED,11395.31,11395.31,9686.01,9686.01,9686.01,4801.98,5583.7,5583.7,SKIPPED,SKIPPED,4899.98,4899.98,9686.01
4060169,972,36904,,,,,,,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX,744.79,297.92,0,744.79,633.07,SKIPPED,744.79,744.79,633.07,633.07,633.07,396.27,364.95,364.95,SKIPPED,SKIPPED,404.36,404.36,0
4060170,481,93452,,,,,,,LFT HRT CATH W/NJX LFT VENT,13129.2,5251.68,0,13129.2,11159.82,SKIPPED,13129.2,13129.2,11159.82,11159.82,11159.82,5532.65,6433.31,6433.31,0,3938.76,5645.56,5645.56,11159.82
4060171,972,93452,,,,,,,LFT HRT CATH W/NJX LFT VENT,1961.19,784.48,0,1961.19,1667.01,SKIPPED,1961.19,1961.19,1667.01,1667.01,1667.01,253.58,960.98,960.98,0,588.36,258.75,258.75,0
4060172,278,,,,,,,,EDORA 8 DR-T,4500,1800,0,3825,3825,SKIPPED,3420,3420,3825,3825,3825,1896.3,2205,2205,0,1350,1935,1935,3825
4060173,272,,,,,,,,ANGIO-SEAL VIP REF#610130 LOT#0000038235,6300,2520,0,5355,5355,SKIPPED,4788,4788,5355,5355,5355,2654.82,3087,3087,0,1890,2709,2709,5355
4060174,481,36901,,,,,,,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH,3394.64,1357.86,0,2885.44,2885.44,SKIPPED,1515.72,1515.72,2885.44,2885.44,2885.44,1430.51,1663.37,1663.37,0,1018.39,1459.7,1459.7,2885.44
4060175,972,33208,,,,,,,INS NEW/RPLCMT PRM PM W/TRANSV ELTRAD,1041.75,416.7,0,1041.75,885.49,SKIPPED,1041.75,1041.75,885.49,885.49,885.49,559.07,510.46,510.46,SKIPPED,SKIPPED,570.48,570.48,0
4060176,278,C1889,,,,,,,CONFIRM RX-IMPLANTABLE LOOP RECORDER,9450,3780,0,8032.5,8032.5,SKIPPED,7182,7182,8032.5,8032.5,8032.5,3982.23,4630.5,4630.5,0,2835,4063.5,4063.5,8032.5
4060177,481,33016,,,,,,,PERICARDIOCENTESIS W/ IMAGING,4109.7,1643.88,0,4109.7,3493.24,SKIPPED,4109.7,4109.7,3493.24,3493.24,3493.24,1731.83,2013.75,2013.75,0,1232.91,1767.17,1767.17,3493.24
4060178,972,33016,,,,,,,PERICARDIOCENTESIS W/ IMAGING,467.38,186.95,0,467.38,397.27,SKIPPED,467.38,467.38,397.27,397.27,397.27,250.82,229.02,229.02,0,140.21,255.94,255.94,0
4060179,481,93453,,,,,,,COMBINED RIGHT/LEFT HEART CATH,15890.7,6356.28,0,13507.1,13507.1,SKIPPED,13364.6,13364.6,13507.1,13507.1,13507.1,6696.34,7786.44,7786.44,0,4767.21,6833,6833,13507.1
4060180,972,93453,,,,,,,COMBINED RIGHT/LEFT HEART CATH,2447.68,979.07,0,2447.68,2080.53,SKIPPED,2447.68,2447.68,2080.53,2080.53,2080.53,337.72,1199.36,1199.36,0,734.3,344.61,344.61,0
4060181,481,37232,,,,,,,REVSC OPN/PRQ TIB/PER W/ ANGIO,11158.64,4463.46,0,9484.84,9484.84,SKIPPED,0,0,9484.84,9484.84,9484.84,4702.26,5467.73,5467.73,0,3347.59,4798.22,4798.22,9484.84
4060182,481,37230,,,,,,,REVSC OPN/PRQ TIB/PER W/ ANGIO STENT,22872.68,9149.07,9638.54,22872.68,19441.78,SKIPPED,22872.68,22872.68,19441.78,19441.78,19441.78,9638.54,11207.61,11207.61,SKIPPED,SKIPPED,9835.25,9835.25,19441.78
4060183,481,92920,,,,,,,PRQ TRLUML CORONARY ANGIO ONE ART/BRANCH,14644.35,5857.74,0,14644.35,12447.7,SKIPPED,14644.35,14644.35,12447.7,12447.7,12447.7,6171.13,7175.73,7175.73,0,4393.3,6297.07,6297.07,12447.7
4060184,972,92920,,,,,,,PRQ TRLUML CORONARY ANGIO ONE ART/BRANCH,1049.37,419.75,0,1049.37,891.96,SKIPPED,1049.37,1049.37,891.96,891.96,891.96,563.17,514.19,514.19,0,314.81,574.66,574.66,0
4060185,481,93461,,,,,,,R&L HRT CATH W/ INJE HRT ART/GRFT & L VE,18635.4,7454.16,0,15840.09,15840.09,SKIPPED,13364.6,13364.6,15840.09,15840.09,15840.09,7852.96,9131.35,9131.35,0,5590.62,8013.22,8013.22,15840.09
4060186,972,93461,,,,,,,R&L HRT CATH W/ INJE HRT ART/GRFT & L VE,2919.5,1167.8,0,2919.5,2481.58,SKIPPED,2919.5,2919.5,2481.58,2481.58,2481.58,442.61,1430.56,1430.56,0,875.85,451.64,451.64,0
4060187,972,33228,,,,,,,REMOVE & REPLACE DUAL LEAD PPM,714.36,285.74,0,714.36,607.21,SKIPPED,714.36,714.36,607.21,607.21,607.21,383.38,350.04,350.04,SKIPPED,SKIPPED,391.2,391.2,0
4060188,481,37234,,,,,,,REVASC ENDOVASC OPEN OR PREQ TIB/PEONEAL,19769.4,7907.76,0,16803.99,16803.99,SKIPPED,0,0,16803.99,16803.99,16803.99,8330.82,9687.01,9687.01,0,5930.82,8500.84,8500.84,16803.99
4060189,972,37234,,,,,,,REVASC ENDOVASC OPEN OR PREQ TIB/PEONEAL,558.89,223.56,0,475.06,475.06,SKIPPED,0,0,475.06,475.06,475.06,299.94,273.86,273.86,0,167.67,306.06,306.06,0
4060190,481,37246,,,,,,,TRMLBALO ANGIOP OPEN/PERQ W/IMG S&I 1ST,12101.25,4840.5,5099.47,12101.25,10286.06,SKIPPED,12101.25,12101.25,10286.06,10286.06,10286.06,5099.47,5929.61,5929.61,SKIPPED,SKIPPED,5203.54,5203.54,10286.06
4060191,481,36215,,,,,,,SLCTV VATHJ EA 1ST ORD THRC/BRCH/CPLC BR,2798.75,1119.5,0,2378.94,2378.94,SKIPPED,0,0,2378.94,2378.94,2378.94,1179.39,1371.39,1371.39,0,839.62,1203.46,1203.46,2378.94
4060192,972,36215,,,,,,,SLCTV VATHJ EA 1ST ORD THRC/BRCH/CPLC BR,408.16,163.26,0,346.94,346.94,SKIPPED,0,0,346.94,346.94,346.94,230,200,200,0,122.45,234.69,234.69,0
4080072,301,80050,,,,,,,PANEL GENERAL HEALTH,193.2,77.28,0,164.22,164.22,SKIPPED,133.65,133.65,164.22,164.22,164.22,81.42,94.67,94.67,0,57.96,83.08,83.08,164.22
4110001,985,93660,,,,,,,TILT TABLE STUDY,381.68,152.67,0,381.68,324.43,SKIPPED,381.68,381.68,324.43,324.43,324.43,102.5,187.02,187.02,0,114.5,104.59,104.59,0
4110002,960,93294,,,,,,,REMOTE PACER INTERROGATION,75.37,30.15,0,75.37,64.06,SKIPPED,75.37,75.37,64.06,64.06,64.06,33.25,36.93,36.93,0,22.61,33.93,33.93,0
4110003,960,93279,,,,,,,PACER PROGRAMMING SINGLE,79,31.6,0,79,67.15,SKIPPED,79,79,67.15,67.15,67.15,35.11,38.71,38.71,0,23.7,35.83,35.83,0
4110004,960,93280,,,,,,,PACER PROGRAMMING DUAL,139.79,55.92,0,139.79,118.82,SKIPPED,139.79,139.79,118.82,118.82,118.82,42.12,68.5,68.5,0,41.94,42.98,42.98,0
4110005,960,93281,,,,,,,PACER PROGRAMMING MULTIPLE,104.54,41.82,0,104.54,88.86,SKIPPED,104.54,104.54,88.86,88.86,88.86,46.73,51.22,51.22,0,31.36,47.68,47.68,0
4110006,960,93288,,,,,,,PACER INTERROGATION,52.27,20.91,0,52.27,44.43,SKIPPED,52.27,52.27,44.43,44.43,44.43,23.19,25.61,25.61,0,15.68,23.66,23.66,0
4110007,960,93298,,,,,,,REMOTE ILR INTERROGATION,65.65,26.26,0,65.65,55.8,SKIPPED,65.65,65.65,55.8,55.8,55.8,29.01,32.17,32.17,0,19.7,29.6,29.6,0
4110008,960,93285,,,,,,,ILR PROGRAMMING,64.42,25.77,0,64.42,54.76,SKIPPED,64.42,64.42,54.76,54.76,54.76,28.56,31.57,31.57,0,19.33,29.14,29.14,0
4110009,960,93291,,,,,,,ILR INTERROGATION,44.97,17.99,0,44.97,38.22,SKIPPED,44.97,44.97,38.22,38.22,38.22,20.24,22.04,22.04,0,13.49,20.65,20.65,0
4110010,960,93299,,,,,,,REMOTE ICM INTERROGATION,91.16,36.46,0,77.49,77.49,SKIPPED,69.28,69.28,77.49,77.49,77.49,0,44.67,44.67,0,27.35,0,0,0
4110011,960,93290,,,,,,,ICM INTERROGATION,53.49,21.4,0,53.49,45.47,SKIPPED,53.49,53.49,45.47,45.47,45.47,23.56,26.21,26.21,0,16.05,24.04,24.04,0
4110012,960,93295,,,,,,,REMOTE ICD INTERROGATION,130.27,52.11,0,130.27,110.73,SKIPPED,130.27,130.27,110.73,110.73,110.73,41.17,63.83,63.83,0,39.08,42.01,42.01,0
4110013,960,93282,,,,,,,ICD PROGRAMMING SINGLE LEAD,103.32,41.33,0,103.32,87.82,SKIPPED,103.32,103.32,87.82,87.82,87.82,46.73,50.63,50.63,0,31,47.68,47.68,0
4110014,960,93283,,,,,,,ICD PROGRAMMING DUAL LEAD,140.99,56.4,0,140.99,119.84,SKIPPED,140.99,140.99,119.84,119.84,119.84,62.9,69.09,69.09,0,42.3,64.18,64.18,0
4110015,960,93289,,,,,,,ICD PROGRAMMING MULTIPLE LEAD,91.16,36.46,0,91.16,77.49,SKIPPED,91.16,91.16,77.49,77.49,77.49,40.96,44.67,44.67,0,27.35,41.8,41.8,0
4110016,510,99489,,,,,,,CMPLX CHRON CARE ADDL 30 MIN,86.21,34.48,0,86.21,73.28,SKIPPED,86.21,86.21,73.28,73.28,0,36.33,42.24,42.24,0,25.86,37.07,37.07,73.28
4110017,510,99487,,,,,,,CMPLX CHRON CARE W/O PT VSIT,160.42,64.17,0,160.42,136.36,SKIPPED,160.42,160.42,136.36,136.36,0,67.6,78.61,78.61,0,48.13,68.98,68.98,136.36
4110018,983,99211,,,,,,,HEART FAILURE OP VISIT LVL 1,20.73,8.29,0,20.73,17.62,SKIPPED,20.73,20.73,17.62,17.62,17.62,9.85,10.16,10.16,0,6.22,10.05,10.05,0
4110019,983,99212,,,,,,,HEART FAILURE OP VISIT LVL 2,57.18,22.87,0,57.18,48.6,SKIPPED,57.18,57.18,48.6,48.6,48.6,39.69,28.02,28.02,0,17.15,40.5,40.5,0
4110020,983,99213,,,,,,,HEART FAILURE OP VISIT LVL 3,116.69,46.68,0,116.69,99.19,SKIPPED,116.69,116.69,99.19,99.19,99.19,73.47,57.18,57.18,0,35.01,74.97,74.97,0
4110021,983,99214,,,,,,,HEART FAILURE OP VISIT LVL 4,179.9,71.96,0,179.9,152.92,SKIPPED,179.9,179.9,152.92,152.92,152.92,108.16,88.15,88.15,0,53.97,110.37,110.37,0
4110022,983,99215,,,,,,,HEART FAILURE OP VISIT LVL 5,252.83,101.13,0,252.83,214.91,SKIPPED,252.83,252.83,214.91,214.91,214.91,160.17,123.89,123.89,0,75.85,163.44,163.44,0
4110023,960,92960,,,,,,,ELECTIVE CARDIOVERSION,267.41,106.96,0,267.41,227.3,SKIPPED,267.41,267.41,227.3,227.3,227.3,119.18,131.03,131.03,0,80.22,121.61,121.61,0
4120001,480,93660,,,,,,,TILT TABLE STUDY,2020.18,808.07,0,2020.18,1717.15,SKIPPED,2020.18,2020.18,1717.15,1717.15,1717.15,851.31,989.89,989.89,0,606.05,868.68,868.68,1717.15
4120002,480,93296,,,,,,,REMOTE PACER INTERROGATION,175.04,70.02,0,175.04,148.78,SKIPPED,175.04,175.04,148.78,148.78,148.78,73.76,85.77,85.77,0,52.51,75.27,75.27,148.78
4120003,480,93279,,,,,,,PACER PROGRAMMING SINGLE,148.3,59.32,0,148.3,126.06,SKIPPED,148.3,148.3,126.06,126.06,126.06,62.49,72.67,72.67,0,44.49,63.77,63.77,126.06
4120004,480,93280,,,,,,,PACER PROGRAMMING DUAL,181.1,72.44,0,179.26,153.94,SKIPPED,179.26,179.26,153.94,153.94,153.94,76.31,88.74,88.74,0,54.33,77.87,77.87,153.94
4120005,480,93281,,,,,,,PACER PROGRAMMING MULTIPLE,165.31,66.12,0,165.31,140.51,SKIPPED,165.31,165.31,140.51,140.51,140.51,69.66,81,81,0,49.59,71.08,71.08,140.51
4120006,480,93288,,,,,,,PACER INTERROGATION,148.3,59.32,0,148.3,126.06,SKIPPED,148.3,148.3,126.06,126.06,126.06,62.49,72.67,72.67,0,44.49,63.77,63.77,126.06
4120007,480,93299,,,,,,,REMOTE ILR INTERROGATION,182.33,72.93,0,154.98,154.98,SKIPPED,138.57,138.57,154.98,154.98,154.98,76.83,89.34,89.34,0,54.7,78.4,78.4,154.98
4120008,480,93285,,,,,,,ILR PROGRAMMING,133.71,53.48,0,133.71,113.65,SKIPPED,133.71,133.71,113.65,113.65,113.65,56.35,65.52,65.52,0,40.11,57.5,57.5,113.65
4120009,480,93291,,,,,,,ILR INTERROGATION,130.06,52.02,0,110.55,110.55,SKIPPED,82.98,82.98,110.55,110.55,110.55,54.81,63.73,63.73,0,39.02,55.93,55.93,110.55
4120010,480,93297,,,,,,,REMOTE ICM INTERROGATION,185.97,74.39,0,158.07,158.07,SKIPPED,127.87,127.87,158.07,158.07,158.07,78.37,91.13,91.13,0,55.79,79.97,79.97,158.07
4120011,480,93290,,,,,,,ICM INTERROGATION,105.76,42.3,0,105.76,89.9,SKIPPED,105.76,105.76,89.9,89.9,89.9,44.57,51.82,51.82,0,31.73,45.48,45.48,89.9
4120012,480,93296,,,,,,,REMOTE ICD INTERROGATION,175.04,70.02,0,175.04,148.78,SKIPPED,175.04,175.04,148.78,148.78,148.78,73.76,85.77,85.77,0,52.51,75.27,75.27,148.78
4120013,480,93282,,,,,,,ICD PROGRAMMING SINGLE LEAD,181.1,72.44,0,179.26,153.94,SKIPPED,179.26,179.26,153.94,153.94,153.94,76.31,88.74,88.74,0,54.33,77.87,77.87,153.94
4120014,480,93283,,,,,,,ICD PROGRAMMING DUAL LEAD,200.56,80.22,0,179.26,170.48,SKIPPED,179.26,179.26,170.48,170.48,170.48,84.52,98.27,98.27,0,60.17,86.24,86.24,170.48
4120015,480,93289,,,,,,,ICD PROGRAMMING MULTIPLE LEAD,199.34,79.74,0,179.26,169.44,SKIPPED,179.26,179.26,169.44,169.44,169.44,84.01,97.68,97.68,0,59.8,85.72,85.72,169.44
4120017,510,99211,,,,,,,HEART FAILURE OP VISIT LVL 1,224.93,89.97,0,191.19,191.19,SKIPPED,44.32,44.32,191.19,191.19,0,94.79,110.22,110.22,0,67.48,96.72,96.72,191.19
4120018,510,99212,,,,,,,HEART FAILURE OP VISIT LVL 2,224.93,89.97,0,191.19,191.19,SKIPPED,122.74,122.74,191.19,191.19,0,94.79,110.22,110.22,0,67.48,96.72,96.72,191.19
4120019,510,99213,,,,,,,HEART FAILURE OP VISIT LVL 3,224.93,89.97,0,224.93,191.19,SKIPPED,224.93,224.93,191.19,191.19,0,94.79,110.22,110.22,0,67.48,96.72,96.72,191.19
4120020,510,99214,,,,,,,HEART FAILURE OP VISIT LVL 4,224.93,89.97,0,224.93,191.19,SKIPPED,224.93,224.93,191.19,191.19,0,94.79,110.22,110.22,0,67.48,96.72,96.72,191.19
4120021,510,99215,,,,,,,HEART FAILURE OP VISIT LVL 5,224.93,89.97,0,224.93,191.19,SKIPPED,224.93,224.93,191.19,191.19,0,94.79,110.22,110.22,0,67.48,96.72,96.72,191.19
4120022,480,92960,,,,,,,ELECTIVE CARDIOVERSION,1757.63,703.05,0,1757.63,1493.99,SKIPPED,1757.63,1757.63,1493.99,1493.99,1493.99,740.66,861.24,861.24,0,527.29,755.78,755.78,1493.99
4120023,480,36584,,,,,,,COMPL REPLACEMENT PICC RS&I,2670.27,1068.11,1125.26,2670.27,2269.73,SKIPPED,2670.27,2670.27,2269.73,2269.73,2269.73,1125.26,1308.43,1308.43,SKIPPED,SKIPPED,1148.22,1148.22,2269.73
4120024,480,36585,,,,,,,REPLACE PICVAD CATH,7989.82,3195.93,3366.91,7989.82,6791.35,SKIPPED,7989.82,7989.82,6791.35,6791.35,6791.35,3366.91,3915.01,3915.01,SKIPPED,SKIPPED,3435.62,3435.62,6791.35
4130000,731,93243,,,,,,,Novi / Zio Patch-Analysis 48hrs-7days,1458.3,583.32,0,1239.56,1239.56,SKIPPED,1108.31,1108.31,1239.56,1239.56,1239.56,614.53,714.57,714.57,0,437.49,627.07,627.07,1239.56
4130004,985,93042,,,,,,,EKG RHYTHM STRIP COMPLETE,16.96,6.78,0,16.96,14.42,SKIPPED,16.96,16.96,14.42,14.42,14.42,7.57,8.31,8.31,0,5.09,7.72,7.72,0
4130005,730,93041,,,,,,,EKG RHYTHM STRIP,161.35,64.54,0,161.35,137.15,SKIPPED,161.35,161.35,137.15,137.15,137.15,67.99,79.06,79.06,0,48.4,69.38,69.38,137.15
4130006,985,93040,,,,,,,EKG RHYTHM STRIP COMPLETE,29.85,11.94,0,29.85,25.37,SKIPPED,29.85,29.85,25.37,25.37,25.37,13.75,14.63,14.63,0,8.96,14.03,14.03,0
4130007,985,93018,,,,,,,EKG STRESS TEST COMPLETE,35.66,14.26,0,35.66,30.31,SKIPPED,35.66,35.66,30.31,30.31,30.31,16.02,17.47,17.47,0,10.7,16.35,16.35,0
4130008,482,93017,,,,,,,EKG STRESS TEST,947.86,379.14,0,947.86,805.68,SKIPPED,947.86,947.86,805.68,805.68,805.68,399.43,464.45,464.45,0,284.36,407.58,407.58,805.68
4130009,985,93015,,,,,,,EKG STRESS TEST COMPLETE,167.86,67.14,0,167.86,142.68,SKIPPED,167.86,167.86,142.68,142.68,142.68,78.44,82.25,82.25,0,50.36,80.04,80.04,0
4130011,731,93244,,,,,,,Novi / Zio Patch- Interpre. 48hrs-7days,53.57,21.43,0,45.53,45.53,SKIPPED,40.71,40.71,45.53,45.53,45.53,22.58,26.25,26.25,0,16.07,23.04,23.04,45.53
4130012,731,93245,,,,,,,Novi / Zio Patch Application 7days-14day,230.62,92.25,0,196.03,196.03,SKIPPED,175.27,175.27,196.03,196.03,196.03,97.19,113,113,0,69.19,99.17,99.17,196.03
4130013,731,93247,,,,,,,Novi Patch- Analysis 7days-14days,211.88,84.75,0,180.1,180.1,SKIPPED,161.03,161.03,180.1,180.1,180.1,89.29,103.82,103.82,0,63.56,91.11,91.11,180.1
4130014,731,93248,,,,,,,Novi / Zio Patch-Interpre. 7days-14days,108.93,43.57,0,92.59,92.59,SKIPPED,82.79,82.79,92.59,92.59,92.59,45.9,53.38,53.38,0,32.68,46.84,46.84,92.59
4130205,985,93293,,,,,,,PACER ACOUSTIC,36.52,14.61,0,36.52,31.04,SKIPPED,36.52,36.52,31.04,31.04,31.04,16.42,17.89,17.89,0,10.96,16.76,16.76,0
4130206,985,93295,,,,,,,ICD PROFESIONAL,138.02,55.21,0,138.02,117.32,SKIPPED,138.02,138.02,117.32,117.32,117.32,41.17,67.63,67.63,0,41.41,42.01,42.01,0
4130207,985,93297,,,,,,,ICM REMOTE PROFESSIONAL,67.2,26.88,0,67.2,57.12,SKIPPED,67.2,67.2,57.12,57.12,57.12,29.01,32.93,32.93,0,20.16,29.6,29.6,0
4130208,985,93298,,,,,,,ILR PROFESIONAL,67.06,26.82,0,67.06,57,SKIPPED,67.06,67.06,57,57,57,29.01,32.86,32.86,0,20.12,29.6,29.6,0
4130209,730,93005,,,,,,,EKG-12 LEAD,263.73,105.49,0,263.73,224.17,SKIPPED,263.73,263.73,224.17,224.17,224.17,111.13,129.23,129.23,0,79.12,113.4,113.4,224.17
4130210,985,93000,,,,,,,EKG COMPLETE,39.73,15.89,0,39.73,33.77,SKIPPED,39.73,39.73,33.77,33.77,33.77,15.65,19.47,19.47,0,11.92,15.97,15.97,0
4130211,985,93010,,,,,,,EKG COMPLETE,20.31,8.12,0,20.31,17.26,SKIPPED,20.31,20.31,17.26,17.26,17.26,9.09,9.95,9.95,0,6.09,9.28,9.28,0
4130215,761,99211,,,,,,,TREATMENT RM 5-15MINS,37.25,14.9,0,37.25,31.66,SKIPPED,37.25,37.25,31.66,31.66,31.66,15.7,18.25,18.25,0,11.18,16.02,16.02,31.66
4130220,761,99212,,,,,,,TREATMENT RM 16-30MINS,96.22,38.49,0,96.22,81.79,SKIPPED,96.22,96.22,81.79,81.79,81.79,40.54,47.15,47.15,0,28.87,41.37,41.37,81.79
4130225,761,99213,,,,,,,TREATMENT RM 31-60MINS,175.29,70.12,0,175.29,149,SKIPPED,175.29,175.29,149,149,149,73.86,85.89,85.89,0,52.59,75.37,75.37,149
4130230,761,99214,,,,,,,TREATMENT RM 61-90MINS,271.37,108.55,0,271.37,230.66,SKIPPED,271.37,271.37,230.66,230.66,230.66,114.36,132.97,132.97,0,81.41,116.69,116.69,230.66
4130403,731,93225,,,,,,,EKG DYNAMIC 24 HR,2081.96,832.78,0,1769.67,1769.67,SKIPPED,498.94,498.94,1769.67,1769.67,1769.67,877.34,1020.16,1020.16,0,624.59,895.24,895.24,1769.67
4130404,985,93224,,,,,,,COMPLETE 24 HR EKG,212.18,84.87,0,212.18,180.35,SKIPPED,212.18,212.18,180.35,180.35,180.35,83.31,103.97,103.97,0,63.65,85.01,85.01,0
4130405,985,93227,,,,,,,COMPLETE 24HR EKG,64.37,25.75,0,64.37,54.71,SKIPPED,64.37,64.37,54.71,54.71,54.71,20.66,31.54,31.54,0,19.31,21.08,21.08,0
4130415,731,93268,,,,,,,ZIO CARD,1621.13,648.45,0,1377.96,1377.96,SKIPPED,993.84,993.84,1377.96,1377.96,1377.96,683.15,794.35,794.35,0,486.34,697.09,697.09,1377.96
4130416,985,93268,,,,,,,ZIO CARD (PROF),493.13,197.25,0,493.13,419.16,SKIPPED,493.13,493.13,419.16,419.16,419.16,204.07,241.63,241.63,0,147.94,208.23,208.23,0
4130417,730,93268,,,,,,,EVENT MONITOR,890.85,356.34,0,890.85,757.22,SKIPPED,890.85,890.85,757.22,757.22,757.22,375.41,436.52,436.52,0,267.26,383.07,383.07,757.22
4130418,985,93268,,,,,,,EVENT MONITOR,495.2,198.08,0,495.2,420.92,SKIPPED,495.2,495.2,420.92,420.92,420.92,204.07,242.65,242.65,0,148.56,208.23,208.23,0
4130419,730,93229,,,,,,,MCT,1476.66,590.66,0,1476.66,1255.16,SKIPPED,1476.66,1476.66,1255.16,1255.16,1255.16,622.26,723.56,723.56,0,443,634.96,634.96,1255.16
4130420,985,93229,,,,,,,MCT,1726.8,690.72,0,1726.8,1467.78,SKIPPED,1726.8,1726.8,1467.78,1467.78,1467.78,979.99,846.13,846.13,0,518.04,999.99,999.99,0
4130421,730,93784,,,,,,,ABP,393.1,157.24,0,334.14,334.14,SKIPPED,259.11,259.11,334.14,334.14,334.14,165.65,192.62,192.62,0,117.93,169.03,169.03,334.14
4130422,985,93784,,,,,,,ABP,131.46,52.58,0,131.46,111.74,SKIPPED,131.46,131.46,111.74,111.74,111.74,50.51,64.42,64.42,0,39.44,51.54,51.54,0
4130423,731,93229,,,,,,,EXT. ECG COMPLETE (GLOBAL),387.28,154.91,0,387.28,329.19,SKIPPED,387.28,387.28,329.19,329.19,329.19,163.2,189.77,189.77,0,116.18,166.53,166.53,329.19
4130424,731,93242,,,,,,,Novi / Zio Patch-Apllication 48hrs-7days,24.15,9.66,0,20.53,20.53,SKIPPED,18.35,18.35,20.53,20.53,20.53,10.17,11.83,11.83,0,7.24,10.38,10.38,20.53
4130425,731,93229,,,,,,,EXT. ECG COMPLETE (TECH),362.15,144.86,0,362.15,307.83,SKIPPED,362.15,362.15,307.83,307.83,307.83,152.61,177.45,177.45,0,108.64,155.72,155.72,307.83
4130426,985,93228,,,,,,,EXT. ECG COMPLETE (PROF),56.01,22.4,0,56.01,47.61,SKIPPED,56.01,56.01,47.61,47.61,47.61,28.19,27.44,27.44,0,16.8,28.77,28.77,0
4130427,986,95819,,,,,,,EEG INCLUD.REC AWAKE & ALSEEP PROF,125.02,50.01,0,125.02,106.27,SKIPPED,125.02,125.02,106.27,106.27,106.27,63.37,61.26,61.26,0,37.51,64.66,64.66,0
4130428,986,95813,,,,,,,EEG EXTENDED MONITOR >1 HOUR PROF,188.97,75.59,0,188.97,160.62,SKIPPED,188.97,188.97,160.62,160.62,160.62,95.8,92.6,92.6,0,56.69,97.75,97.75,0
4130429,986,95722,,,,,,,RETROSPECTIVE REVIEW 36-60 HOURS,540.91,216.36,0,540.91,459.77,SKIPPED,540.91,540.91,459.77,459.77,459.77,275.54,265.05,265.05,0,162.27,281.16,281.16,0
4130430,986,95724,,,,,,,RETROSPECTIVE REVIEW 60-84 HOURS,690.54,276.22,0,690.54,586.96,SKIPPED,690.54,690.54,586.96,586.96,586.96,350.41,338.36,338.36,0,207.16,357.56,357.56,0
4130431,986,95726,,,,,,,RETROSPECTIVE REVIEW >84 HOURS,873.48,349.39,0,873.48,742.46,SKIPPED,873.48,873.48,742.46,742.46,742.46,444.5,428.01,428.01,0,262.04,453.57,453.57,0
4130432,986,95816,,,,,,,EEG INCLD REC. AWAKE & DROWSY PROF,124.28,49.71,0,124.28,105.64,SKIPPED,124.28,124.28,105.64,105.64,105.64,63,60.9,60.9,0,37.28,64.29,64.29,0
4130433,986,95957,,,,,,,DIGITAL ANALYSIS EEG PROF,221.78,88.71,0,221.78,188.51,SKIPPED,221.78,221.78,188.51,188.51,188.51,113.16,108.67,108.67,0,66.53,115.47,115.47,0
4130434,986,95822,,,,,,,EEG RECORDING COMA OR ALSEEP ONLY PROF,125.02,50.01,0,125.02,106.27,SKIPPED,125.02,125.02,106.27,106.27,106.27,63.37,61.26,61.26,0,37.51,64.66,64.66,0
4130435,986,95812,,,,,,,EEG EXTENDED MONITOR 41-60 MIN PROF,124.28,49.71,0,124.28,105.64,SKIPPED,124.28,124.28,105.64,105.64,105.64,63,60.9,60.9,0,37.28,64.29,64.29,0
4150000,948,94625,,,,,,,Pulmonary rehab w exer,75.29,30.12,0,64,64,SKIPPED,57.22,57.22,64,64,64,31.72,36.89,36.89,0,22.59,32.37,32.37,64
4150001,943,93798,,,,,,,CARDIAC REHAB/MONITOR,33.8,13.52,0,33.8,28.73,SKIPPED,33.8,33.8,28.73,28.73,28.73,14.24,16.56,16.56,0,10.14,14.53,14.53,28.73
4150002,948,G0237,,,,,,,THERAPEUTIC PROC TO INCREASE RESP MUSC.,24.91,9.96,0,24.91,21.17,SKIPPED,24.91,24.91,21.17,21.17,21.17,10.5,12.21,12.21,0,7.47,10.71,10.71,21.17
4150003,948,G0238,,,,,,,THERAPEUTIC PROC TO IMPROVE RESP FUNC.,25.8,10.32,0,25.8,21.93,SKIPPED,25.8,25.8,21.93,21.93,21.93,10.87,12.64,12.64,0,7.74,11.09,11.09,21.93
4150004,948,G0239,,,,,,,THERAPY PROC TO IMPROVE RESP FUNC(GROUP),32.94,13.18,0,32.94,28,SKIPPED,32.94,32.94,28,28,28,13.88,16.14,16.14,0,9.88,14.16,14.16,28
4150006,948,93668,,,,,,,PERIPHERAL ARTERIAL DISEASE REHAB PER SE,44.6,17.84,0,44.6,37.91,SKIPPED,44.6,44.6,37.91,37.91,37.91,18.8,21.85,21.85,0,13.38,19.18,19.18,37.91
4150007,948,93797,,,,,,,CARDIAC REHAB W/O CONT ECG MONITOR,21.17,8.47,0,21.17,17.99,SKIPPED,21.17,21.17,17.99,17.99,17.99,8.92,10.37,10.37,0,6.35,9.1,9.1,17.99
4160000,948,94625,,,,,,,Pulmonary rehab w exer,1003.81,401.52,0,853.24,853.24,SKIPPED,762.9,762.9,853.24,853.24,853.24,423.01,491.87,491.87,0,301.14,431.64,431.64,853.24
4160001,943,93798,,,,,,,CARDIAC REHAB/MONITOR,286.1,114.44,0,243.18,243.18,SKIPPED,68.21,68.21,243.18,243.18,243.18,120.56,140.19,140.19,0,85.83,123.02,123.02,243.18
4160002,489,G0237,,,,,,,THERAPEUTIC PROC TO INCREASE RESP MUSC.,139.37,55.75,0,118.46,118.46,SKIPPED,47.74,47.74,118.46,118.46,118.46,58.73,68.29,68.29,0,41.81,59.93,59.93,118.46
4160003,489,G0238,,,,,,,THERAPEUTIC PROC TO IMPROVE RESP FUNC.,140.71,56.28,0,119.6,119.6,SKIPPED,49.45,49.45,119.6,119.6,119.6,59.3,68.95,68.95,0,42.21,60.51,60.51,119.6
4160004,489,G0239,,,,,,,THERAPY PROC TO IMPROVE RESP FUNC(GROUP),195.43,78.17,0,166.12,166.12,SKIPPED,63.08,63.08,166.12,166.12,166.12,82.35,95.76,95.76,0,58.63,84.03,84.03,166.12
4160005,489,,,,,,,,CARDIOPULM REHAB MAINT 30 MIN.,19.15,7.66,0,16.28,16.28,SKIPPED,14.55,14.55,16.28,16.28,16.28,8.07,9.38,9.38,0,5.74,8.23,8.23,16.28
4160006,489,93668,,,,,,,PERIPHERAL ARTERIAL DISEASE REHAB PER SE,210.59,84.24,0,179,179,SKIPPED,93.76,93.76,179,179,179,88.74,103.19,103.19,0,63.18,90.55,90.55,179
4160007,489,93797,,,,,,,CARDIAC REHAB W/O CONT ECG MONITOR,237.39,94.96,0,201.78,201.78,SKIPPED,42.61,42.61,201.78,201.78,201.78,100.04,116.32,116.32,0,71.22,102.08,102.08,201.78
4170011,740,95812,,,,,,,EEG EXTENDED MONITOR 41-60 MIN,1272.64,509.06,0,1272.64,1081.74,SKIPPED,1272.64,1272.64,1081.74,1081.74,1081.74,536.3,623.59,623.59,0,381.79,547.24,547.24,1081.74
4170012,740,95813,,,,,,,EEG EXTENDED MONITOR >1 HOUR,1583.81,633.52,0,1541.04,1346.24,SKIPPED,1541.04,1541.04,1346.24,1346.24,1346.24,667.42,776.07,776.07,0,475.14,681.04,681.04,1346.24
4170013,740,95816,,,,,,,EEG INCLD REC. AWAKE & DROWSY,1097.61,439.04,0,1097.61,932.97,SKIPPED,1097.61,1097.61,932.97,932.97,932.97,462.53,537.83,537.83,0,329.28,471.97,471.97,932.97
4170014,740,95819,,,,,,,EEG INCLD REC. AWAKE & ASLEEP,1219.16,487.66,0,1219.16,1036.29,SKIPPED,1219.16,1219.16,1036.29,1036.29,1036.29,513.76,597.39,597.39,0,365.75,524.24,524.24,1036.29
4170015,740,95822,,,,,,,EEG RECORDING COMA OR ALSEEP ONLY,1216.72,486.69,0,1216.72,1034.21,SKIPPED,1216.72,1216.72,1034.21,1034.21,1034.21,512.73,596.19,596.19,0,365.02,523.19,523.19,1034.21
4170016,740,95824,,,,,,,EEG-CEREBRAL DEATH EVAL ONLY,1284.79,513.92,0,1092.07,1092.07,SKIPPED,192.61,192.61,1092.07,1092.07,1092.07,541.41,629.55,629.55,0,385.44,552.46,552.46,1092.07
4170017,740,95827,,,,,,,EEG ALL NIGHT RECORDING,1828.12,731.25,0,1553.9,1553.9,SKIPPED,1389.37,1389.37,1553.9,1553.9,1553.9,770.37,895.78,895.78,0,548.44,786.09,786.09,1553.9
4170018,740,95950,,,,,,,MONITORING ID LATERAL SEIZURE FOCUS,2270.56,908.22,0,1929.98,1929.98,SKIPPED,1725.63,1725.63,1929.98,1929.98,1929.98,956.81,1112.57,1112.57,0,681.17,976.34,976.34,1929.98
4170019,740,95951,,,,,,,LOCALIZE CEREBRAL SEIZURE CABLE/RADIO EE,4200.79,1680.32,0,3570.67,3570.67,SKIPPED,3192.6,3192.6,3570.67,3570.67,3570.67,1770.21,2058.39,2058.39,0,1260.24,1806.34,1806.34,3570.67
4170020,740,95953,,,,,,,LOCALIZE CEREBRAL SEIZURE CPTR PORT.EEG,3170.04,1268.02,0,2694.53,2694.53,SKIPPED,2409.23,2409.23,2694.53,2694.53,2694.53,1335.86,1553.32,1553.32,0,951.01,1363.12,1363.12,2694.53
4170021,740,95956,,,,,,,MNTR SEIZURE CMPTR 16 CHAN EEG ATND EA,3621,1448.4,0,3077.85,3077.85,SKIPPED,2751.96,2751.96,3077.85,3077.85,3077.85,1525.89,1774.29,1774.29,0,1086.3,1557.03,1557.03,3077.85
4170022,740,95957,,,,,,,DIGITAL ANALYSIS EEG,679.48,271.79,0,679.48,577.56,SKIPPED,679.48,679.48,577.56,577.56,577.56,286.34,332.95,332.95,0,203.84,292.18,292.18,577.56
4170023,740,95999,,,,,,,EEG SET UP/TAKE DOWN,153.86,61.54,0,153.86,130.78,SKIPPED,153.86,153.86,130.78,130.78,130.78,64.84,75.39,75.39,0,46.16,66.16,66.16,130.78
4170024,740,95711,,,,,,,EEG UNMONITORED(RETRO REVIEW) 2-12 HOURS,291.55,116.62,0,291.55,247.82,SKIPPED,291.55,291.55,247.82,247.82,247.82,122.86,142.86,142.86,0,87.46,125.37,125.37,247.82
4170025,740,95714,,,,,,,EEG UNMONITORED(RETRO REVIEW) 12-26 HOUR,537.78,215.11,0,537.78,457.11,SKIPPED,537.78,537.78,457.11,457.11,457.11,226.62,263.51,263.51,0,161.33,231.25,231.25,457.11
4180001,460,94015,,,,,,,SIMPLE SPIROMETRY,119.42,47.77,0,119.42,101.51,SKIPPED,119.42,119.42,101.51,101.51,101.51,50.32,58.52,58.52,0,35.83,51.35,51.35,101.51
4180002,460,94060,,,,,,,SPIROMETRY PRE AND POST,201.69,80.68,0,201.69,171.44,SKIPPED,201.69,201.69,171.44,171.44,171.44,85,98.83,98.83,0,60.51,86.73,86.73,171.44
4180003,460,94070,,,,,,,BRONCHIAL PROVOCATION,150.36,60.14,0,150.36,127.81,SKIPPED,150.36,150.36,127.81,127.81,127.81,63.36,73.68,73.68,0,45.11,64.65,64.65,127.81
4180004,460,94150,,,,,,,SLOW VITAL CAPACITY,72.91,29.16,0,72.91,61.97,SKIPPED,72.91,72.91,61.97,61.97,61.97,30.72,35.73,35.73,0,21.87,31.35,31.35,61.97
4180005,460,94375,,,,,,,FLOW VOLUME LOOP,128.79,51.52,0,128.79,109.47,SKIPPED,128.79,128.79,109.47,109.47,109.47,54.27,63.11,63.11,0,38.64,55.38,55.38,109.47
4180011,460,94726,,,,,,,PLETHYSMOGRAPHY,1535.9,614.36,0,1305.52,1305.52,SKIPPED,1181.94,1181.94,1305.52,1305.52,1305.52,647.23,752.59,752.59,0,460.77,660.44,660.44,1305.52
4180012,460,94750,,,,,,,AIRWAY RES (RAW),166.05,66.42,0,166.05,141.14,SKIPPED,166.05,166.05,141.14,141.14,141.14,69.97,81.36,81.36,0,49.82,71.4,71.4,141.14
4180015,460,94729,,,,,,,DLCO,183.06,73.22,0,183.06,155.6,SKIPPED,183.06,183.06,155.6,155.6,155.6,77.15,89.7,89.7,0,54.92,78.72,78.72,155.6
4180019,460,94618,,,,,,,PFT-6 MIN. WAL TEST,369.86,147.94,0,369.86,314.38,SKIPPED,369.86,369.86,314.38,314.38,314.38,155.86,181.23,181.23,0,110.96,159.04,159.04,314.38
4180020,460,94060,,,,,,,OCCUPATIONAL HEALTH-PFT,85.1,34.04,0,85.1,72.34,SKIPPED,85.1,85.1,72.34,72.34,72.34,35.86,41.7,41.7,0,25.53,36.59,36.59,72.34
4180021,460,94799,,,,,,,OCCUPATIONAL HEALTH-RESPIRATOR FIT TEST,68.15,27.26,0,68.15,57.93,SKIPPED,68.15,68.15,57.93,57.93,57.93,28.71,33.39,33.39,0,20.44,29.3,29.3,57.93
4190001,972,74185,,,,,,,MRA ABDOMEN WITH CONTRAST,259.98,103.99,0,259.98,220.98,SKIPPED,259.98,259.98,220.98,220.98,220.98,95.34,127.39,127.39,0,77.99,97.29,97.29,0
4190002,972,70544,,,,,,,MRA HEAD W/O CONTRAST,174.35,69.74,0,174.35,148.2,SKIPPED,174.35,174.35,148.2,148.2,148.2,64.41,174.35,174.35,0,149.14,65.72,65.72,0
4190003,972,70548,,,,,,,MRA NECK W CONTRAST,181.03,72.41,0,181.03,153.88,SKIPPED,181.03,181.03,153.88,153.88,153.88,80.44,181.03,181.03,0,162.26,82.08,82.08,0
4190004,972,70549,,,,,,,MRA NECK WITH & W/O CONTRAST,261.46,104.58,0,261.46,222.24,SKIPPED,261.46,261.46,222.24,222.24,222.24,96.46,261.46,261.46,0,261.46,98.43,98.43,0
4190005,972,74181,,,,,,,MRCP IMAGING,211.33,84.53,0,211.33,179.63,SKIPPED,211.33,211.33,179.63,179.63,179.63,78.14,211.33,211.33,0,149.14,79.73,79.73,0
4190006,972,74183,,,,,,,MRI ABDOMEN W / WO CONTRAST,328.05,131.22,0,328.05,278.84,SKIPPED,328.05,328.05,278.84,278.84,278.84,117.13,328.05,328.05,0,292.99,119.52,119.52,0
4190007,972,70553,,,,,,,MRI BRAIN W / WO CONTRAST,342.8,137.12,0,342.8,291.38,SKIPPED,342.8,342.8,291.38,291.38,291.38,122.36,342.8,342.8,0,292.99,124.86,124.86,0
4190008,972,70551,,,,,,,MRI BRAIN/BRAIN STEM W/O,215.76,86.3,0,215.76,183.4,SKIPPED,215.76,215.76,183.4,183.4,183.4,79.28,215.76,215.76,0,149.14,80.9,80.9,0
4190009,972,70552,,,,,,,MRI BRAIN/BRAIN STEM W CO,259.98,103.99,0,259.98,220.98,SKIPPED,259.98,259.98,220.98,220.98,220.98,95.31,259.98,259.98,0,162.26,97.26,97.26,0
4190010,972,72141,,,,,,,MRI CERV SPINE W/O CONTRA,233.45,93.38,0,233.45,198.43,SKIPPED,233.45,233.45,198.43,198.43,198.43,79.65,233.45,233.45,0,149.14,81.28,81.28,0
4190011,972,72148,,,,,,,MRI LUMBAR SPINE W/O CONT,217.23,86.89,0,217.23,184.65,SKIPPED,217.23,217.23,184.65,184.65,184.65,79.65,217.23,217.23,0,149.14,81.28,81.28,0
4190012,972,72158,,,,,,,MRI LUMBAR SPINE W/WO CON,345.74,138.3,0,345.74,293.88,SKIPPED,345.74,345.74,293.88,293.88,293.88,122.36,345.74,345.74,0,292.99,124.86,124.86,0
4190013,972,73718,,,,,,,MRI LWR EX OTR THN JTW/O,196.47,78.59,0,196.47,167,SKIPPED,196.47,196.47,167,167,167,72.13,196.47,196.47,0,149.14,73.6,73.6,0
4190014,972,73720,,,,,,,MRI LWR EX OTR THN JTW/WO,311.7,124.68,0,311.7,264.94,SKIPPED,311.7,311.7,264.94,264.94,264.94,114.81,311.7,311.7,0,292.99,117.15,117.15,0
4190015,972,73721,,,,,,,MRI LWR EXT ANY JOINT W/O,199.4,79.76,0,199.4,169.49,SKIPPED,199.4,199.4,169.49,169.49,169.49,73.1,199.4,199.4,0,149.14,74.59,74.59,0
4190016,972,72195,,,,,,,MRI PELVIS W/O CONTRAST,214.31,85.72,0,214.31,182.16,SKIPPED,214.31,214.31,182.16,182.16,182.16,78.51,214.31,214.31,0,149.14,80.11,80.11,0
4190017,972,72197,,,,,,,MRI PELVIS W/WO CONTRAST,328.05,131.22,0,328.05,278.84,SKIPPED,328.05,328.05,278.84,278.84,278.84,117.5,328.05,328.05,0,292.99,119.9,119.9,0
4190018,972,72146,,,,,,,MRI THORACIC SPINE W/O CO,233.45,93.38,0,233.45,198.43,SKIPPED,233.45,233.45,198.43,198.43,198.43,79.28,233.45,233.45,0,149.14,80.9,80.9,0
4190019,972,72157,,,,,,,MRI THORACIC SPINE W/WO C,275.08,110.03,0,275.08,233.82,SKIPPED,275.08,275.08,233.82,233.82,233.82,122.36,275.08,275.08,0,275.08,124.86,124.86,0
4190020,972,73218,,,,,,,MRI UPR EX OTH THN JT W/O,196.47,78.59,0,196.47,167,SKIPPED,196.47,196.47,167,167,167,72.87,196.47,196.47,0,149.14,74.36,74.36,0
4190021,972,73221,,,,,,,MRI UPR EXT ANY JOINT W/O,199.4,79.76,0,199.4,169.49,SKIPPED,199.4,199.4,169.49,169.49,169.49,73.1,199.4,199.4,0,149.14,74.59,74.59,0
4190022,972,74182,,,,,,,MRI ABDOMEN W / CONTRAST,1056.31,422.52,0,1056.31,897.86,SKIPPED,1056.31,1056.31,897.86,897.86,897.86,92.62,463.83,463.83,0,292.99,94.51,94.51,0
4190023,972,73719,,,,,,,MRI LOWER EXT W/CONTRAST PROF,293.28,117.31,0,293.28,249.29,SKIPPED,293.28,293.28,249.29,249.29,249.29,86.84,293.28,293.28,0,162.26,88.61,88.61,0
4190024,972,72149,,,,,,,MRI LUMBAR W/ CONTRAST PROF,249.4,99.76,0,249.4,211.99,SKIPPED,249.4,249.4,211.99,211.99,211.99,95.31,249.4,249.4,0,249.4,97.26,97.26,0
4190025,972,72156,,,,,,,MRI CERVICAL SPINE W/WO,412.61,165.04,0,412.61,350.72,SKIPPED,412.61,412.61,350.72,350.72,350.72,122.36,412.61,412.61,0,292.99,124.86,124.86,0
4190026,972,70543,,,,,,,MRI ORBIT-FACE-NECK W/WO,386.09,154.44,0,386.09,328.18,SKIPPED,386.09,386.09,328.18,328.18,328.18,114.43,386.09,386.09,0,292.99,116.77,116.77,0
4190028,972,73723,,,,,,,MRI LWR EXT ANY JT W/WO,387.27,154.91,0,387.27,329.18,SKIPPED,387.27,387.27,329.18,329.18,329.18,114.81,387.27,387.27,0,292.99,117.15,117.15,0
4190029,972,76377,,,,,,,MRI 3-D,143.35,57.34,0,143.35,121.85,SKIPPED,143.35,143.35,121.85,121.85,121.85,42.52,70.24,70.24,0,43,43.39,43.39,0
4194015,976,94016,,,,,,,SIMPLE SPIROMETRY PROF,81.63,32.65,0,81.63,69.39,SKIPPED,81.63,81.63,69.39,69.39,69.39,27.44,40,40,0,24.49,28,28,0
4194060,976,94060,,,,,,,SPIROMETRY PRE & POST,31.45,12.58,0,31.45,26.73,SKIPPED,31.45,31.45,26.73,26.73,26.73,11.42,15.41,15.41,0,9.44,11.65,11.65,0
4194070,976,94070,,,,,,,BRONCHIAL PROVOCATION PROF,69.59,27.84,0,69.59,59.15,SKIPPED,69.59,69.59,59.15,59.15,59.15,31.31,34.1,34.1,0,20.88,31.95,31.95,0
4194150,976,94150,,,,,,,SLOW VITAL CAPACITY PROF,67.55,27.02,0,67.55,57.42,SKIPPED,67.55,67.55,57.42,57.42,57.42,0,33.1,33.1,0,20.26,0,0,0
4194375,976,94375,,,,,,,FLOW VOLUME LOOP PROF,35.7,14.28,0,35.7,30.34,SKIPPED,35.7,35.7,30.34,30.34,30.34,16.03,17.49,17.49,0,10.71,16.36,16.36,0
4194726,976,94726,,,,,,,PLETHYSMOGAPHY PROF,29.75,11.9,0,29.75,25.29,SKIPPED,29.75,29.75,25.29,25.29,25.29,13.35,14.58,14.58,0,8.92,13.62,13.62,0
4194729,976,94729,,,,,,,DLCO PROF,22.03,8.81,0,22.03,18.73,SKIPPED,22.03,22.03,18.73,18.73,18.73,9.87,10.79,10.79,0,6.61,10.07,10.07,0
4194750,976,94750,,,,,,,AIRWAY RES PROF,26.32,10.53,0,26.32,22.37,SKIPPED,26.32,26.32,22.37,22.37,22.37,12.33,12.9,12.9,0,7.9,12.58,12.58,0
4200001,972,77066,,,,,,,CAD DIAGNOSTIC,9.25,3.7,0,54.64,7.86,SKIPPED,9.25,9.25,7.86,7.86,7.86,53.55,4.53,4.53,0,2.78,54.64,54.64,0
4200003,972,77066,,,,,,,DIGITAL DIAG BILAT MAMMO,136.56,54.62,0,136.56,116.08,SKIPPED,136.56,136.56,116.08,116.08,116.08,53.55,66.91,66.91,0,40.97,54.64,54.64,0
4200004,972,77065,,,,,,,DIGITAL DIAG UNI MAMMO,108.69,43.48,0,108.69,92.39,SKIPPED,108.69,108.69,92.39,92.39,92.39,43.3,53.26,53.26,0,32.61,44.18,44.18,0
4200005,972,77067,,,,,,,SCREENMAMMO2DALLVIEWS,117.93,47.17,0,117.93,100.24,SKIPPED,117.93,117.93,100.24,100.24,100.24,40.6,57.79,57.79,0,35.38,41.43,41.43,0
4200006,972,19282,,,,,,,NEEDLE PLACEMENT EACH LE,123.04,49.22,0,104.58,104.58,SKIPPED,0,0,104.58,104.58,104.58,54.46,60.29,60.29,0,36.91,55.57,55.57,0
4200007,972,76098,,,,,,,SPECIMAN MAMMO P/SPE,24.79,9.92,0,24.79,21.07,SKIPPED,24.79,24.79,21.07,21.07,21.07,17.02,24.79,24.79,0,24.79,17.37,17.37,0
4200008,972,74177,,,,,,,ABD & PEL W/CONTRAST,277.66,111.06,0,277.66,236.01,SKIPPED,277.66,277.66,236.01,236.01,236.01,97.61,277.66,277.66,0,162.26,99.6,99.6,0
4200009,972,74176,,,,,,,ABD & PEL W/O CONTRAST,314.92,125.97,0,314.92,267.68,SKIPPED,314.92,314.92,267.68,267.68,267.68,93,289.96,289.96,0,149.14,94.9,94.9,0
4200010,972,74178,,,,,,,ABD & PEL W/WO CONTRAST,324.18,129.67,0,324.18,275.55,SKIPPED,324.18,324.18,275.55,275.55,275.55,107.26,324.18,324.18,0,162.26,109.45,109.45,0
4200011,972,74170,,,,,,,CT ABD W & W/O CONTRAST,214.01,85.6,0,214.01,181.91,SKIPPED,214.01,214.01,181.91,181.91,181.91,75.05,214.01,214.01,0,162.26,76.58,76.58,0
4200012,972,74160,,,,,,,CT ABD W/ CONTRAST,193.94,77.58,0,193.94,164.85,SKIPPED,193.94,193.94,164.85,164.85,164.85,68.27,193.94,193.94,0,162.26,69.66,69.66,0
4200013,972,74150,,,,,,,CT ABD W/O CONTRAST,181.59,72.64,0,181.59,154.35,SKIPPED,181.59,181.59,154.35,154.35,154.35,64.02,137.3,137.3,0,73.48,65.33,65.33,0
4200014,972,72127,,,,,,,CT CERV SP W/O & W/C,193.94,77.58,0,193.94,164.85,SKIPPED,193.94,193.94,164.85,164.85,164.85,68.12,193.94,193.94,0,162.26,69.51,69.51,0
4200015,972,72125,,,,,,,CT CERVICAL SPINE W/O CON,162.95,65.18,0,162.95,138.51,SKIPPED,162.95,162.95,138.51,138.51,138.51,53.55,137.3,137.3,0,73.48,54.64,54.64,0
4200016,972,71275,,,,,,,CT CHEST FOR PE CTA,293.21,117.28,0,293.21,249.23,SKIPPED,293.21,293.21,249.23,249.23,249.23,97.24,224.97,224.97,0,162.26,99.22,99.22,0
4200018,972,74176,,,,,,,CT FOR KIDNEY STONE,265.22,106.09,0,265.22,225.44,SKIPPED,265.22,265.22,225.44,225.44,225.44,93,265.22,265.22,0,149.14,94.9,94.9,0
4200019,972,70460,,,,,,,CT HEAD/BRAIN W/CONTRAST,170.72,68.29,0,170.72,145.11,SKIPPED,170.72,170.72,145.11,145.11,145.11,60.49,170.72,170.72,0,162.26,61.72,61.72,0
4200020,972,70470,,,,,,,CT HEAD/BRAIN W/O &,193.94,77.58,0,193.94,164.85,SKIPPED,193.94,193.94,164.85,164.85,164.85,68.27,193.94,193.94,0,162.26,69.66,69.66,0
4200021,972,70450,,,,,,,CT HEAD/BRAIN W/O CONTRAS,128.79,51.52,0,128.79,109.47,SKIPPED,128.79,128.79,109.47,109.47,109.47,45.24,128.79,128.79,0,73.48,46.16,46.16,0
4200022,972,72132,,,,,,,CT LUMBARSP W/CONTRAST,186.14,74.46,0,186.14,158.22,SKIPPED,186.14,186.14,158.22,158.22,158.22,65.2,186.14,186.14,0,186.14,66.53,66.53,0
4200023,972,72133,,,,,,,CT LUMBAR SP W/O CON,192.31,76.92,0,192.31,163.46,SKIPPED,192.31,192.31,163.46,163.46,163.46,68.12,192.31,192.31,0,162.26,69.51,69.51,0
4200024,972,70488,,,,,,,CT MAXILLOFACIAL W/W,217.23,86.89,0,217.23,184.65,SKIPPED,217.23,217.23,184.65,184.65,184.65,67.89,217.23,217.23,0,162.26,69.28,69.28,0
4200025,972,70492,,,,,,,CT NECK SOFT TISSUE WO/W,220.31,88.12,0,220.31,187.26,SKIPPED,220.31,220.31,187.26,187.26,187.26,86.47,220.31,220.31,0,162.26,88.23,88.23,0
4200026,972,72192,,,,,,,CT PELVIS W/O CONTRAST,164.43,65.77,0,164.43,139.77,SKIPPED,164.43,164.43,139.77,139.77,139.77,58.17,137.3,137.3,0,73.48,59.36,59.36,0
4200027,972,72193,,,,,,,CT PELVIS W/ CONTRAST,176.89,70.76,0,176.89,150.36,SKIPPED,176.89,176.89,150.36,150.36,150.36,62.01,176.89,176.89,0,162.26,63.28,63.28,0
4200028,972,70496,,,,,,,CTA BRAIN/HEAD,265.22,106.09,0,265.22,225.44,SKIPPED,265.22,265.22,225.44,225.44,225.44,93.39,224.97,224.97,0,162.26,95.3,95.3,0
4200030,972,70498,,,,,,,CTA NECK,265.22,106.09,0,265.22,225.44,SKIPPED,265.22,265.22,225.44,225.44,225.44,93.39,224.97,224.97,0,162.26,95.3,95.3,0
4200031,972,73700,,,,,,,LOWER EXT W/O CONTRAST,153.58,61.43,0,153.58,130.54,SKIPPED,153.58,153.58,130.54,130.54,130.54,53.55,137.3,137.3,0,73.48,54.64,54.64,0
4200032,972,73701,,,,,,,LOWER EXT W/CONTRAST,176.89,70.76,0,176.89,150.36,SKIPPED,176.89,176.89,150.36,150.36,150.36,62.01,176.89,176.89,0,162.26,63.28,63.28,0
4200033,972,70488,,,,,,,MAXILLAFACIAL ARE W/O F/U,217.23,86.89,0,217.23,184.65,SKIPPED,217.23,217.23,184.65,184.65,184.65,67.89,217.23,217.23,0,162.26,69.28,69.28,0
4200034,972,70487,,,,,,,MAXILLOFAC W/CONTRAST,196.99,78.8,0,196.99,167.44,SKIPPED,196.99,196.99,167.44,167.44,167.44,60.11,196.99,196.99,0,162.26,61.34,61.34,0
4200035,972,70486,,,,,,,MAXILLOFAC W/O CONTRAST,173.82,69.53,0,173.82,147.75,SKIPPED,173.82,173.82,147.75,147.75,147.75,45.61,137.3,137.3,0,73.48,46.54,46.54,0
4200036,972,70491,,,,,,,SOFT TISS NECK W/CONTRAST,209.32,83.73,0,209.32,177.92,SKIPPED,209.32,209.32,177.92,177.92,177.92,74.05,209.32,209.32,0,162.26,75.56,75.56,0
4200037,972,70490,,,,,,,SOFT TISS NECK W/O CONTRA,195.38,78.15,0,195.38,166.07,SKIPPED,195.38,195.38,166.07,166.07,166.07,68.65,137.3,137.3,0,73.48,70.05,70.05,0
4200038,972,72128,,,,,,,THORACIC SPINE W/O CONTRA,151.96,60.78,0,151.96,129.17,SKIPPED,151.96,151.96,129.17,129.17,129.17,53.55,137.3,137.3,0,73.48,54.64,54.64,0
4200039,972,71260,,,,,,,THORAX W/CONTRAST,190.83,76.33,0,190.83,162.21,SKIPPED,190.83,190.83,162.21,162.21,162.21,62.01,190.83,190.83,0,162.26,63.28,63.28,0
4200040,972,71250,,,,,,,THORAX W/O CONTRAST,155.18,62.07,0,155.18,131.9,SKIPPED,155.18,155.18,131.9,131.9,131.9,57.78,137.3,137.3,0,73.48,58.96,58.96,0
4200041,972,71270,,,,,,,THORAX W/O FOL W/CONTRAST,209.32,83.73,0,209.32,177.92,SKIPPED,209.32,209.32,177.92,177.92,177.92,67.1,209.32,209.32,0,162.26,68.47,68.47,0
4200042,972,73200,,,,,,,UPPER EXT W/O CONTRAST,153.58,61.43,0,153.58,130.54,SKIPPED,153.58,153.58,130.54,130.54,130.54,53.55,137.3,137.3,0,73.48,54.64,54.64,0
4200043,972,73050,,,,,,,A-C JOINTS BILATERAL,25.36,10.14,0,25.36,21.56,SKIPPED,25.36,25.36,21.56,21.56,21.56,10.23,25.36,25.36,0,25.36,10.44,10.44,0
4200044,972,74019,,,,,,,ABD W/OBLIQUE OR CON,27.96,11.18,0,27.96,23.77,SKIPPED,27.96,27.96,23.77,23.77,23.77,12.55,27.96,27.96,0,27.96,12.81,12.81,0
4200045,972,74019,,,,,,,ABD-FLAT&ERECT/DECUB,27.96,11.18,0,27.96,23.77,SKIPPED,27.96,27.96,23.77,23.77,23.77,12.55,27.96,27.96,0,27.96,12.81,12.81,0
4200046,972,74018,,,,,,,ABDOMEN 1 VIEW,21.99,8.8,0,21.99,18.69,SKIPPED,21.99,21.99,18.69,18.69,18.69,9.85,21.99,21.99,0,21.99,10.05,10.05,0
4200047,972,74022,,,,,,,ACUTE ABD W/PA CHEST,38.89,15.56,0,38.89,33.06,SKIPPED,38.89,38.89,33.06,33.06,33.06,17.18,38.89,38.89,0,38.89,17.53,17.53,0
4200048,972,73600,,,,,,,RIGHT ANKLE 2 VIEW PROF,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,8.7,20.27,20.27,0,20.27,8.88,8.88,0
4200049,972,73610,,,,,,,RIGHT ANKLE 3 VIEW PROF,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200050,972,73650,,,,,,,RIGHT CALCANEUS,19.45,7.78,0,19.45,16.53,SKIPPED,19.45,19.45,16.53,16.53,16.53,8.7,19.45,19.45,0,19.45,8.88,8.88,0
4200051,972,71045,,,,,,,CHEST 1 VIEW,21.99,8.8,0,21.99,18.69,SKIPPED,21.99,21.99,18.69,18.69,18.69,9.85,21.99,21.99,0,21.99,10.05,10.05,0
4200052,972,71046,,,,,,,CHEST 2 VIEW,26.26,10.5,0,26.26,22.32,SKIPPED,26.26,26.26,22.32,22.32,22.32,11.79,26.26,26.26,0,26.26,12.03,12.03,0
4200053,972,71047,,,,,,,CHEST PA/LAT W/LORDO,33.87,13.55,0,33.87,28.79,SKIPPED,33.87,33.87,28.79,28.79,28.79,14.48,33.87,33.87,0,33.87,14.78,14.78,0
4200054,972,71047,,,,,,,CHEST SPEC VIEWS (DEC,33.87,13.55,0,33.87,28.79,SKIPPED,33.87,33.87,28.79,28.79,28.79,14.48,33.87,33.87,0,33.87,14.78,14.78,0
4200057,972,73000,,,,,,,RIGHT CLAVICLE PROF,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,9.07,20.27,20.27,0,20.27,9.26,9.26,0
4200058,972,74280,,,,,,,COLON W/AIR CONTRAST,119.29,47.72,0,119.29,101.4,SKIPPED,119.29,119.29,101.4,101.4,101.4,67.49,119.29,119.29,0,119.29,68.87,68.87,0
4200059,972,77080,,,,,,,DEXA-BONE DENSITY,24.54,9.82,0,24.54,20.86,SKIPPED,24.54,24.54,20.86,20.86,20.86,10.64,24.54,24.54,0,24.54,10.86,10.86,0
4200060,972,73070,,,,,,,RIGHT ELBOW 2 VIEW,19.4,7.76,0,19.4,16.49,SKIPPED,19.4,19.4,16.49,16.49,16.49,9.07,19.4,19.4,0,19.4,9.26,9.26,0
4200061,972,73080,,,,,,,RIGHT ELBOW 3 VIEWS PROF,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200062,972,74220,,,,,,,ESOPHAGUS,55.79,22.32,0,55.79,47.42,SKIPPED,55.79,55.79,47.42,47.42,47.42,32.13,55.79,55.79,0,55.79,32.79,32.79,0
4200063,972,70140,,,,,,,FACIAL BONES LESS 3V,25.32,10.13,0,25.32,21.52,SKIPPED,25.32,25.32,21.52,21.52,21.52,10.99,25.32,25.32,0,25.32,11.21,11.21,0
4200064,972,70150,,,,,,,FACIAL BONES MIN 3 V,32.17,12.87,0,32.17,27.34,SKIPPED,32.17,32.17,27.34,27.34,27.34,14.09,32.17,32.17,0,32.17,14.38,14.38,0
4200065,972,73552,,,,,,,RIGHT FEMUR 2 VIEW,22.83,9.13,0,22.83,19.41,SKIPPED,22.83,22.83,19.41,19.41,19.41,9.85,22.83,22.83,0,22.83,10.05,10.05,0
4200066,972,73140,,,,,,,RIGHT FINGER PROF,16.84,6.74,0,16.84,14.31,SKIPPED,16.84,16.84,14.31,14.31,14.31,7.53,16.84,16.84,0,16.84,7.68,7.68,0
4200068,972,76000,,,,,,,FLURO MISC UP TO 1 H,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200070,972,73620,,,,,,,RIGHT FOOT 2 VIEW PROF,18.61,7.44,0,18.61,15.82,SKIPPED,18.61,18.61,15.82,15.82,15.82,8.33,18.61,18.61,0,18.61,8.5,8.5,0
4200071,972,73630,,,,,,,RIGHT FOOT 3 VIEW PROF,20.31,8.12,0,20.31,17.26,SKIPPED,20.31,20.31,17.26,17.26,17.26,9.09,20.31,20.31,0,20.31,9.28,9.28,0
4200072,972,73090,,,,,,,RIGHT FOREARM 2 VIEW PROF,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,8.7,20.27,20.27,0,20.27,8.88,8.88,0
4200073,972,74246,,,,,,,GI/HD BARIUM,82.95,33.18,0,82.95,70.51,SKIPPED,82.95,82.95,70.51,70.51,70.51,47.93,82.95,82.95,0,82.95,48.91,48.91,0
4200074,972,73120,,,,,,,RIGHT HAND 2 VIEW PROF,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,9.07,20.27,20.27,0,20.27,9.26,9.26,0
4200075,972,73130,,,,,,,RIGHT HAND 3 VIEW PROF,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200076,972,73502,,,,,,,HIP & PELVIS/CHILD,27.1,10.84,0,27.1,23.04,SKIPPED,27.1,27.1,23.04,23.04,23.04,12.16,27.1,27.1,0,27.1,12.41,12.41,0
4200077,972,73501,,,,,,,RIGHT HIP 1 VIEW PROF,22.83,9.13,0,22.83,19.41,SKIPPED,22.83,22.83,19.41,19.41,19.41,10.23,22.83,22.83,0,22.83,10.44,10.44,0
4200078,972,73502,,,,,,,RIGHT HIP 2 VIEW MIN,27.1,10.84,0,27.1,23.04,SKIPPED,27.1,27.1,23.04,23.04,23.04,12.16,27.1,27.1,0,27.1,12.41,12.41,0
4200079,972,73502,,,,,,,HIP JOINT BILATERAL,128.79,51.52,0,128.79,109.47,SKIPPED,128.79,128.79,109.47,109.47,109.47,12.16,101.93,101.93,0,39.88,12.41,12.41,0
4200080,972,73060,,,,,,,RIGHT HUMERUS,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,8.7,20.27,20.27,0,20.27,8.88,8.88,0
4200081,972,74400,,,,,,,IVP W/O TOMO,59.21,23.68,0,59.21,50.33,SKIPPED,59.21,59.21,50.33,50.33,50.33,25.9,59.21,59.21,0,59.21,26.43,26.43,0
4200082,972,73560,,,,,,,RIGHT KNEE 2 VIEW,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,9.07,20.27,20.27,0,20.27,9.26,9.26,0
4200083,972,73562,,,,,,,RIGHT KNEE 3 VIEWS PROF,22.83,9.13,0,22.83,19.41,SKIPPED,22.83,22.83,19.41,19.41,19.41,10.23,22.83,22.83,0,22.83,10.44,10.44,0
4200084,972,73564,,,,,,,RIGHT KNEE 4 OR MORE VIEWS,27.1,10.84,0,27.1,23.04,SKIPPED,27.1,27.1,23.04,23.04,23.04,12.16,27.1,27.1,0,27.1,12.41,12.41,0
4200085,972,73565,,,,,,,KNEE BOTH AP ERECT,21.08,8.43,0,21.08,17.92,SKIPPED,21.08,21.08,17.92,17.92,17.92,9.45,21.08,21.08,0,21.08,9.64,9.64,0
4200086,972,73590,,,,,,,LEG 2 VIEW,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,8.7,20.27,20.27,0,20.27,8.88,8.88,0
4200087,972,70110,,,,,,,MANDIBLE MIN 4 VIEWS,30.49,12.2,0,30.49,25.92,SKIPPED,30.49,30.49,25.92,25.92,25.92,13.33,30.49,30.49,0,30.49,13.6,13.6,0
4200088,972,74230,,,,,,,MODIFIED COOKIE SWAL,64.3,25.72,0,64.3,54.66,SKIPPED,64.3,64.3,54.66,54.66,54.66,28.66,64.3,64.3,0,64.3,29.24,29.24,0
4200089,972,70160,,,,,,,NASAL BONES,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200090,972,70360,,,,,,,NECK SOFT TISSUE,20.31,8.12,0,20.31,17.26,SKIPPED,20.31,20.31,17.26,17.26,17.26,9.85,20.31,20.31,0,20.31,10.05,10.05,0
4200091,972,76010,,,,,,,NOSE TO RECTUM/1FLM,21.99,8.8,0,21.99,18.69,SKIPPED,21.99,21.99,18.69,18.69,18.69,9.85,21.99,21.99,0,21.99,10.05,10.05,0
4200092,972,70200,,,,,,,ORBIT X-RAY,34.76,13.9,0,34.76,29.55,SKIPPED,34.76,34.76,29.55,29.55,29.55,15.25,34.76,34.76,0,34.76,15.56,15.56,0
4200093,972,72170,,,,,,,PELVIS 1 OR 2 VIEWS,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200094,972,72190,,,,,,,PELVIS 3 VIEW,26.24,10.5,0,26.24,22.3,SKIPPED,26.24,26.24,22.3,22.3,22.3,13.7,26.24,26.24,0,26.24,13.98,13.98,0
4200095,972,71110,,,,,,,RIBS BILAT 3 VIEWS,35.62,14.25,0,35.62,30.28,SKIPPED,35.62,35.62,30.28,30.28,30.28,15.63,35.62,35.62,0,35.62,15.95,15.95,0
4200096,972,71111,,,,,,,RIBS BILAT W/1 VIEW C,39.71,15.88,0,39.71,33.75,SKIPPED,39.71,39.71,33.75,33.75,33.75,17.18,39.71,39.71,0,39.71,17.53,17.53,0
4200097,972,71101,,,,,,,RIBS UNILA W/1 VIEW C,32.94,13.18,0,32.94,28,SKIPPED,32.94,32.94,28,28,28,14.48,32.94,32.94,0,32.94,14.78,14.78,0
4200098,972,71100,,,,,,,RIBS UNILAT 2 VIEWS,27.1,10.84,0,27.1,23.04,SKIPPED,27.1,27.1,23.04,23.04,23.04,12.16,27.1,27.1,0,27.1,12.41,12.41,0
4200099,972,72202,,,,,,,S I JOINTS 3 VIEWS,22.87,9.15,0,22.87,19.44,SKIPPED,22.87,22.87,19.44,19.44,19.44,12.18,22.87,22.87,0,22.87,12.43,12.43,0
4200100,972,72200,,,,,,,S I JOINTS LESS THAN,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.09,21.13,21.13,0,21.13,9.28,9.28,0
4200101,972,72220,,,,,,,SACRUM/COCCYX,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200102,972,73010,,,,,,,RIGHT SCAPULA COMPLETE,21.95,8.78,0,21.95,18.66,SKIPPED,21.95,21.95,18.66,18.66,18.66,9.84,21.95,21.95,0,21.95,10.04,10.04,0
4200103,972,72082,,,,,,,SCOLIOSIS STUDY,38.83,15.53,0,38.83,33.01,SKIPPED,38.83,38.83,33.01,33.01,33.01,17.02,38.83,38.83,0,38.83,17.37,17.37,0
4200104,972,73020,,,,,,,SHOULDER 1 VIEW,19.4,7.76,0,19.4,16.49,SKIPPED,19.4,19.4,16.49,16.49,16.49,8.32,19.4,19.4,0,19.4,8.49,8.49,0
4200105,972,73030,,,,,,,SHOULDER 2 VIEWS MIN,22.83,9.13,0,22.83,19.41,SKIPPED,22.83,22.83,19.41,19.41,19.41,10.23,22.83,22.83,0,22.83,10.44,10.44,0
4200106,972,70210,,,,,,,SINUSES LESS THAN 3,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200107,972,70220,,,,,,,SINUSES MIN OF 3 VIEWS,30.49,12.2,0,30.49,25.92,SKIPPED,30.49,30.49,25.92,25.92,25.92,11.79,30.49,30.49,0,30.49,12.03,12.03,0
4200108,972,70250,,,,,,,SKULL LESS THAN 4 VIEWS,30.45,12.18,0,30.45,25.88,SKIPPED,30.45,30.45,25.88,25.88,25.88,9.85,30.45,30.45,0,30.45,10.05,10.05,0
4200109,972,72040,,,,,,,SPINE CERVICAL 3V OR LESS,27.1,10.84,0,27.1,23.04,SKIPPED,27.1,27.1,23.04,23.04,23.04,12.16,27.1,27.1,0,27.1,12.41,12.41,0
4200111,972,72050,,,,,,,SPINE CERVICAL 6V OR MORE,38.04,15.22,0,38.04,32.33,SKIPPED,38.04,38.04,32.33,32.33,32.33,14.86,38.04,38.04,0,38.04,15.16,15.16,0
4200112,972,72020,,,,,,,SPINE LUMBAR 1 VIEW,18.56,7.42,0,18.56,15.78,SKIPPED,18.56,18.56,15.78,15.78,15.78,8.7,18.56,18.56,0,18.56,8.88,8.88,0
4200113,972,72100,,,,,,,SPINE LUMBAR 2 0R 3 VIEWS,27.1,10.84,0,27.1,23.04,SKIPPED,27.1,27.1,23.04,23.04,23.04,12.16,27.1,27.1,0,27.1,12.41,12.41,0
4200114,972,72110,,,,,,,SPINE LUMBAR 4/5 VIEWS,38.04,15.22,0,38.04,32.33,SKIPPED,38.04,38.04,32.33,32.33,32.33,14.09,38.04,38.04,0,38.04,14.38,14.38,0
4200115,972,72020,,,,,,,SPINE THORACIC 1 VIEW,18.56,7.42,0,18.56,15.78,SKIPPED,18.56,18.56,15.78,15.78,15.78,8.7,18.56,18.56,0,18.56,8.88,8.88,0
4200116,972,72070,,,,,,,SPINE THORACIC 2 VIEWS,27.1,10.84,0,27.1,23.04,SKIPPED,27.1,27.1,23.04,23.04,23.04,11.02,27.1,27.1,0,27.1,11.24,11.24,0
4200117,972,72074,,,,,,,SPINE THORACIC MIN 4,26.26,10.5,0,26.26,22.32,SKIPPED,26.26,26.26,22.32,22.32,22.32,13.33,26.26,26.26,0,26.26,13.6,13.6,0
4200118,972,72072,,,,,,,SPINE THORACIC W/SWI,26.26,10.5,0,26.26,22.32,SKIPPED,26.26,26.26,22.32,22.32,22.32,12.18,26.26,26.26,0,26.26,12.43,12.43,0
4200119,972,71120,,,,,,,STERNUM MIN 2 VIEWS,24.54,9.82,0,24.54,20.86,SKIPPED,24.54,24.54,20.86,20.86,20.86,10.64,24.54,24.54,0,24.54,10.86,10.86,0
4200120,972,72072,,,,,,,THORACIC SPINE W/SWI,26.26,10.5,0,26.26,22.32,SKIPPED,26.26,26.26,22.32,22.32,22.32,12.18,26.26,26.26,0,26.26,12.43,12.43,0
4200121,972,76536,,,,,,,THYROID ECHO,67.71,27.08,0,67.71,57.55,SKIPPED,67.71,67.71,57.55,57.55,57.55,30.58,67.71,67.71,0,67.71,31.2,31.2,0
4200122,972,73660,,,,,,,TOES,16.03,6.41,0,16.03,13.63,SKIPPED,16.03,16.03,13.63,13.63,13.63,7.15,16.03,16.03,0,16.03,7.3,7.3,0
4200123,972,73100,,,,,,,RIGHT WRIST 2 VIEWS,21.08,8.43,0,21.08,17.92,SKIPPED,21.08,21.08,17.92,17.92,17.92,9.07,21.08,21.08,0,21.08,9.26,9.26,0
4200124,972,73110,,,,,,,WRIST 3 VIEWS,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200125,972,76700,,,,,,,ABD COMPLETE ECHO,97.42,38.97,0,97.42,82.81,SKIPPED,97.42,97.42,82.81,82.81,82.81,43.3,97.42,97.42,0,73.48,44.18,44.18,0
4200126,972,76705,,,,,,,ABDOMINAL LIMITED ECHO,71.14,28.46,0,71.14,60.47,SKIPPED,71.14,71.14,60.47,60.47,60.47,31.75,71.14,71.14,0,71.14,32.4,32.4,0
4200127,972,76775,,,,,,,AORTA NON VASCULAR,69.46,27.78,0,69.46,59.04,SKIPPED,69.46,69.46,59.04,59.04,59.04,30.98,69.46,69.46,0,69.46,31.61,31.61,0
4200128,972,93978,,,,,,,AORTA/IVC W/COP COMP,95.12,38.05,0,95.12,80.85,SKIPPED,95.12,95.12,80.85,80.85,80.85,42.05,95.12,95.12,0,95.12,42.91,42.91,0
4200129,972,93923,,,,,,,ART DOP COMP BILATERAL,53.06,21.22,0,53.06,45.1,SKIPPED,53.06,53.06,45.1,45.1,45.1,23.98,53.06,53.06,0,53.06,24.47,24.47,0
4200130,972,93922,,,,,,,ART DOP SINGLE LEVEL,30.25,12.1,0,30.25,25.71,SKIPPED,30.25,30.25,25.71,25.71,25.71,13.27,14.82,14.82,0,9.08,13.54,13.54,0
4200131,972,93880,,,,,,,CAROTID DUP EXTRCRANIAL,96.16,38.46,0,96.16,81.74,SKIPPED,96.16,96.16,81.74,81.74,81.74,42.7,96.16,96.16,0,96.16,43.57,43.57,0
4200132,972,93970,,,,,,,DUP EXT VEINS BILATERAL,82.73,33.09,0,82.73,70.32,SKIPPED,82.73,82.73,70.32,70.32,70.32,37.09,82.73,82.73,0,82.73,37.85,37.85,0
4200133,972,93971,,,,,,,DEP EXT VEINS UNI/LIM,53.98,21.59,0,53.98,45.88,SKIPPED,53.98,53.98,45.88,45.88,45.88,23.68,53.98,53.98,0,53.98,24.16,24.16,0
4200134,972,93925,,,,,,,DUP LOW EXT ART BI,95.37,38.15,0,95.37,81.06,SKIPPED,95.37,95.37,81.06,81.06,81.06,42.1,95.37,95.37,0,95.37,42.96,42.96,0
4200135,972,93926,,,,,,,DUP LOW EXT ART UNI,58.19,23.28,0,58.19,49.46,SKIPPED,58.19,58.19,49.46,49.46,49.46,25.48,58.19,58.19,0,58.19,26,26,0
4200137,972,76882,,,,,,,EXTREMITY ECHO NON VAS,108.69,43.48,0,108.69,92.39,SKIPPED,108.69,108.69,92.39,92.39,92.39,25.9,108.69,108.69,0,59.11,26.43,26.43,0
4200138,972,76705,,,,,,,GALLBLADDER ECHO,71.14,28.46,0,71.14,60.47,SKIPPED,71.14,71.14,60.47,60.47,60.47,31.75,71.14,71.14,0,71.14,32.4,32.4,0
4200139,972,76705,,,,,,,HEPATIC ECHO,71.14,28.46,0,71.14,60.47,SKIPPED,71.14,71.14,60.47,60.47,60.47,31.75,71.14,71.14,0,71.14,32.4,32.4,0
4200140,972,76770,,,,,,,LYMPH NODE ULTRASOUND,88.9,35.56,0,88.9,75.56,SKIPPED,88.9,88.9,75.56,75.56,75.56,39.45,88.9,88.9,0,73.48,40.26,40.26,0
4200141,972,76942,,,,,,,NEEDLE BX ULTRA GUIDANCE,78.08,31.23,0,78.08,66.37,SKIPPED,78.08,78.08,66.37,66.37,66.37,34.11,38.26,38.26,0,23.42,34.81,34.81,0
4200142,972,76815,,,,,,,OB ECHO LIMITED,78.66,31.46,0,78.66,66.86,SKIPPED,78.66,78.66,66.86,66.86,66.86,34.83,78.66,78.66,0,73.48,35.54,35.54,0
4200143,972,76801,,,,,,,OB ECHO <14WK P/GESTATION,206.24,82.5,0,206.24,175.3,SKIPPED,206.24,206.24,175.3,175.3,175.3,52.94,137.3,137.3,0,73.48,54.02,54.02,0
4200144,972,76801,,,,,,,OB ECHO > 14WK P/GESTATIO,120.09,48.04,0,120.09,102.08,SKIPPED,120.09,120.09,102.08,102.08,102.08,52.94,120.09,120.09,0,73.48,54.02,54.02,0
4200145,972,76801,,,,,,,OB US 1ST TRI <14WK 0 DAY,120.09,48.04,0,120.09,102.08,SKIPPED,120.09,120.09,102.08,102.08,102.08,52.94,120.09,120.09,0,73.48,54.02,54.02,0
4200146,972,76811,,,,,,,OB US AFTER 1ST TRI/GESTE,235.19,94.08,0,235.19,199.91,SKIPPED,235.19,235.19,199.91,199.91,199.91,102.51,235.19,235.19,0,73.48,104.6,104.6,0
4200147,972,76856,,,,,,,PELVIC ECHO,82.95,33.18,0,82.95,70.51,SKIPPED,82.95,82.95,70.51,70.51,70.51,37.13,82.95,82.95,0,82.95,37.89,37.89,0
4200148,972,93976,,,,,,,RENAL ARTERY INFLOW,95.63,38.25,0,95.63,81.29,SKIPPED,95.63,95.63,81.29,81.29,81.29,42.54,95.63,95.63,0,72.23,43.41,43.41,0
4200149,972,76770,,,,,,,RENAL ULTRASOUND,88.9,35.56,0,88.9,75.56,SKIPPED,88.9,88.9,75.56,75.56,75.56,39.45,88.9,88.9,0,73.48,40.26,40.26,0
4200151,972,76536,,,,,,,THYROID ECHO,67.71,27.08,0,67.71,57.55,SKIPPED,67.71,67.71,57.55,57.55,57.55,30.58,67.71,67.71,0,67.71,31.2,31.2,0
4200152,972,76830,,,,,,,TRANSVAG US N ON PREG UT,83.75,33.5,0,83.75,71.19,SKIPPED,83.75,83.75,71.19,71.19,71.19,37.13,83.75,83.75,0,73.48,37.89,37.89,0
4200153,972,76641,,,,,,,US BILAT BREAST SONO COMPLETE PROF,88.02,35.21,0,88.02,74.82,SKIPPED,88.02,88.02,74.82,74.82,74.82,39.06,88.02,88.02,0,73.48,39.86,39.86,0
4200154,972,76942,,,,,,,US GUIDANCE PROF,78.08,31.23,0,78.08,66.37,SKIPPED,78.08,78.08,66.37,66.37,66.37,34.11,38.26,38.26,0,23.42,34.81,34.81,0
4200155,972,76817,,,,,,,US PREG UTERUS TRANSVAG,91.29,36.52,0,91.29,77.6,SKIPPED,91.29,91.29,77.6,77.6,77.6,40.59,91.29,91.29,0,73.48,41.42,41.42,0
4200156,972,76870,,,,,,,US SCROTUN & CONTENTS,76.95,30.78,0,76.95,65.41,SKIPPED,76.95,76.95,65.41,65.41,65.41,34.44,76.95,76.95,0,73.48,35.14,35.14,0
4200158,972,93306,,,,,,,ECHOCARDIOGRAM COMPLETE,176.64,70.66,0,176.64,150.14,SKIPPED,176.64,176.64,150.14,150.14,150.14,77.45,86.55,86.55,0,52.99,79.03,79.03,0
4200159,972,93308,,,,,,,ECHOCARDIOGRAM LTD/FU,70.38,28.15,0,70.38,59.82,SKIPPED,70.38,70.38,59.82,59.82,59.82,27.82,70.38,70.38,0,70.38,28.39,28.39,0
4200160,972,93351,,,,,,,STRESS ECHO,209.82,83.93,0,209.82,178.35,SKIPPED,209.82,209.82,178.35,178.35,178.35,92.94,102.81,102.81,0,62.95,94.84,94.84,0
4200161,972,78315,,,,,,,BONE IMAGING 3 PHASE,120.37,48.15,0,120.37,102.31,SKIPPED,120.37,120.37,102.31,102.31,102.31,53.35,120.37,120.37,0,120.37,54.44,54.44,0
4200162,972,78306,,,,,,,BONE IMAGING WHOLE B,102.43,40.97,0,102.43,87.07,SKIPPED,102.43,102.43,87.07,87.07,87.07,44.87,102.43,102.43,0,102.43,45.79,45.79,0
4200163,972,78305,,,,,,,BONE SCAN/MULTIPLE A,99.03,39.61,0,99.03,84.18,SKIPPED,99.03,99.03,84.18,84.18,84.18,43.72,99.03,99.03,0,99.03,44.61,44.61,0
4200165,972,78805,,,,,,,CERETEC BONE SCAN,86.42,34.57,0,86.42,73.46,SKIPPED,65.68,65.68,73.46,73.46,73.46,40.47,42.35,42.35,0,86.42,41.3,41.3,0
4200168,972,78264,,,,,,,GASTRIC EMPTYING STUDY,93.25,37.3,0,93.25,79.26,SKIPPED,93.25,93.25,79.26,79.26,79.26,41.78,93.25,93.25,0,93.25,42.63,42.63,0
4200169,972,78227,,,,,,,HEPATOBILIARY SYSTEM,107.54,43.02,0,107.54,91.41,SKIPPED,107.54,107.54,91.41,91.41,91.41,47.56,107.54,107.54,0,107.54,48.53,48.53,0
4200170,972,78226,,,,,,,HIDA NO EF,88.1,35.24,0,88.1,74.88,SKIPPED,88.1,88.1,74.88,74.88,74.88,39.08,88.1,88.1,0,88.1,39.88,39.88,0
4200171,972,70100,,,,,,,MANDIBLE PARTIAL LESS THAN 4 VIEWS,21.99,8.8,0,21.99,18.69,SKIPPED,21.99,21.99,18.69,18.69,18.69,9.85,21.99,21.99,0,21.99,10.05,10.05,0
4200172,972,78582,,,,,,,LUNG SCAN PERF/VENT,127.01,50.8,0,127.01,107.96,SKIPPED,127.01,127.01,107.96,107.96,107.96,56.05,127.01,127.01,0,127.01,57.19,57.19,0
4200173,972,78452,,,,,,,STRESS & REST PERFUSION,200.77,80.31,0,200.77,170.65,SKIPPED,200.77,200.77,170.65,170.65,170.65,85.63,200.77,200.77,0,200.77,87.38,87.38,0
4200174,972,78451,,,,,,,NM CARDIAC STRESS ONLY,170.44,68.18,0,170.44,144.87,SKIPPED,170.44,170.44,144.87,144.87,144.87,72.47,170.44,170.44,0,170.44,73.95,73.95,0
4200179,972,76700,,,,,,,TDCJ ABDOMEN US,122.62,49.05,0,122.62,104.23,SKIPPED,122.62,122.62,104.23,104.23,104.23,43.3,122.62,122.62,0,73.48,44.18,44.18,0
4200180,972,76705,,,,,,,TDCJ GALLBLADDER US,89.92,35.97,0,89.92,76.43,SKIPPED,89.92,89.92,76.43,76.43,76.43,31.75,89.92,89.92,0,73.48,32.4,32.4,0
4200181,972,76830,,,,,,,TDCJ INTRAVAG US,105.6,42.24,0,105.6,89.76,SKIPPED,105.6,105.6,89.76,89.76,89.76,37.13,105.6,105.6,0,73.48,37.89,37.89,0
4200182,972,76705,,,,,,,TDCJ LIVER US,122.62,49.05,0,122.62,104.23,SKIPPED,122.62,122.62,104.23,104.23,104.23,31.75,122.62,122.62,0,73.48,32.4,32.4,0
4200183,972,76805,,,,,,,TDCJ OB US,151.96,60.78,0,151.96,129.17,SKIPPED,151.96,151.96,129.17,129.17,129.17,53.31,137.3,137.3,0,73.48,54.4,54.4,0
4200184,972,76856,,,,,,,TDCJ PELVIC US,103.99,41.6,0,103.99,88.39,SKIPPED,103.99,103.99,88.39,88.39,88.39,37.13,103.99,103.99,0,98.6,37.89,37.89,0
4200185,972,76705,,,,,,,TDCJ RENAL US,89.92,35.97,0,89.92,76.43,SKIPPED,89.92,89.92,76.43,76.43,76.43,31.75,89.92,89.92,0,73.48,32.4,32.4,0
4200186,972,,,,,,,,SKELETAL SURV OSSEOUS PRO,68.22,27.29,0,57.99,57.99,SKIPPED,51.85,51.85,57.99,57.99,57.99,0,33.43,33.43,0,20.47,0,0,0
4200187,972,19001,,,,,,,DRAIN BREAST LESION ADDON,77.6,31.04,0,65.96,65.96,SKIPPED,0,0,65.96,65.96,65.96,23.11,38.02,38.02,0,23.28,23.58,23.58,0
4200188,972,,,,,,,,PLACE BREAST CLIP PERCUT,283.98,113.59,0,241.38,241.38,SKIPPED,215.82,215.82,241.38,241.38,241.38,0,139.15,139.15,0,85.19,0,0,0
4200189,972,,,,,,,,BX BREAST PERCUT W/IMAGE,662.41,264.96,0,563.05,563.05,SKIPPED,503.43,503.43,563.05,563.05,563.05,0,324.58,324.58,0,198.72,0,0,0
4200190,972,19000,,,,,,,CYST ASPIRATION,134.96,53.98,0,134.96,114.72,SKIPPED,134.96,134.96,114.72,114.72,114.72,46.59,66.13,66.13,0,40.49,47.54,47.54,0
4200191,972,10005,,,,,,,FNA BREAST W/IMAGING GUIDANCE,201.69,80.68,0,201.69,171.44,SKIPPED,201.69,201.69,171.44,171.44,171.44,80.93,98.83,98.83,0,60.51,82.58,82.58,0
4200192,972,19083,,,,,,,BREAST CORE BIOPSY,521.18,208.47,0,521.18,443,SKIPPED,521.18,521.18,443,443,443,169.9,255.38,255.38,SKIPPED,SKIPPED,173.37,173.37,0
4200193,972,19084,,,,,,,BX BREAST ADD LESION US IMAG,249.81,99.92,0,212.34,212.34,SKIPPED,0,0,212.34,212.34,212.34,84.51,122.41,122.41,0,74.94,86.23,86.23,0
4200196,972,19281,,,,,,,PERQ DEVICE BREAST 1ST IMAG,314.92,125.97,0,314.92,267.68,SKIPPED,314.92,314.92,267.68,267.68,267.68,108.93,154.31,154.31,0,94.48,111.15,111.15,0
4200197,972,19282,,,,,,,PERQ DEVICE BREAST EA IMAG,151.96,60.78,0,129.17,129.17,SKIPPED,0,0,129.17,129.17,129.17,54.46,74.46,74.46,0,45.59,55.57,55.57,0
4200199,972,19286,,,,,,,PERQ DEV B REAST ADD US IMAG,130.26,52.1,0,110.72,110.72,SKIPPED,0,0,110.72,110.72,110.72,46.75,63.83,63.83,0,39.08,47.7,47.7,0
4200201,972,76604,,,,,,,US EXAM CHEST PROF,65.25,26.1,0,65.25,55.46,SKIPPED,65.25,65.25,55.46,55.46,55.46,31.01,65.25,65.25,0,65.25,31.64,31.64,0
4200202,972,74300,,,,,,,X-RAY BILE DUCTS/PANCREAS PROF,55.88,22.35,0,55.88,47.5,SKIPPED,55.88,55.88,47.5,47.5,47.5,14.71,27.38,27.38,0,16.76,15.01,15.01,0
4200203,972,45300,,,,,,,US OF APPENDIX PROF,130.4,52.16,0,130.4,110.84,SKIPPED,130.4,130.4,110.84,110.84,110.84,51.96,63.9,63.9,SKIPPED,SKIPPED,53.02,53.02,0
4200204,972,73092,,,,,,,UPPER EXTREMITY/INFANT PROF,23.58,9.43,0,23.58,20.04,SKIPPED,23.58,23.58,20.04,20.04,20.04,8.7,23.58,23.58,0,23.58,8.88,8.88,0
4200207,972,74175,,,,,,,CT ANGIO ABDOM W/O (DISSECTION),686.6,274.64,0,686.6,583.61,SKIPPED,686.6,686.6,583.61,583.61,583.61,96.49,224.97,224.97,0,162.26,98.46,98.46,0
4200208,972,70330,,,,,,,TMJ BILATERAL,29.63,11.85,0,29.63,25.19,SKIPPED,29.63,29.63,25.19,25.19,25.19,12.94,29.63,29.63,0,29.63,13.2,13.2,0
4200209,972,70328,,,,,,,TMJ UNILATERAL,21.99,8.8,0,21.99,18.69,SKIPPED,21.99,21.99,18.69,18.69,18.69,9.85,21.99,21.99,0,21.99,10.05,10.05,0
4200212,972,73201,,,,,,,CT UPR EXT W/CONTRAST PROF,147.81,59.12,0,147.81,125.64,SKIPPED,147.81,147.81,125.64,125.64,125.64,61.65,147.81,147.81,0,147.81,62.91,62.91,0
4200213,972,73202,,,,,,,CT UPR EXT W/ & W/O CONTRAST PROF,133.67,53.47,0,133.67,113.62,SKIPPED,133.67,133.67,113.62,113.62,113.62,65.2,133.67,133.67,0,133.67,66.53,66.53,0
4200214,972,73702,,,,,,,CT LWE EXT W/ & W/O CONTRAST PROF,177.85,71.14,0,177.85,151.17,SKIPPED,177.85,177.85,151.17,151.17,151.17,65.2,177.85,177.85,0,162.26,66.53,66.53,0
4200215,972,70482,,,,,,,"CT ORBIT,SELLA, INN W/ W/O",174.39,69.76,0,174.39,148.23,SKIPPED,174.39,174.39,148.23,148.23,148.23,67.89,174.39,174.39,0,162.26,69.28,69.28,0
4200217,972,72129,,,,,,,CT CHEST SPINE W/ CONTRAST,147.23,58.89,0,147.23,125.15,SKIPPED,147.23,147.23,125.15,125.15,125.15,65.57,147.23,147.23,0,147.23,66.91,66.91,0
4200218,972,74248,,,,,,,GI /SMALL BOWEL,110.03,44.01,0,110.03,93.53,SKIPPED,110.03,110.03,93.53,93.53,93.53,37.51,86.88,86.88,0,33.01,38.28,38.28,0
4200221,972,78195,,,,,,,LYMPHOSCINTIGRAPHY PROF,141.42,56.57,0,141.42,120.21,SKIPPED,141.42,141.42,120.21,120.21,120.21,62.47,141.42,141.42,0,141.42,63.74,63.74,0
4200222,972,74174,,,,,,,CT ANGIO ABD&PELV W/O&W/DYE,262.4,104.96,0,262.4,223.04,SKIPPED,262.4,262.4,223.04,223.04,223.04,116.61,262.4,262.4,0,162.26,118.99,118.99,0
4200223,972,75571,,,,,,,CORONARY SCREEN PROF,52.5,21,0,52.5,44.62,SKIPPED,52.5,52.5,44.62,44.62,44.62,30.98,52.5,52.5,0,39.88,31.61,31.61,0
4200224,972,77075,,,,,,,X-RAY BONE SURVEY COMPLETE,65.18,26.07,0,65.18,55.4,SKIPPED,65.18,65.18,55.4,55.4,55.4,29.81,65.18,65.18,0,65.18,30.42,30.42,0
4200225,972,75635,,,,,,,CT ANGIO ABD ARTERIES(CTA RUNOFF),285.33,114.13,0,285.33,242.53,SKIPPED,285.33,285.33,242.53,242.53,242.53,126.28,224.97,224.97,0,162.26,128.86,128.86,0
4200226,972,76642,,,,,,,US BILAT BREAST SONO LIMITED PROF,82.09,32.84,0,82.09,69.78,SKIPPED,82.09,82.09,69.78,69.78,69.78,36.37,82.09,82.09,0,39.88,37.11,37.11,0
4200227,972,77072,,,,,,,BONE AGE STUDY X-RAY,22.87,9.15,0,22.87,19.44,SKIPPED,22.87,22.87,19.44,19.44,19.44,10.24,22.87,22.87,0,22.87,10.45,10.45,0
4200228,972,73706,,,,,,,CTA LOWER EXT. W/ & W/O CONTRAST,227.67,91.07,0,227.67,193.52,SKIPPED,227.67,227.67,193.52,193.52,193.52,100.36,224.97,224.97,0,162.26,102.41,102.41,0
4200229,972,73600,,,,,,,LEFT ANKLE 2 VIEWS PROF,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,8.7,20.27,20.27,0,20.27,8.88,8.88,0
4200230,972,73610,,,,,,,LEFT ANKLE 3 VIEWS PROF,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200231,972,73000,,,,,,,LEFT CLAVICLE PROF,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,9.07,20.27,20.27,0,20.27,9.26,9.26,0
4200232,972,73070,,,,,,,LEFT ELBOW 2 VIEWS PROF,19.4,7.76,0,19.4,16.49,SKIPPED,19.4,19.4,16.49,16.49,16.49,9.07,19.4,19.4,0,19.4,9.26,9.26,0
4200233,972,73080,,,,,,,LEFT ELBOW 3 VIEWS PROF,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200234,972,73552,,,,,,,LEFT FEMUR PROF,22.83,9.13,0,22.83,19.41,SKIPPED,22.83,22.83,19.41,19.41,19.41,9.85,22.83,22.83,0,22.83,10.05,10.05,0
4200235,972,73140,,,,,,,LEFT FINGER PROF,16.84,6.74,0,16.84,14.31,SKIPPED,16.84,16.84,14.31,14.31,14.31,7.53,16.84,16.84,0,16.84,7.68,7.68,0
4200236,972,73620,,,,,,,LEFT FOOT 2 VIEWS PROF,18.61,7.44,0,18.61,15.82,SKIPPED,18.61,18.61,15.82,15.82,15.82,8.33,18.61,18.61,0,18.61,8.5,8.5,0
4200237,972,73630,,,,,,,LEFT FOOT 3 VIEWS PROF,20.31,8.12,0,20.31,17.26,SKIPPED,20.31,20.31,17.26,17.26,17.26,9.09,20.31,20.31,0,20.31,9.28,9.28,0
4200238,972,73090,,,,,,,LEFT FOREARM 2 VIEWS PROF,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,8.7,20.27,20.27,0,20.27,8.88,8.88,0
4200239,972,73120,,,,,,,LEFT HAND 2 VIEWS PROF,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,9.07,20.27,20.27,0,20.27,9.26,9.26,0
4200240,972,73130,,,,,,,LEFT HAND 3 VIEWS PROF,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200241,972,73501,,,,,,,LEFT HIP 1 VIEW PROF,22.83,9.13,0,22.83,19.41,SKIPPED,22.83,22.83,19.41,19.41,19.41,10.23,22.83,22.83,0,22.83,10.44,10.44,0
4200242,972,73502,,,,,,,LEFT HIP 2 VIEW PROF,27.1,10.84,0,27.1,23.04,SKIPPED,27.1,27.1,23.04,23.04,23.04,12.16,27.1,27.1,0,27.1,12.41,12.41,0
4200243,972,73060,,,,,,,LEFT HUMERUS PROF,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,8.7,20.27,20.27,0,20.27,8.88,8.88,0
4200244,972,73560,,,,,,,LEFT KNEE 2 VIEWS PROF,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,9.07,20.27,20.27,0,20.27,9.26,9.26,0
4200245,972,73562,,,,,,,LEFT KNEE 3 VIEWS PROF,22.83,9.13,0,22.83,19.41,SKIPPED,22.83,22.83,19.41,19.41,19.41,10.23,22.83,22.83,0,22.83,10.44,10.44,0
4200246,972,73564,,,,,,,LEFT KNEE 4 OR MORE VIEWS PROF,27.1,10.84,0,27.1,23.04,SKIPPED,27.1,27.1,23.04,23.04,23.04,12.16,27.1,27.1,0,27.1,12.41,12.41,0
4200247,972,73592,,,,,,,LEFT LOWER EXT. INFANT PROF,19.45,7.78,0,19.45,16.53,SKIPPED,19.45,19.45,16.53,16.53,16.53,8.7,19.45,19.45,0,19.45,8.88,8.88,0
4200248,972,73010,,,,,,,LEFT SCAPULA COMPLETE PROF,21.95,8.78,0,21.95,18.66,SKIPPED,21.95,21.95,18.66,18.66,18.66,9.84,21.95,21.95,0,21.95,10.04,10.04,0
4200249,972,73020,,,,,,,LEFT SHOULDER 1 VIEW PROF,19.4,7.76,0,19.4,16.49,SKIPPED,19.4,19.4,16.49,16.49,16.49,8.32,19.4,19.4,0,19.4,8.49,8.49,0
4200250,972,73660,,,,,,,LEFT TOES 3 VIEWS PROF,16.03,6.41,0,16.03,13.63,SKIPPED,16.03,16.03,13.63,13.63,13.63,7.15,16.03,16.03,0,16.03,7.3,7.3,0
4200251,972,73100,,,,,,,LEFT WRIST 2 VIEWS PROF,21.08,8.43,0,21.08,17.92,SKIPPED,21.08,21.08,17.92,17.92,17.92,9.07,21.08,21.08,0,21.08,9.26,9.26,0
4200252,972,73110,,,,,,,LEFT WRIST 3 VIEWS PRF,21.13,8.45,0,21.13,17.96,SKIPPED,21.13,21.13,17.96,17.96,17.96,9.47,21.13,21.13,0,21.13,9.66,9.66,0
4200253,972,73650,,,,,,,LEFT CALCANEOUS PROF,19.45,7.78,0,19.45,16.53,SKIPPED,19.45,19.45,16.53,16.53,16.53,8.7,19.45,19.45,0,19.45,8.88,8.88,0
4200254,972,73590,,,,,,,LEFT LOWER LEG TIB/FIB PROF,20.27,8.11,0,20.27,17.23,SKIPPED,20.27,20.27,17.23,17.23,17.23,8.7,20.27,20.27,0,20.27,8.88,8.88,0
4200255,972,71101,,,,,,,LEFT RIBS UNILATERAL PROF,32.94,13.18,0,32.94,28,SKIPPED,32.94,32.94,28,28,28,14.48,32.94,32.94,0,32.94,14.78,14.78,0
4200256,972,71111,,,,,,,LEFT RIBS UNILATERAL W/ 1 VIEW CXR PROF,39.71,15.88,0,39.71,33.75,SKIPPED,39.71,39.71,33.75,33.75,33.75,17.18,39.71,39.71,0,39.71,17.53,17.53,0
4200257,972,73030,,,,,,,LEFT SHOULDER UNILATERAL PROF,22.83,9.13,0,22.83,19.41,SKIPPED,22.83,22.83,19.41,19.41,19.41,10.23,22.83,22.83,0,22.83,10.44,10.44,0
4200258,972,93990,,,,,,,RT DUPLEX SCAN FOR HEMODIALYSIS,58.63,23.45,0,58.63,49.84,SKIPPED,58.63,58.63,49.84,49.84,49.84,25.65,58.63,58.63,0,58.63,26.17,26.17,0
4200259,972,93990,,,,,,,LT DUPLEX SCAN FOR HEMODIALYSIS,58.63,23.45,0,58.63,49.84,SKIPPED,58.63,58.63,49.84,49.84,49.84,25.65,58.63,58.63,0,58.63,26.17,26.17,0
4200260,972,93990,,,,,,,BILAT DUPLEX SCAN FOR HEMODIALYSIS,58.63,23.45,0,58.63,49.84,SKIPPED,58.63,58.63,49.84,49.84,49.84,25.65,58.63,58.63,0,58.63,26.17,26.17,0
4200261,972,93985,,,,,,,RT VESSEL MAPPING FOR HEMODIALYSIS,29.44,11.78,0,42.38,25.02,SKIPPED,29.44,29.44,25.02,25.02,25.02,41.53,14.43,14.43,0,8.83,42.38,42.38,0
4200262,972,93985,,,,,,,LT VESSEL MAPPING FOR HEMODIALYSIS,29.44,11.78,0,42.38,25.02,SKIPPED,29.44,29.44,25.02,25.02,25.02,41.53,14.43,14.43,0,8.83,42.38,42.38,0
4200263,972,93985,,,,,,,BILAT VESSEL MAPPING FOR HEMODIALYSIS,29.44,11.78,0,42.38,25.02,SKIPPED,29.44,29.44,25.02,25.02,25.02,41.53,14.43,14.43,0,8.83,42.38,42.38,0
4200264,972,76942,,,,,,,ECHO GUIDE FOR BIOPSY,78.08,31.23,0,78.08,66.37,SKIPPED,78.08,78.08,66.37,66.37,66.37,34.11,38.26,38.26,0,23.42,34.81,34.81,0
4200265,972,93930,,,,,,,ART UPPER EXTREM BILAT.,96.05,38.42,0,96.05,81.64,SKIPPED,96.05,96.05,81.64,81.64,81.64,42.2,96.05,96.05,0,96.05,43.06,43.06,0
4200266,972,76805,,,,,,,OB US >/= 14 WKS SNGL FETUS,121.61,48.64,0,121.61,103.37,SKIPPED,121.61,121.61,103.37,103.37,103.37,53.31,121.61,121.61,0,73.48,54.4,54.4,0
4200267,972,93922,,,,,,,UPR/L XTREMITY ART 2 LEVELS,30.25,12.1,0,30.25,25.71,SKIPPED,30.25,30.25,25.71,25.71,25.71,13.27,14.82,14.82,0,9.08,13.54,13.54,0
4200268,972,93931,,,,,,,ART UPPER EXTREM UNI,59.03,23.61,0,59.03,50.18,SKIPPED,59.03,59.03,50.18,50.18,50.18,26.22,59.03,59.03,0,59.03,26.76,26.76,0
4200269,972,74250,,,,,,,SMALL BOWEL SERIES,56.65,22.66,0,56.65,48.15,SKIPPED,56.65,56.65,48.15,48.15,48.15,43.3,56.65,56.65,0,56.65,44.18,44.18,0
4200270,972,77073,,,,,,,BONE LENGTH STUDY SCANOGRAM,34.56,13.82,0,34.56,29.38,SKIPPED,34.56,34.56,29.38,29.38,29.38,14.7,34.56,34.56,0,34.56,15,15,0
4200271,972,76942,,,,,,,US RENAL BX-ECHO GUIDE,78.08,31.23,0,78.08,66.37,SKIPPED,78.08,78.08,66.37,66.37,66.37,34.11,38.26,38.26,0,23.42,34.81,34.81,0
4200272,972,78707,,,,,,,RENAL FLOW/FUNCT IMAGE W/O DRUG,111.93,44.77,0,111.93,95.14,SKIPPED,111.93,111.93,95.14,95.14,95.14,49.53,111.93,111.93,0,111.93,50.54,50.54,0
4200273,972,93312,,,,,,,CU TEE TRANSESOPHAGEAL ECHO,264.24,105.7,0,264.24,224.6,SKIPPED,264.24,264.24,224.6,224.6,224.6,119.69,264.24,264.24,0,264.24,122.13,122.13,0
4200274,974,78071,,,,,,,NM Parathyroid with SPECT,141.54,56.62,0,141.54,120.31,SKIPPED,141.54,141.54,120.31,120.31,120.31,62.84,141.54,141.54,0,141.54,64.12,64.12,0
4200275,972,76000,,,,,,,SNIFF TEST,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200276,972,78070,,,,,,,NM PARATHYROID SCAN PROF,94.11,37.64,0,94.11,79.99,SKIPPED,94.11,94.11,79.99,79.99,79.99,41.8,94.11,94.11,0,94.11,42.65,42.65,0
4200277,972,71271,,,,,,,CT LOW DOSE FOR LUNG SCREEN(LDCT),119.24,47.7,0,101.93,101.35,SKIPPED,90.62,90.62,101.35,101.35,101.35,57.78,101.93,101.93,0,35.77,58.96,58.96,0
4200278,972,73206,,,,,,,CTA UPPER EXTREMITY,207.07,82.83,0,207.07,176.01,SKIPPED,207.07,207.07,176.01,176.01,176.01,95.74,207.07,207.07,0,162.26,97.69,97.69,0
4200279,972,76000,,,,,,,LHC FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200280,972,76000,,,,,,,LHC CORS ONLY FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200281,972,76000,,,,,,,LHC AND GRAFTS FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200282,972,76000,,,,,,,LHC/RHC GRAFTS FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200283,972,76000,,,,,,,RHC FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200284,972,76000,,,,,,,LHC/PTCA FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200285,972,76000,,,,,,,ABDOMINAL ANGIO FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200286,972,76000,,,,,,,ABDOMINAL RUN OFF BILAT FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200287,972,76000,,,,,,,ABDOMINAL RUN OFF UNILAT FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200288,972,76000,,,,,,,ABDOMINAL ANGIO PTA FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200289,972,76000,,,,,,,ABDOMINAL RUN OFF PTA FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200290,972,76000,,,,,,,EXTREMITY UNILATERAL FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200291,972,76000,,,,,,,EXTREMITY PTA FLURO PROF,20.99,8.4,0,20.99,17.84,SKIPPED,20.99,20.99,17.84,17.84,17.84,16.71,20.99,20.99,0,20.99,17.05,17.05,0
4200292,972,37252,,,,,,,IVUS INITIAL VESSEL PROF,198.23,79.29,0,168.5,168.5,SKIPPED,0,0,168.5,168.5,168.5,94.7,97.13,97.13,0,59.47,96.63,96.63,0
4200293,972,37253,,,,,,,IVUS ADDITIONAL 3 VESSELS PROF,158.96,63.58,0,135.12,135.12,SKIPPED,0,0,135.12,135.12,135.12,75.26,77.89,77.89,0,47.69,76.8,76.8,0
4200294,972,76937,,,,,,,US GUIDANCE FOR VASCULAR ACCESS,31.75,12.7,0,31.75,26.99,SKIPPED,31.75,31.75,26.99,26.99,26.99,15.13,15.56,15.56,0,9.52,15.44,15.44,0
4200295,972,93975,,,,,,,US Penis Art/Venous,115.44,46.18,0,115.44,98.12,SKIPPED,115.44,115.44,98.12,98.12,98.12,61.45,115.44,115.44,0,115.44,62.7,62.7,0
4200296,972,76857,,,,,,,US Penis,98.81,39.52,0,98.81,83.99,SKIPPED,98.81,98.81,83.99,83.99,83.99,26.29,98.81,98.81,0,59.11,26.83,26.83,0
4200297,972,77067,,,,,,,MG 3D TOMO SCREENING CAD,76.99,30.8,0,76.99,65.44,SKIPPED,76.99,76.99,65.44,65.44,65.44,40.6,37.73,37.73,0,23.1,41.43,41.43,0
4200298,972,77063,,,,,,,MG 3D TOMO SCREENING,61.07,24.43,0,61.07,51.91,SKIPPED,61.07,61.07,51.91,51.91,51.91,32.51,29.92,29.92,0,18.32,33.17,33.17,0
4200299,972,77066,,,,,,,MG 3D TOMO DIAGNOSTIC BILATERAL CAD,100.61,40.24,0,100.61,85.52,SKIPPED,100.61,100.61,85.52,85.52,85.52,53.55,49.3,49.3,0,30.18,54.64,54.64,0
4200300,972,G0279,,,,,,,MG 3D TOMO DIAGNOSTIC BILATERAL,61.07,24.43,0,61.07,51.91,SKIPPED,61.07,61.07,51.91,51.91,51.91,32.51,29.92,29.92,0,18.32,33.17,33.17,0
4200301,972,77065,,,,,,,MG 3D TOMO DIAGNOSTIC RIGHT CAD,81.35,32.54,0,81.35,69.15,SKIPPED,81.35,81.35,69.15,69.15,69.15,43.3,39.86,39.86,0,24.4,44.18,44.18,0
4200302,972,G0279,,,,,,,MG 3D TOMO DIAGNOSTIC RIGHT,61.07,24.43,0,61.07,51.91,SKIPPED,61.07,61.07,51.91,51.91,51.91,32.51,29.92,29.92,0,18.32,33.17,33.17,0
4200303,972,77065,,,,,,,MG 3D TOMO DIAGNOSTIC LEFT CAD,81.35,32.54,0,81.35,69.15,SKIPPED,81.35,81.35,69.15,69.15,69.15,43.3,39.86,39.86,0,24.4,44.18,44.18,0
4200304,972,G0279,,,,,,,MG 3D TOMO DIAGNOSTIC LEFT,61.07,24.43,0,61.07,51.91,SKIPPED,61.07,61.07,51.91,51.91,51.91,32.51,29.92,29.92,0,18.32,33.17,33.17,0
4200305,972,78830,,,,,,,RADIO PHARMA LOC TUMOR(SPECT),142.34,56.94,0,142.34,120.99,SKIPPED,142.34,142.34,120.99,120.99,120.99,76.39,142.34,142.34,0,42.7,77.95,77.95,0
4200306,972,93356,,,,,,,MYOCCARDIAL STRAIN IMAGE(ADD-ON),24.42,9.77,0,24.42,20.76,SKIPPED,24.42,24.42,20.76,20.76,20.76,13.16,11.97,11.97,0,7.33,13.43,13.43,0
4200307,972,91200,,,,,,,LIVER ELASTOGRAPHY W/O IMAG W/I&R,41.37,16.55,0,41.37,35.16,SKIPPED,41.37,41.37,35.16,35.16,35.16,11.77,20.27,20.27,0,12.41,12.01,12.01,0
420055,972,71048,,,,,,,CHEST WITH OBLIQUE,38.94,15.58,0,38.94,33.1,SKIPPED,38.94,38.94,33.1,33.1,33.1,16.8,38.94,38.94,0,38.94,17.14,17.14,0
420929,771,0072A,,,,,,,ADMIN 2ND DOSE PEDI COVID VACCINE,56.78,22.71,0,48.26,48.26,SKIPPED,43.15,43.15,48.26,48.26,48.26,23.93,27.82,27.82,0,17.03,24.42,24.42,0
4210100,611,70551,,,,,,,MRI BRAIN/BRAIN STEM W/O,3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210101,611,70552,,,,,,,MRI BRAIN/BRAIN STM W/CON,4048.96,1619.58,0,3441.62,3441.62,SKIPPED,1283.92,1283.92,3441.62,3441.62,3441.62,1706.23,463.83,463.83,0,162.26,1741.05,1741.05,3441.62
4210102,611,70553,,,,,,,MRI BRAIN W/WO CONTRAST,5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210103,615,70544,,,,,,,MRA HEAD W/O CONTRAST,3060.76,1224.3,0,2601.65,2601.65,SKIPPED,1180.13,1180.13,2601.65,2601.65,2601.65,1289.81,289.96,289.96,0,149.14,1316.13,1316.13,2601.65
4210104,615,70545,,,,,,,MRA HEAD W/CONTRAST,3331.09,1332.44,0,2831.43,2831.43,SKIPPED,1283.92,1283.92,2831.43,2831.43,2831.43,1403.72,463.83,463.83,0,162.26,1432.37,1432.37,2831.43
4210106,610,70543,,,,,,,MRI ORBT FACE NECK W/WO,5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210107,610,70542,,,,,,,MRI ORBIT FACE NECK W/CON,3331.09,1332.44,0,2831.43,2831.43,SKIPPED,2318.36,2318.36,2831.43,2831.43,2831.43,1403.72,463.83,463.83,0,292.99,1432.37,1432.37,2831.43
4210108,610,70540,,,,,,,MRI ORBIT FACE NECK W/O,3241.58,1296.63,0,2755.34,2755.34,SKIPPED,1180.13,1180.13,2755.34,2755.34,2755.34,1366,289.96,289.96,0,149.14,1393.88,1393.88,2755.34
4210110,615,70547,,,,,,,MRA NECK W/O CONTRAST,3075.98,1230.39,0,2614.58,2614.58,SKIPPED,1180.13,1180.13,2614.58,2614.58,2614.58,1296.22,289.96,289.96,0,149.14,1322.67,1322.67,2614.58
4210111,615,70548,,,,,,,MRA NECK W/CONTRAST,4048.96,1619.58,0,3441.62,3441.62,SKIPPED,1283.92,1283.92,3441.62,3441.62,3441.62,1706.23,463.83,463.83,0,162.26,1741.05,1741.05,3441.62
4210112,615,70549,,,,,,,MRA NECK W/WO CONT,3870.33,1548.13,0,3289.78,3289.78,SKIPPED,2318.36,2318.36,3289.78,3289.78,3289.78,1630.96,463.83,463.83,0,292.99,1664.24,1664.24,3289.78
4210117,612,72141,,,,,,,MRI CERV SPINE W/O CONTRA,3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210119,612,72156,,,,,,,MRI CERV SPINE W/WO CONTR,5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210120,612,72146,,,,,,,MRI THORACIC SPINE W/O CO,3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210121,612,72147,,,,,,,MRI THORACIC SPINE W/CONT,3672.52,1469.01,0,3121.64,3121.64,SKIPPED,2318.36,2318.36,3121.64,3121.64,3121.64,1547.6,463.83,463.83,0,292.99,1579.18,1579.18,3121.64
4210122,612,72157,,,,,,,MRI THORACIC SPINE W/WO C,5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210124,612,72148,,,,,,,MRI LUMBAR SPINE W/O CONT,3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210125,612,72149,,,,,,,MRI LUMBAR SPINE W/CONTRA,4048.96,1619.58,0,3441.62,3441.62,SKIPPED,2318.36,2318.36,3441.62,3441.62,3441.62,1706.23,463.83,463.83,0,292.99,1741.05,1741.05,3441.62
4210126,612,72158,,,,,,,MRI LUMBAR SPINE W/WO CON,5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210128,612,72195,,,,,,,MRI PELVIS W/O CONTRAST,3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210129,612,72196,,,,,,,MRI PELVIS W/CONTRAST,2826.43,1130.57,0,2402.47,2402.47,SKIPPED,2318.36,2318.36,2402.47,2402.47,2402.47,1191.05,463.83,463.83,0,292.99,1215.36,1215.36,2402.47
4210130,612,72197,,,,,,,MRI PELVIS W/WO CONTRAST,5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210131,610,73221,,,,,,,MRI UPR EXT ANY JOINT W/O,3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210132,610,73222,,,,,,,MRI UPR EX ANY JOINT W/CO,4223.08,1689.23,0,3589.62,3589.62,SKIPPED,3463.95,3463.95,3589.62,3589.62,3589.62,1779.6,901.13,901.13,0,437.77,1815.92,1815.92,3589.62
4210133,610,73223,,,,,,,MRI UPR EX ANY JOINT W/WO,5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210134,610,73218,,,,,,,MRI UPR EX OTH THN JT W/O,3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210138,610,73721,,,,,,,MRI LWR EXT ANY JOINT W/O,3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210139,610,73722,,,,,,,MRI LWR EXT ANY JNT W/CON,4223.08,1689.23,0,3589.62,3589.62,SKIPPED,3463.95,3463.95,3589.62,3589.62,3589.62,1779.6,901.13,901.13,0,437.77,1815.92,1815.92,3589.62
4210140,610,73723,,,,,,,MRI LWR EXT ANY JT W/WO,5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210141,610,73718,,,,,,,MRI LWR EX OTR THN JTW/O,3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210142,610,73719,,,,,,,MRI LWR EX OTR THN JT W/C,4048.96,1619.58,0,3441.62,3441.62,SKIPPED,1283.92,1283.92,3441.62,3441.62,3441.62,1706.23,463.83,463.83,0,162.26,1741.05,1741.05,3441.62
4210143,610,73720,,,,,,,MRI LWR EX OTR THN JTW/WO,5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210145,610,74181,,,,,,,MRCP IMAGING,3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210146,610,74182,,,,,,,MRI ABDOMEN W/CONTRAST,3331.09,1332.44,0,2831.43,2831.43,SKIPPED,2318.36,2318.36,2831.43,2831.43,2831.43,1403.72,463.83,463.83,0,292.99,1432.37,1432.37,2831.43
4210147,610,74183,,,,,,,MRI ABDOMEN W/WO CONT,5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210148,610,74185,,,,,,,MRA ABDOMEN WITH CONTRAST,4048.96,1619.58,0,3441.62,3441.62,SKIPPED,1618.95,1618.95,3441.62,3441.62,3441.62,1706.23,1983.99,1983.99,0,1214.69,1741.05,1741.05,3441.62
4210200,610,73721,,,,,,,MRI HIP W/O CONTRAST,3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210202,610,73723,,,,,,,"MRI Hip, with & without IV Contrast",5108.96,2043.58,0,4342.62,4342.62,SKIPPED,2318.36,2318.36,4342.62,4342.62,4342.62,2152.91,463.83,463.83,0,292.99,2196.85,2196.85,4342.62
4210203,610,73718,,,,,,,"MRI Femur, without IV Contrast",3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210206,610,73721,,,,,,,"MRI Knee, without IV Contrast",3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210208,610,73718,,,,,,,"MRI Tib/Fib, without IV Contrast",3403.66,1361.46,0,2893.11,2893.11,SKIPPED,1180.13,1180.13,2893.11,2893.11,2893.11,1434.3,289.96,289.96,0,149.14,1463.57,1463.57,2893.11
4210209,610,73723,,,,,,,"MRI Knee, with & without IV Contrast",4633.98,1853.59,0,3938.88,3938.88,SKIPPED,2318.36,2318.36,3938.88,3938.88,3938.88,1952.76,463.83,463.83,0,292.99,1992.61,1992.61,3938.88
4210210,610,73719,,,,,,,"MRI Tib/Fib, with IV Contrast",3672.52,1469.01,0,3121.64,3121.64,SKIPPED,1283.92,1283.92,3121.64,3121.64,3121.64,1547.6,463.83,463.83,0,162.26,1579.18,1579.18,3121.64
4210211,610,73720,,,,,,,"MRI Tib/Fib, with & without IV Contrast",4865.68,1946.27,0,4135.83,4135.83,SKIPPED,2318.36,2318.36,4135.83,4135.83,4135.83,2050.4,463.83,463.83,0,292.99,2092.24,2092.24,4135.83
4210212,610,73721,,,,,,,"MRI Ankle/Hind Foot, without IV Contrast",3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210213,610,73722,,,,,,,"MRI Ankle/Hind Foot, with IV Contrast",4223.08,1689.23,0,3589.62,3589.62,SKIPPED,3463.95,3463.95,3589.62,3589.62,3589.62,1779.6,901.13,901.13,0,437.77,1815.92,1815.92,3589.62
4210214,610,73723,,,,,,,"MRI Ankle/Hind Foot, with & without IV C",5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210215,610,73718,,,,,,,"MRI Foot, without IV Contrast",3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210216,610,73719,,,,,,,"MRI Foot, with IV Contrast",4048.96,1619.58,0,3441.62,3441.62,SKIPPED,1283.92,1283.92,3441.62,3441.62,3441.62,1706.23,463.83,463.83,0,162.26,1741.05,1741.05,3441.62
4210217,610,73720,,,,,,,"MRI Foot, with & without IV Contrast",5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210218,610,73218,,,,,,,"MRI Hand, without IV Contrast",3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210220,610,73220,,,,,,,"MRI Hand, with & without IV Contrast",5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210221,610,73221,,,,,,,"MRI Wrist, without IV Contrast",3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210223,610,73223,,,,,,,"MRI Wrist, with & without IV Contrast",4865.68,1946.27,0,4135.83,4135.83,SKIPPED,2318.36,2318.36,4135.83,4135.83,4135.83,2050.4,463.83,463.83,0,292.99,2092.24,2092.24,4135.83
4210224,610,73218,,,,,,,"MRI Forearm, without IV Contrast",3573.84,1429.54,0,3037.76,3037.76,SKIPPED,1180.13,1180.13,3037.76,3037.76,3037.76,1506.02,289.96,289.96,0,149.14,1536.75,1536.75,3037.76
4210227,610,73221,,,,,,,"MRI Elbow, without IV Contrast",3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210229,610,73223,,,,,,,"MRI Elbow, with & without IV Contrast",4865.68,1946.27,0,4135.83,4135.83,SKIPPED,2318.36,2318.36,4135.83,4135.83,4135.83,2050.4,463.83,463.83,0,292.99,2092.24,2092.24,4135.83
4210230,610,73218,,,,,,,"MRI Humerus, without IV Contrast",3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210231,610,73219,,,,,,,"MRI Humerus, with IV Contrast",4048.96,1619.58,0,3441.62,3441.62,SKIPPED,2318.36,2318.36,3441.62,3441.62,3441.62,1706.23,463.83,463.83,0,292.99,1741.05,1741.05,3441.62
4210232,610,73220,,,,,,,"MRI Humerus, with & without IV Contrast",5364.41,2145.76,0,4559.75,4559.75,SKIPPED,2318.36,2318.36,4559.75,4559.75,4559.75,2260.57,463.83,463.83,0,292.99,2306.7,2306.7,4559.75
4210233,610,73221,,,,,,,"MRI Shoulder, without IV Contrast",3752.53,1501.01,0,3189.65,3189.65,SKIPPED,1180.13,1180.13,3189.65,3189.65,3189.65,1581.32,289.96,289.96,0,149.14,1613.59,1613.59,3189.65
4210234,610,73222,,,,,,,"MRI Shoulder, with IV Contrast",4223.08,1689.23,0,3589.62,3589.62,SKIPPED,3463.95,3463.95,3589.62,3589.62,3589.62,1779.6,901.13,901.13,0,437.77,1815.92,1815.92,3589.62
4210236,610,76377,,,,,,,MRI 3-D,854.93,341.97,0,726.69,726.69,SKIPPED,160.43,160.43,726.69,726.69,726.69,360.27,418.92,418.92,0,256.48,367.62,367.62,726.69
4210237,610,S8037,,,,,,,Magnetic resonance cholangiopancreatogra,1316.7,526.68,0,1119.2,1119.2,SKIPPED,738.84,738.84,1119.2,1119.2,1119.2,554.86,645.18,645.18,0,395.01,566.18,566.18,1119.2
4220050,403,77057,,,,,,,SCREENING MAMMO,203.16,81.26,0,172.69,172.69,SKIPPED,154.4,154.4,172.69,172.69,172.69,42.26,99.55,99.55,0,60.95,43.12,43.12,172.69
4220200,401,19281,,,,,,,MAMMO NEEDLE LOC,567.43,226.97,0,567.43,482.32,SKIPPED,567.43,567.43,482.32,482.32,482.32,239.11,278.04,278.04,0,170.23,243.99,243.99,482.32
4220250,403,76098,,,,,,,SPECIMAN MAMMO P/SPE,167.65,67.06,0,167.65,142.5,SKIPPED,167.65,167.65,142.5,142.5,142.5,24.49,167.65,167.65,0,167.65,24.99,24.99,142.5
4220251,403,77067,,,,,,,MG 3D TOMO SCREENING CAD,455.57,182.23,0,455.57,387.23,SKIPPED,455.57,455.57,387.23,387.23,387.23,89.27,223.23,223.23,0,136.67,91.09,91.09,387.23
4220252,403,77063,,,,,,,MG 3D TOMO SCREENING,103.95,41.58,0,103.95,88.36,SKIPPED,103.95,103.95,88.36,88.36,88.36,43.81,50.94,50.94,0,31.18,44.7,44.7,88.36
4220253,401,77066,,,,,,,MG 3D TOMO DIAGNOSTIC BILATERAL CAD,564.9,225.96,0,564.9,480.16,SKIPPED,564.9,564.9,480.16,480.16,480.16,238.05,276.8,276.8,0,169.47,242.91,242.91,480.16
4220254,401,G0279,,,,,,,MG 3D TOMO DIAGNOSTIC BILATERAL,107.72,43.09,0,107.72,91.56,SKIPPED,107.72,107.72,91.56,91.56,91.56,45.39,52.78,52.78,0,32.32,46.32,46.32,91.56
4220255,401,77065,,,,,,,MG 3D TOMO DIAGNOSTIC RIGHT CAD,448.27,179.31,0,448.27,381.03,SKIPPED,448.27,448.27,381.03,381.03,381.03,188.9,219.65,219.65,0,134.48,192.76,192.76,381.03
4220256,401,G0279,,,,,,,MG 3D TOMO DIAGNOSTIC RIGHT,107.72,43.09,0,107.72,91.56,SKIPPED,107.72,107.72,91.56,91.56,91.56,45.39,52.78,52.78,0,32.32,46.32,46.32,91.56
4220257,401,77065,,,,,,,MG 3D TOMO DIAGNOSTIC LEFT CAD,448.27,179.31,0,448.27,381.03,SKIPPED,448.27,448.27,381.03,381.03,381.03,188.9,219.65,219.65,0,134.48,192.76,192.76,381.03
4220258,401,G0279,,,,,,,MG 3D TOMO DIAGNOSTIC LEFT,107.72,43.09,0,107.72,91.56,SKIPPED,107.72,107.72,91.56,91.56,91.56,45.39,52.78,52.78,0,32.32,46.32,46.32,91.56
4220350,403,77067,,,,,,,SCREENMAMMO2DALLVIEWS,324.72,129.89,0,324.72,276.01,SKIPPED,324.72,324.72,276.01,276.01,276.01,89.27,159.11,159.11,0,97.42,91.09,91.09,276.01
4220400,401,77066,,,,,,,DIGITAL DIAG BILAT MAMMO,460.72,184.29,0,460.72,391.61,SKIPPED,460.72,460.72,391.61,391.61,391.61,194.15,225.75,225.75,0,138.22,198.11,198.11,391.61
4220450,401,77065,,,,,,,MAMMO RIGHT DIGITAL DAGNOSTIC,359.95,143.98,0,359.95,305.96,SKIPPED,359.95,359.95,305.96,305.96,305.96,151.68,176.38,176.38,0,107.98,154.78,154.78,305.96
4220500,401,77066,,,,,,,CAD DIAGNOSTIC,91.54,36.62,0,91.54,77.81,SKIPPED,91.54,91.54,77.81,77.81,77.81,38.57,44.85,44.85,0,27.46,39.36,39.36,77.81
4220600,401,77065,,,,,,,MAMMO LEFT DIGITAL DAGNOSTIC,359.95,143.98,0,359.95,305.96,SKIPPED,359.95,359.95,305.96,305.96,305.96,151.68,176.38,176.38,0,107.98,154.78,154.78,305.96
4230001,350,70450,,,,,,,CT HEAD/BRAIN W/O CO,1376,550.4,0,1169.6,1169.6,SKIPPED,581.46,581.46,1169.6,1169.6,1169.6,579.85,137.3,137.3,0,73.48,591.68,591.68,1169.6
4230002,350,74176,,,,,,,ABD & PEL W/O CONTRAST,3054.49,1221.8,0,2596.32,2596.32,SKIPPED,1180.13,1180.13,2596.32,2596.32,2596.32,1287.16,289.96,289.96,0,149.14,1313.43,1313.43,2596.32
4230003,350,74177,,,,,,,ABD & PEL W/CONTRAST,3591.34,1436.54,0,3052.64,3052.64,SKIPPED,1283.92,1283.92,3052.64,3052.64,3052.64,1513.39,463.83,463.83,0,162.26,1544.28,1544.28,3052.64
4230004,350,70496,,,,,,,CTA BRAIN/HEAD,2265.03,906.01,0,1925.28,1925.28,SKIPPED,1283.92,1283.92,1925.28,1925.28,1925.28,954.48,224.97,224.97,0,162.26,973.96,973.96,1925.28
4230005,350,70460,,,,,,,CT HEAD/BRAIN W/CONT,1760.76,704.3,0,1496.65,1496.65,SKIPPED,1283.92,1283.92,1496.65,1496.65,1496.65,741.99,224.97,224.97,0,162.26,757.13,757.13,1496.65
4230006,350,74178,,,,,,,ABD & PEL W/WO CONTRAST,3951.29,1580.52,0,3358.6,3358.6,SKIPPED,1283.92,1283.92,3358.6,3358.6,3358.6,1665.07,463.83,463.83,0,162.26,1699.05,1699.05,3358.6
4230007,350,71275,,,,,,,CT CHEST FOR PE CTA,1939.12,775.65,0,1648.25,1648.25,SKIPPED,1283.92,1283.92,1648.25,1648.25,1648.25,817.14,224.97,224.97,0,162.26,833.82,833.82,1648.25
4230008,350,70496,,,,,,,CTA HEAD,3267.17,1306.87,0,2777.09,2777.09,SKIPPED,1283.92,1283.92,2777.09,2777.09,2777.09,1376.78,224.97,224.97,0,162.26,1404.88,1404.88,2777.09
4230009,350,70498,,,,,,,CTA NECK,3223.73,1289.49,0,2740.17,2740.17,SKIPPED,1283.92,1283.92,2740.17,2740.17,2740.17,1358.48,224.97,224.97,0,162.26,1386.2,1386.2,2740.17
4230010,350,70470,,,,,,,CT HEAD/BRAIN W/O &,2092.83,837.13,0,1778.91,1778.91,SKIPPED,1283.92,1283.92,1778.91,1778.91,1778.91,881.92,224.97,224.97,0,162.26,899.92,899.92,1778.91
4230030,350,72125,,,,,,,CT CERVICAL SPINE W/O CON,1802.68,721.07,0,1532.28,1532.28,SKIPPED,581.46,581.46,1532.28,1532.28,1532.28,759.65,137.3,137.3,0,73.48,775.15,775.15,1532.28
4230035,350,72126,,,,,,,CT CERVICAL SPINE WITH CO,3574.31,1429.72,0,3038.16,3038.16,SKIPPED,2318.36,2318.36,3038.16,3038.16,3038.16,1506.21,463.83,463.83,0,292.99,1536.95,1536.95,3038.16
4230040,350,72127,,,,,,,CT CERV SP W/O & W/C,2509.99,1004,0,2133.49,2133.49,SKIPPED,1283.92,1283.92,2133.49,2133.49,2133.49,1057.71,224.97,224.97,0,162.26,1079.3,1079.3,2133.49
4230060,350,72133,,,,,,,CT LUMBAR SP W/O CON,2462.03,984.81,0,2092.73,2092.73,SKIPPED,1283.92,1283.92,2092.73,2092.73,2092.73,1037.5,224.97,224.97,0,162.26,1058.67,1058.67,2092.73
4230065,350,72132,,,,,,,CT LUMBAR SP W/CONTR,2199.77,879.91,0,2199.77,1869.8,SKIPPED,2199.77,2199.77,1869.8,1869.8,1869.8,926.98,463.83,463.83,0,292.99,945.9,945.9,1869.8
4230070,350,72131,,,,,,,CT LUMBAR W & W/O CO,2683.82,1073.53,0,2281.25,2281.25,SKIPPED,581.46,581.46,2281.25,2281.25,2281.25,1130.96,137.3,137.3,0,73.48,1154.04,1154.04,2281.25
4230085,350,72194,,,,,,,CT PELVIS W & W/O CO,2255.66,902.26,0,1917.31,1917.31,SKIPPED,1283.92,1283.92,1917.31,1917.31,1917.31,950.53,224.97,224.97,0,162.26,969.93,969.93,1917.31
4230090,350,74150,,,,,,,CT ABD W/O CONTRAST,1728.18,691.27,0,1468.95,1468.95,SKIPPED,581.46,581.46,1468.95,1468.95,1468.95,728.26,137.3,137.3,0,73.48,743.12,743.12,1468.95
4230095,350,74160,,,,,,,CT ABD W/CONTRAST,1960.96,784.38,0,1666.82,1666.82,SKIPPED,1283.92,1283.92,1666.82,1666.82,1666.82,826.35,224.97,224.97,0,162.26,843.21,843.21,1666.82
4230100,350,74170,,,,,,,CT ABD W & W/O CONTR,2308.32,923.33,0,1962.07,1962.07,SKIPPED,1283.92,1283.92,1962.07,1962.07,1962.07,972.73,224.97,224.97,0,162.26,992.58,992.58,1962.07
4230105,350,72192,,,,,,,CT PELVIS W/O CONTRA,1577.7,631.08,0,1341.04,1341.04,SKIPPED,581.46,581.46,1341.04,1341.04,1341.04,664.84,137.3,137.3,0,73.48,678.41,678.41,1341.04
4230110,350,72193,,,,,,,CT PELVIS WITH CONTR,1838.34,735.34,0,1562.59,1562.59,SKIPPED,1283.92,1283.92,1562.59,1562.59,1562.59,774.68,224.97,224.97,0,162.26,790.49,790.49,1562.59
4230125,350,75989,,,,,,,CT ABSCESS DRAINAGE,1498.6,599.44,0,1273.81,1273.81,SKIPPED,324.51,324.51,1273.81,1273.81,1273.81,631.51,734.31,734.31,0,449.58,644.4,644.4,1273.81
4230130,350,70480,,,,,,,"ORBIT, SELLA INNER W",1425.74,570.3,0,1211.88,1211.88,SKIPPED,581.46,581.46,1211.88,1211.88,1211.88,600.81,137.3,137.3,0,73.48,613.07,613.07,1211.88
4230135,350,70481,,,,,,,"ORBIT,SELLA OR INNER",1565.3,626.12,0,1330.5,1330.5,SKIPPED,1283.92,1283.92,1330.5,1330.5,1330.5,659.62,224.97,224.97,0,162.26,673.08,673.08,1330.5
4230136,350,70482,,,,,,,ORBIT SELLA INN W/O F/UP,1751.38,700.55,0,1488.67,1488.67,SKIPPED,1283.92,1283.92,1488.67,1488.67,1488.67,738.03,224.97,224.97,0,162.26,753.09,753.09,1488.67
4230140,350,70486,,,,,,,MAXILLOFAC W/O CONTR,1658.38,663.35,0,1409.62,1409.62,SKIPPED,581.46,581.46,1409.62,1409.62,1409.62,698.84,137.3,137.3,0,73.48,713.1,713.1,1409.62
4230145,350,70487,,,,,,,MAXILLOFAC W/CONTRAS,1779.39,711.76,0,1512.48,1512.48,SKIPPED,1283.92,1283.92,1512.48,1512.48,1512.48,749.84,224.97,224.97,0,162.26,765.14,765.14,1512.48
4230146,350,70488,,,,,,,MAXILLAFACIAL ARE W/O F/U,1860.05,744.02,0,1581.04,1581.04,SKIPPED,1283.92,1283.92,1581.04,1581.04,1581.04,783.82,224.97,224.97,0,162.26,799.82,799.82,1581.04
4230150,350,70490,,,,,,,SOFT TISS NECK W/O C,1673.93,669.57,0,1422.84,1422.84,SKIPPED,581.46,581.46,1422.84,1422.84,1422.84,705.39,137.3,137.3,0,73.48,719.79,719.79,1422.84
4230155,350,70491,,,,,,,SOFT TISS NECK W/CON,1565.3,626.12,0,1330.5,1330.5,SKIPPED,1283.92,1283.92,1330.5,1330.5,1330.5,659.62,224.97,224.97,0,162.26,673.08,673.08,1330.5
4230156,350,70492,,,,,,,SOFT TISS NECK W/O F/U,1658.38,663.35,0,1409.62,1409.62,SKIPPED,1283.92,1283.92,1409.62,1409.62,1409.62,698.84,224.97,224.97,0,162.26,713.1,713.1,1409.62
4230160,350,71250,,,,,,,THORAX W/O CONTRAST,1568.32,627.33,0,1333.07,1333.07,SKIPPED,581.46,581.46,1333.07,1333.07,1333.07,660.89,137.3,137.3,0,73.48,674.38,674.38,1333.07
4230165,350,71260,,,,,,,CHEST W/CONTRAST,1939.12,775.65,0,1648.25,1648.25,SKIPPED,1283.92,1283.92,1648.25,1648.25,1648.25,817.14,224.97,224.97,0,162.26,833.82,833.82,1648.25
4230170,350,71270,,,,,,,THORAX W/O FOL W/CON,2286.75,914.7,0,1943.74,1943.74,SKIPPED,1283.92,1283.92,1943.74,1943.74,1943.74,963.63,224.97,224.97,0,162.26,983.3,983.3,1943.74
4230175,350,72128,,,,,,,THORACIC SPINE W/O C,1802.68,721.07,0,1532.28,1532.28,SKIPPED,581.46,581.46,1532.28,1532.28,1532.28,759.65,137.3,137.3,0,73.48,775.15,775.15,1532.28
4230180,350,72130,,,,,,,THORACIC W/O FOL WIT,2434.3,973.72,0,2069.16,2069.16,SKIPPED,1283.92,1283.92,2069.16,2069.16,2069.16,1025.82,224.97,224.97,0,162.26,1046.75,1046.75,2069.16
4230185,350,72129,,,,,,,THORACIC SPINE W/CON,2153.27,861.31,0,1830.28,1830.28,SKIPPED,1283.92,1283.92,1830.28,1830.28,1830.28,907.39,224.97,224.97,0,162.26,925.91,925.91,1830.28
4230210,350,73700,,,,,,,LOWER EXT W/O CONTRA,1365.16,546.06,0,1160.39,1160.39,SKIPPED,581.46,581.46,1160.39,1160.39,1160.39,575.28,137.3,137.3,0,73.48,587.02,587.02,1160.39
4230215,350,73701,,,,,,,LOWWER EXT W/CONTRAS,1770.15,708.06,0,1504.63,1504.63,SKIPPED,1283.92,1283.92,1504.63,1504.63,1504.63,745.94,224.97,224.97,0,162.26,761.16,761.16,1504.63
4230235,350,75571,,,,,,,CORONARY SCREEN,52.5,21,0,52.5,44.62,SKIPPED,52.5,52.5,44.62,44.62,44.62,22.13,52.5,52.5,0,39.88,22.58,22.58,44.62
4230240,350,70488,,,,,,,CT MAXILLOFACIAL W/W,2109.86,843.94,0,1793.38,1793.38,SKIPPED,1283.92,1283.92,1793.38,1793.38,1793.38,889.1,224.97,224.97,0,162.26,907.24,907.24,1793.38
4230245,350,70492,,,,,,,CT NECK SOFT TISSUE WO/W,2173.36,869.34,0,1847.36,1847.36,SKIPPED,1283.92,1283.92,1847.36,1847.36,1847.36,915.85,224.97,224.97,0,162.26,934.54,934.54,1847.36
4230255,350,76380,,,,,,,CT FOR APPENDICITIS,1369.31,547.72,0,1163.91,1163.91,SKIPPED,315.57,315.57,1163.91,1163.91,1163.91,577.02,101.93,101.93,0,39.88,588.8,588.8,1163.91
4230260,350,74176,,,,,,,CT FOR KIDNEY STONE,1728.18,691.27,0,1468.95,1468.95,SKIPPED,1180.13,1180.13,1468.95,1468.95,1468.95,728.26,289.96,289.96,0,149.14,743.12,743.12,1468.95
4230320,350,73200,,,,,,,"CT HAND, W/O IV CONTRAST",1461.38,584.55,0,1242.17,1242.17,SKIPPED,581.46,581.46,1242.17,1242.17,1242.17,615.82,137.3,137.3,0,73.48,628.39,628.39,1242.17
4230321,350,73201,,,,,,,"CT HAND, W IV CONTRAST",1529.12,611.65,0,1299.75,1299.75,SKIPPED,1283.92,1283.92,1299.75,1299.75,1299.75,644.37,463.83,463.83,0,162.26,657.52,657.52,1299.75
4230323,350,73200,,,,,,,"CT WRIST, W/O IV CONTRAST",1461.38,584.55,0,1242.17,1242.17,SKIPPED,581.46,581.46,1242.17,1242.17,1242.17,615.82,137.3,137.3,0,73.48,628.39,628.39,1242.17
4230324,350,73201,,,,,,,"CT WRIST, W IV CONTRAST",1456.3,582.52,0,1283.92,1237.86,SKIPPED,1283.92,1283.92,1237.86,1237.86,1237.86,613.69,463.83,463.83,0,162.26,626.21,626.21,1237.86
4230326,350,73200,,,,,,,"CT FOREARM, W/O IV CONTRAST",1391.79,556.72,0,1183.02,1183.02,SKIPPED,581.46,581.46,1183.02,1183.02,1183.02,586.5,137.3,137.3,0,73.48,598.47,598.47,1183.02
4230327,350,73201,,,,,,,"CT FOREARM, W IV CONTRAST",1685.86,674.34,0,1432.98,1432.98,SKIPPED,1283.92,1283.92,1432.98,1432.98,1432.98,710.42,463.83,463.83,0,162.26,724.92,724.92,1432.98
4230328,350,73202,,,,,,,"CT FOREARM, W & W/O IV CONTRAST",1873.46,749.38,0,1592.44,1592.44,SKIPPED,1283.92,1283.92,1592.44,1592.44,1592.44,789.48,224.97,224.97,0,162.26,805.59,805.59,1592.44
4230329,350,73200,,,,,,,"CT ELBOW, W/O IV CONTRAST",1461.38,584.55,0,1242.17,1242.17,SKIPPED,581.46,581.46,1242.17,1242.17,1242.17,615.82,137.3,137.3,0,73.48,628.39,628.39,1242.17
4230330,350,73201,,,,,,,"CT ELBOW, W IV CONTRAST",1386.95,554.78,0,1283.92,1178.91,SKIPPED,1283.92,1283.92,1178.91,1178.91,1178.91,584.46,463.83,463.83,0,162.26,596.39,596.39,1178.91
4230332,350,73200,,,,,,,"CT HUMERUS, W/O IV CONTRAST",1461.38,584.55,0,1242.17,1242.17,SKIPPED,581.46,581.46,1242.17,1242.17,1242.17,615.82,137.3,137.3,0,73.48,628.39,628.39,1242.17
4230333,350,73201,,,,,,,"CT HUMERUS, W IV CONTRAST",1565.3,626.12,0,1330.5,1330.5,SKIPPED,1283.92,1283.92,1330.5,1330.5,1330.5,659.62,463.83,463.83,0,162.26,673.08,673.08,1330.5
4230335,350,73200,,,,,,,"CT SHOULDER, W/O IV CONTRAST",1461.38,584.55,0,1242.17,1242.17,SKIPPED,581.46,581.46,1242.17,1242.17,1242.17,615.82,137.3,137.3,0,73.48,628.39,628.39,1242.17
4230336,350,73201,,,,,,,"CT SHOULDER, W IV CONTRAST",1770.15,708.06,0,1504.63,1504.63,SKIPPED,1283.92,1283.92,1504.63,1504.63,1504.63,745.94,463.83,463.83,0,162.26,761.16,761.16,1504.63
4230370,350,73700,,,,,,,"CT HIP, W/O IV CONTRAST",1365.16,546.06,0,1160.39,1160.39,SKIPPED,581.46,581.46,1160.39,1160.39,1160.39,575.28,137.3,137.3,0,73.48,587.02,587.02,1160.39
4230371,350,73701,,,,,,,"CT HIP, W IV CONTRAST",1529.12,611.65,0,1299.75,1299.75,SKIPPED,1283.92,1283.92,1299.75,1299.75,1299.75,644.37,224.97,224.97,0,162.26,657.52,657.52,1299.75
4230373,350,73700,,,,,,,"CT FEMUR, W/O IV CONTRAST",1365.16,546.06,0,1160.39,1160.39,SKIPPED,581.46,581.46,1160.39,1160.39,1160.39,575.28,137.3,137.3,0,73.48,587.02,587.02,1160.39
4230374,350,73701,,,,,,,"CT FEMUR, W IV CONTRAST",1770.15,708.06,0,1504.63,1504.63,SKIPPED,1283.92,1283.92,1504.63,1504.63,1504.63,745.94,224.97,224.97,0,162.26,761.16,761.16,1504.63
4230376,350,73700,,,,,,,"CT KNEE, W/O IV CONTRAST",1365.16,546.06,0,1160.39,1160.39,SKIPPED,581.46,581.46,1160.39,1160.39,1160.39,575.28,137.3,137.3,0,73.48,587.02,587.02,1160.39
4230377,350,73701,,,,,,,"CT KNEE, W IV CONTRAST",1770.15,708.06,0,1504.63,1504.63,SKIPPED,1283.92,1283.92,1504.63,1504.63,1504.63,745.94,224.97,224.97,0,162.26,761.16,761.16,1504.63
4230379,350,73700,,,,,,,"CT TIB/FIB, W/O IV CONTRAST",1365.16,546.06,0,1160.39,1160.39,SKIPPED,581.46,581.46,1160.39,1160.39,1160.39,575.28,137.3,137.3,0,73.48,587.02,587.02,1160.39
4230380,350,73701,,,,,,,"CT TIB/FIB, W IV CONTRAST",1770.15,708.06,0,1504.63,1504.63,SKIPPED,1283.92,1283.92,1504.63,1504.63,1504.63,745.94,224.97,224.97,0,162.26,761.16,761.16,1504.63
4230382,350,73700,,,,,,,"CT ANKLE/HIND FOOT, W/I IV CONTRAST",1365.16,546.06,0,1160.39,1160.39,SKIPPED,581.46,581.46,1160.39,1160.39,1160.39,575.28,137.3,137.3,0,73.48,587.02,587.02,1160.39
4230385,350,73700,,,,,,,"CT FOOT, W/O IV CONTRAST",1365.16,546.06,0,1160.39,1160.39,SKIPPED,581.46,581.46,1160.39,1160.39,1160.39,575.28,137.3,137.3,0,73.48,587.02,587.02,1160.39
4230386,350,73701,,,,,,,"CT FOOT, W IV CONTRAST",1770.15,708.06,0,1504.63,1504.63,SKIPPED,1283.92,1283.92,1504.63,1504.63,1504.63,745.94,224.97,224.97,0,162.26,761.16,761.16,1504.63
4230387,350,73702,,,,,,,"CT FOOT, W & W/O IV CONTRAST",1922.11,768.84,0,1633.79,1633.79,SKIPPED,1283.92,1283.92,1633.79,1633.79,1633.79,809.98,224.97,224.97,0,162.26,826.51,826.51,1633.79
4230389,350,74175,,,,,,,CT ANGIO ABDOM W/O (DISSECTION),4183.66,1673.46,0,3556.11,3556.11,SKIPPED,1283.92,1283.92,3556.11,3556.11,3556.11,1762.99,224.97,224.97,0,162.26,1798.97,1798.97,3556.11
4230720,350,74174,,,,,,,CT ANGIO ABD&PELV W/O&W/DYE,2976.75,1190.7,0,2530.24,2530.24,SKIPPED,1279.86,1279.86,2530.24,2530.24,2530.24,1254.4,463.83,463.83,0,162.26,1280,1280,2530.24
4230721,350,75635,,,,,,,CT ANGIO ABD ARTERIES(CTA RUNOFF),3733.11,1493.24,0,3173.14,3173.14,SKIPPED,1283.92,1283.92,3173.14,3173.14,3173.14,1573.14,224.97,224.97,0,162.26,1605.24,1605.24,3173.14
4230722,350,73706,,,,,,,CTA LOWER EXT. W/ & W/O CONTRAST,3416.44,1366.58,0,2903.97,2903.97,SKIPPED,1283.92,1283.92,2903.97,2903.97,2903.97,1439.69,224.97,224.97,0,162.26,1469.07,1469.07,2903.97
4230723,350,77073,,,,,,,BONE LENGTH STUDY SCANOGRAM,478.68,191.47,0,478.68,406.88,SKIPPED,478.68,478.68,406.88,406.88,406.88,201.71,137.3,137.3,0,73.48,205.83,205.83,406.88
4230724,350,71271,,,,,,,CT LOW DOSE FOR LUNG SCREEN(LDCT),489.68,195.87,0,416.23,416.23,SKIPPED,372.16,372.16,416.23,416.23,416.23,206.35,101.93,101.93,0,146.9,210.56,210.56,416.23
4230725,350,73206,,,,,,,CTA UPPER EXTREMITY,2937.3,1174.92,0,2496.7,2496.7,SKIPPED,1283.92,1283.92,2496.7,2496.7,2496.7,1237.78,224.97,224.97,0,162.26,1263.04,1263.04,2496.7
4240003,320,77080,,,,,,,DEXA-BONE DENSITY,200.05,80.02,0,170.04,170.04,SKIPPED,164.08,164.08,170.04,170.04,170.04,84.3,137.3,137.3,0,73.48,86.02,86.02,170.04
4240005,320,70130,,,,,,,MASTOID MIN 3VIEW/SI,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4240007,320,74230,,,,,,,MODIFIED COOKIE SWAL,171.12,68.45,0,171.12,145.45,SKIPPED,171.12,171.12,145.45,145.45,145.45,72.11,171.12,171.12,0,73.48,73.58,73.58,145.45
4240012,320,74300,,,,,,,CHOLANGIOGRAPHY INTRAOPER,115.56,46.22,0,98.23,98.23,SKIPPED,94.79,94.79,98.23,98.23,98.23,48.7,56.62,56.62,0,34.67,49.69,49.69,98.23
4240030,320,70360,,,,,,,NECK SOFT TISSUE,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4240040,320,76010,,,,,,,NOSE TO RECTUM/1FLM/,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4240043,320,76080,,,,,,,FISTULOGRAM ABSESS,1438.76,575.5,0,1222.95,1222.95,SKIPPED,1180.13,1180.13,1222.95,1222.95,1222.95,606.3,608.44,608.44,0,149.14,618.67,618.67,1222.95
4240052,320,74018,,,,,,,ABDOMEN 1 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4240055,320,74019,,,,,,,ABD-FLAT&ERECT/DECUB,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4240101,320,71045,,,,,,,CHEST 1 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4240105,320,73620,,,,,,,RIGHT FOOT 2 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4240116,320,73630,,,,,,,RIGHT FOOT 3 VIEW,415.63,166.25,0,353.29,353.29,SKIPPED,315.57,315.57,353.29,353.29,353.29,175.15,101.93,101.93,0,39.88,178.72,178.72,353.29
4240203,320,71046,,,,,,,CHEST 2 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4240220,320,71048,,,,,,,CHEST WITH OBLIQUE,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4240309,320,73090,,,,,,,RIGHT FOREARM 2 VIEW,415.63,166.25,0,353.29,353.29,SKIPPED,315.57,315.57,353.29,353.29,353.29,175.15,101.93,101.93,0,39.88,178.72,178.72,353.29
4240350,320,71047,,,,,,,CHEST SPEC VIEWS(DEC,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4240429,320,71048,,,,,,,CHEST MIN4VIEWS COMP,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4240435,320,71047,,,,,,,CHEST PA/LAT W/LORDO,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4240500,320,73050,,,,,,,A-C JOINTS BILATERAL,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4240501,320,73000,,,,,,,RIGHT CLAVICLE,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4240720,320,72072,,,,,,,THORACIC SPINE W/SWI,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4240809,320,73120,,,,,,,RIGHT HAND 2 VIEW,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4240900,320,72082,,,,,,,SCOLIOSIS STUDY,669,267.6,0,581.46,568.65,SKIPPED,581.46,581.46,568.65,568.65,568.65,281.92,137.3,137.3,0,73.48,287.67,287.67,568.65
4240901,320,73130,,,,,,,RIGHT HAND 3 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4240910,320,72082,,,,,,,SCOLIOSIS UPR&SUP,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4241057,320,74280,,,,,,,COLON W/AIR CONTRAST,1024.68,409.87,0,870.98,870.98,SKIPPED,840.49,840.49,870.98,870.98,870.98,431.8,224.97,224.97,0,162.26,440.61,440.61,870.98
4241100,320,74019,,,,,,,ABD W/OBLIQUE OR CON,384.73,153.89,0,384.73,327.02,SKIPPED,384.73,384.73,327.02,327.02,327.02,162.12,137.3,137.3,0,73.48,165.43,165.43,327.02
4241106,320,73501,,,,,,,RIGHT HIP 1 VIEW UNILAT,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4241206,320,74270,,,,,,,COLON W/FLUORO,558.79,223.52,0,558.79,474.97,SKIPPED,558.79,558.79,474.97,474.97,474.97,235.47,224.97,224.97,0,162.26,240.28,240.28,474.97
4241300,320,73502,,,,,,,RIGHT HIP 2 VIEW MIN,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4241304,320,74022,,,,,,,ACUTE ABD W/PA CHEST,384.73,153.89,0,384.73,327.02,SKIPPED,384.73,384.73,327.02,327.02,327.02,162.12,137.3,137.3,0,73.48,165.43,165.43,327.02
4241310,320,,,,,,,,COPY OF RADIOGRAPH,31.09,12.44,0,26.43,26.43,SKIPPED,23.63,23.63,26.43,26.43,26.43,13.1,15.23,15.23,0,9.33,13.37,13.37,26.43
4241402,320,73521,,,,,,,HIP JOINT BILATERAL,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4241600,320,73600,,,,,,,RIGHT ANKLE 2 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4242009,320,73610,,,,,,,RIGHT ANKLE 3 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4242229,320,73070,,,,,,,RIGHT ELBOW 2 VIEW,708.89,283.56,0,602.56,602.56,SKIPPED,315.57,315.57,602.56,602.56,602.56,298.72,101.93,101.93,0,39.88,304.82,304.82,602.56
4242235,320,73080,,,,,,,RIGHT ELBOW 3 VIEWS,415.63,166.25,0,353.29,353.29,SKIPPED,315.57,315.57,353.29,353.29,353.29,175.15,101.93,101.93,0,39.88,178.72,178.72,353.29
4242490,320,74248,,,,,,,GI/SM BWL/HD BARIUM/,862.42,344.97,0,733.06,733.06,SKIPPED,242.47,242.47,733.06,733.06,733.06,363.42,86.88,86.88,0,258.73,370.84,370.84,733.06
4243008,320,70160,,,,,,,NASAL BONES,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4243010,320,70200,,,,,,,ORBIT X-RAY,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4243033,921,93880,,,,,,,CAROTID DOPPLER/BILA,317.74,127.1,0,317.74,270.08,SKIPPED,317.74,317.74,270.08,270.08,270.08,133.9,289.96,289.96,0,148.02,136.63,136.63,270.08
4243064,320,72170,,,,,,,PELVIS 1OR 2 VIEWS,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4243166,320,72190,,,,,,,PELVIS 3 VIEW,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4243206,402,76536,,,,,,,THYROID ECHO,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4243230,972,93931,,,,,,,ART UPPER EXTREM UNI,59.03,23.61,0,59.03,50.18,SKIPPED,59.03,59.03,50.18,50.18,50.18,26.22,59.03,59.03,0,59.03,26.76,26.76,0
4243251,972,74250,,,,,,,SMALL BOWELL SERIES,56.65,22.66,0,56.65,48.15,SKIPPED,56.65,56.65,48.15,48.15,48.15,43.3,56.65,56.65,0,56.65,44.18,44.18,0
4244010,320,74220,,,,,,,ESOPHAGUS,1565.3,626.12,0,1330.5,1330.5,SKIPPED,1283.92,1283.92,1330.5,1330.5,1330.5,659.62,224.97,224.97,0,162.26,673.08,673.08,1330.5
4244015,320,70150,,,,,,,FACIAL BONES MIN 3 V,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4244020,320,70140,,,,,,,FACIAL BONES LESS 3V,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4244021,320,74400,,,,,,,UROGRAPHY W/SPEC CON,533.43,213.37,0,453.42,453.42,SKIPPED,437.54,437.54,453.42,453.42,453.42,224.78,224.97,224.97,0,162.26,229.37,229.37,453.42
4244022,320,71100,,,,,,,RIBS UNILAT 2 VIEWS,708.89,283.56,0,602.56,602.56,SKIPPED,315.57,315.57,602.56,602.56,602.56,298.72,101.93,101.93,0,39.88,304.82,304.82,602.56
4244156,320,71111,,,,,,,RIBS BILAT W/1VIEW C,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4244160,320,71110,,,,,,,RIBS BILAT 3 VIEWS,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4244310,320,73552,,,,,,,FEMUR 2 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4244316,320,71101,,,,,,,RIBS UNILA W/1VIEW C,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4244325,320,73140,,,,,,,RIGHT FINGER,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4244330,320,76000,,,,,,,FLURO MISC UP TO 1 H,244.51,97.8,0,244.51,207.83,SKIPPED,200.56,200.56,207.83,207.83,207.83,103.04,244.51,244.51,0,149.14,105.14,105.14,207.83
4244335,320,76001,,,,,,,FLURO ONE HOUR PLUS,233.36,93.34,0,198.36,198.36,SKIPPED,177.35,177.35,198.36,198.36,198.36,98.33,114.35,114.35,0,70.01,100.34,100.34,198.36
4244340,320,77002,,,,,,,"FLURO LOCAL,NEEDLE,",415.63,166.25,0,353.29,353.29,SKIPPED,340.92,340.92,353.29,353.29,353.29,175.15,203.66,203.66,0,124.69,178.72,178.72,353.29
4244598,320,72202,,,,,,,S I JOINTS 3 VIEWS,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4244600,320,72200,,,,,,,S I JOINTS LESS THAN,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4244747,320,72220,,,,,,,SACRUM/COCCYX,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4244770,320,73010,,,,,,,RIGHT SCAPULA COMPLETE,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4244805,320,73020,,,,,,,SHOULDER 1 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4244816,320,73030,,,,,,,SHOULDER 2 VIEWS MIN,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4244835,320,70210,,,,,,,SINUSES LESS THAN 3,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4244849,320,70220,,,,,,,SINUSES MIN OF 3 VIE,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4244883,320,70250,,,,,,,SKULL LESS THAN 4 VI,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4244929,320,70260,,,,,,,SKULL MIN 4 VIEWS,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4245008,320,73530,,,,,,,HIP NAILING IN OR,584.82,233.93,0,497.1,497.1,SKIPPED,444.46,444.46,497.1,497.1,497.1,246.44,286.56,286.56,0,175.45,251.47,251.47,497.1
4245015,320,73502,,,,,,,HIP & PELVIS XRAY/CHILD,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4245053,320,73060,,,,,,,RIGHT HUMERUS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4245120,320,74340,,,,,,,INDUCT GI W/FLURO/FI,171.12,68.45,0,145.45,145.45,SKIPPED,140.36,140.36,145.45,145.45,145.45,72.11,83.85,83.85,0,51.34,73.58,73.58,145.45
4245519,320,73560,,,,,,,RIGHT KNEE 2 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4245525,320,73565,,,,,,,KNEE BOTH AP ERECT,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4245620,320,73562,,,,,,,RIGHT KNEE 3 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4245625,320,73564,,,,,,,RIGHT KNEE 4 OR MORE VIEWS,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4246101,320,73590,,,,,,,LEG 2 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4246110,320,73592,,,,,,,RIGHT LOWER EXTREM/INFANT,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4246500,320,73650,,,,,,,RIGHT CALCANEUS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4246601,320,70110,,,,,,,MANDIBLE MIN 4VIEWS,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4246615,320,70100,,,,,,,MANDIBLE LESS THAN 4,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247104,320,74250,,,,,,,SMALL BOWEL SERIES,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,224.97,224.97,0,73.48,304.82,304.82,602.56
4247411,320,72040,,,,,,,SPINE CERVICAL 3V OR LESS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247422,320,72040,,,,,,,Spine Cervical 3V OR LESS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247433,320,72050,,,,,,,SPINE CERVICAL 6V OR MORE,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247443,320,72052,,,,,,,SPINE CERVICAL 4OR 5V,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247455,320,72020,,,,,,,SPINE THORACIC 1 VIE,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247466,320,72070,,,,,,,SPINE THORACIC 2 VIE,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247499,320,72100,,,,,,,SPINE LUMBAR 2 or 3 view,384.73,153.89,0,384.73,327.02,SKIPPED,384.73,384.73,327.02,327.02,327.02,162.12,137.3,137.3,0,73.48,165.43,165.43,327.02
4247513,320,72110,,,,,,,SPINE LUMBAR4/5 view,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247520,320,72020,,,,,,,SPINE LUMBAR 1 VIEW,708.89,283.56,0,602.56,602.56,SKIPPED,315.57,315.57,602.56,602.56,602.56,298.72,101.93,101.93,0,39.88,304.82,304.82,602.56
4247525,320,72072,,,,,,,SPINE THORACIC W/SWI,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247530,320,72114,,,,,,,Spine Lum COMPLETE W/BEND,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247535,320,71120,,,,,,,STERNUM MIN 2 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247540,320,72074,,,,,,,SPINE THORACIC MIN 4,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247546,320,70330,,,,,,,T M JOINTS BILATERAL,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247555,320,70328,,,,,,,TM JOINTS UNILATERAL,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247557,320,73660,,,,,,,TOES,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247580,320,74246,,,,,,,GI/HD BARIUM,1565.3,626.12,0,1330.5,1330.5,SKIPPED,1283.92,1283.92,1330.5,1330.5,1330.5,659.62,224.97,224.97,0,162.26,673.08,673.08,1330.5
4247582,320,74240,,,,,,,UGI W/O KUB,288.53,115.41,0,288.53,245.25,SKIPPED,288.53,288.53,245.25,245.25,245.25,121.59,224.97,224.97,0,162.26,124.07,124.07,245.25
4247584,320,73092,,,,,,,UPPER EXTREM/INFANT,384.73,153.89,0,384.73,327.02,SKIPPED,384.73,384.73,327.02,327.02,327.02,162.12,137.3,137.3,0,73.48,165.43,165.43,327.02
4247626,320,73100,,,,,,,RIGHT WRIST 2 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247637,320,73110,,,,,,,WRIST 3 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247671,320,,,,,,,,SKELETAL SURVEY OSSEOUS,733.85,293.54,0,623.77,623.77,SKIPPED,557.73,557.73,623.77,623.77,623.77,309.25,359.59,359.59,0,220.16,315.56,315.56,623.77
4247672,320,77075,,,,,,,X-RAY BONE SURVEY COMPLETE,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247673,320,77072,,,,,,,BONE AGE STUDY X-RAY,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247674,320,73600,,,,,,,LEFT ANKLE 2 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247675,320,73610,,,,,,,LEFT ANKLE 3 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247676,320,73000,,,,,,,LEFT CLAVICLE,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247677,320,73070,,,,,,,LEFT ELBOW 2 VIEWS,708.89,283.56,0,602.56,602.56,SKIPPED,315.57,315.57,602.56,602.56,602.56,298.72,101.93,101.93,0,39.88,304.82,304.82,602.56
4247678,320,73080,,,,,,,LEFT ELBOW 3 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247679,320,73552,,,,,,,LEFT FEMUR,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247680,320,73140,,,,,,,LEFT FINGER,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247681,320,73620,,,,,,,LEFT FOOT 2 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247682,320,73630,,,,,,,LEFT FOOT 3 VIEWS,415.63,166.25,0,353.29,353.29,SKIPPED,315.57,315.57,353.29,353.29,353.29,175.15,101.93,101.93,0,39.88,178.72,178.72,353.29
4247683,320,73090,,,,,,,LEFT FOREARM 2 VIEWS,415.63,166.25,0,353.29,353.29,SKIPPED,315.57,315.57,353.29,353.29,353.29,175.15,101.93,101.93,0,39.88,178.72,178.72,353.29
4247684,320,73120,,,,,,,LEFT HAND 2 VIEWS,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247685,320,73130,,,,,,,LEFT HAND 3 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247686,320,73501,,,,,,,LEFT HIP 1 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247687,320,73502,,,,,,,LEFT HIP 2 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247688,320,73060,,,,,,,LEFT HUMERUS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247689,320,73560,,,,,,,LEFT KNEE 2 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247690,320,73562,,,,,,,LEFT KNEE 3 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247691,320,73564,,,,,,,LEFT KNEE 4 OR MORE VIEWS,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247692,320,73592,,,,,,,LEFT LOWER EXT. INFANT,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247693,320,73010,,,,,,,LEFT SCAPULA COMPLETE,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247694,320,73020,,,,,,,LEFT SHOULDER 1 VIEW,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247695,320,73660,,,,,,,LEFT TOES 3 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247696,320,73100,,,,,,,LEFT WRIST 2 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247697,320,73110,,,,,,,LEFT WRIST 3 VIEWS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247698,320,73650,,,,,,,LEFT CALCANEOUS,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247699,320,73590,,,,,,,LEFT LOWER LEG TIB/FIB,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247700,320,71101,,,,,,,LEFT RIBS UNILATERAL,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247701,320,71111,,,,,,,LEFT RIBS UNILATERAL W/ 1 VIEW CXR,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4247702,320,73030,,,,,,,LEFT SHOULDER UNILATERAL,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4247703,320,76000,,,,,,,SNIFF TEST,244.51,97.8,0,244.51,207.83,SKIPPED,200.56,200.56,207.83,207.83,207.83,103.04,244.51,244.51,0,149.14,105.14,105.14,207.83
4247704,510,91200,,,,,,,LIVER ELASTOGRAPHY W/O IMAG W/I&R,380,152,0,380,323,SKIPPED,380,380,323,323,0,160.13,186.2,186.2,0,114,163.4,163.4,323
4249999,260,96374,,,,,,,IV INJ,207.86,83.14,0,207.86,176.68,SKIPPED,207.86,207.86,176.68,176.68,176.68,87.59,101.85,101.85,0,62.36,89.38,89.38,176.68
4250001,320,76000,,,,,,,OR-FLUORO < 1 HR,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250002,320,76001,,,,,,,OR-FLUORO > 1 HR,691.9,276.76,0,588.12,588.12,SKIPPED,525.84,525.84,588.12,588.12,588.12,291.57,339.03,339.03,0,207.57,297.52,297.52,588.12
4250003,320,73630,,,,,,,OR-FOOT RT,311.85,124.74,0,311.85,265.07,SKIPPED,311.85,311.85,265.07,265.07,265.07,131.42,101.93,101.93,0,39.88,134.1,134.1,265.07
4250004,320,73630,,,,,,,OR-FOOT LT,311.85,124.74,0,311.85,265.07,SKIPPED,311.85,311.85,265.07,265.07,265.07,131.42,101.93,101.93,0,39.88,134.1,134.1,265.07
4250005,320,73610,,,,,,,OR-ANKLE RT,311.85,124.74,0,311.85,265.07,SKIPPED,311.85,311.85,265.07,265.07,265.07,131.42,101.93,101.93,0,39.88,134.1,134.1,265.07
4250006,320,73610,,,,,,,OR-ANKLE LT,311.85,124.74,0,311.85,265.07,SKIPPED,311.85,311.85,265.07,265.07,265.07,131.42,101.93,101.93,0,39.88,134.1,134.1,265.07
4250007,320,73530,,,,,,,OR-HIP PINNING RT,584.82,233.93,0,497.1,497.1,SKIPPED,444.46,444.46,497.1,497.1,497.1,246.44,286.56,286.56,0,175.45,251.47,251.47,497.1
4250008,320,73530,,,,,,,OR-HIP PINNING LT,584.82,233.93,0,497.1,497.1,SKIPPED,444.46,444.46,497.1,497.1,497.1,246.44,286.56,286.56,0,175.45,251.47,251.47,497.1
4250009,320,74300,,,,,,,OR-CHOLANGIOGRAM,1140.16,456.06,0,969.14,969.14,SKIPPED,94.79,94.79,969.14,969.14,969.14,480.46,558.68,558.68,0,342.05,490.27,490.27,969.14
4250010,320,72040,,,,,,,OR-CERVICAL SPINE > 3 VIEWS,307.15,122.86,0,307.15,261.08,SKIPPED,307.15,307.15,261.08,261.08,261.08,129.43,101.93,101.93,0,39.88,132.07,132.07,261.08
4250011,402,76942,,,,,,,OR- US NERVE BLOCK,1444.91,577.96,0,1228.17,1228.17,SKIPPED,142.19,142.19,1228.17,1228.17,1228.17,608.88,708.01,708.01,0,433.47,621.31,621.31,1228.17
4250012,320,76000,,,,,,,LHC FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250013,320,76000,,,,,,,LHC CORS ONLY FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250014,320,76000,,,,,,,LHC AND GRAFTS FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250015,320,76000,,,,,,,LHC/RHC GRAFTS FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250016,320,76000,,,,,,,RHC FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250017,320,76000,,,,,,,LHC/PTCA FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250018,320,76000,,,,,,,ABDOMINAL ANGIO FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250019,320,76000,,,,,,,ABDOMINAL RUN OFF BILAT FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250020,320,76000,,,,,,,ABDOMINAL RUN OFF UNILAT FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250021,320,76000,,,,,,,ABDOMINAL ANGIO PTA FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250022,320,76000,,,,,,,ABDOMINAL RUN OFF PTA FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250023,320,76000,,,,,,,EXTREMITY UNILATERAL FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250024,320,76000,,,,,,,EXTREMITY PTA FLURO,507.23,202.89,0,431.15,431.15,SKIPPED,200.56,200.56,431.15,431.15,431.15,213.75,289.96,289.96,0,149.14,218.11,218.11,431.15
4250025,320,37252,,,,,,,IVUS INITIAL VESSEL,4928.18,1971.27,0,4188.95,4188.95,SKIPPED,0,0,4188.95,4188.95,4188.95,2076.74,2414.81,2414.81,0,1478.45,2119.12,2119.12,4188.95
4250026,320,37253,,,,,,,IVUS ADDITIONAL 3 VESSELS,3626.47,1450.59,0,3082.5,3082.5,SKIPPED,0,0,3082.5,3082.5,3082.5,1528.19,1776.97,1776.97,0,1087.94,1559.38,1559.38,3082.5
4250027,320,76937,,,,,,,US GUIDANCE FOR VASCULAR ACCESS,595.98,238.39,0,506.58,506.58,SKIPPED,87.53,87.53,506.58,506.58,506.58,251.14,292.03,292.03,0,178.79,256.27,256.27,506.58
4260001,402,76536,,,,,,,US ST HEAD/NECK,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4260002,402,76801,,,,,,,OB US 1ST TRI <14WK 0 DAY,466.79,186.72,0,396.77,396.77,SKIPPED,382.88,382.88,396.77,396.77,396.77,196.71,137.3,137.3,0,73.48,200.72,200.72,396.77
4260003,402,76811,,,,,,,OB US AFTER 1ST TRI/GESTE,620.61,248.24,0,527.52,527.52,SKIPPED,443.03,443.03,527.52,527.52,527.52,261.52,289.96,289.96,0,73.48,266.86,266.86,527.52
4260005,402,76817,,,,,,,US PREG UTERUS TRANSVAG,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4260010,921,93978,,,,,,,AORTA/IVC W/DOP COMP,95.12,38.05,0,95.12,80.85,SKIPPED,95.12,95.12,80.85,80.85,80.85,40.08,95.12,95.12,0,95.12,40.9,40.9,80.85
4260011,921,93922,,,,,,,ART. DOP. SINGLE LEVEL,30.25,12.1,0,30.25,25.71,SKIPPED,30.25,30.25,25.71,25.71,25.71,12.75,14.82,14.82,0,9.08,13.01,13.01,25.71
4260012,402,76775,,,,,,,AORTA NON VASCULAR,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4260013,402,93923,,,,,,,ART. DOP. COMP. BILATERAL,691.24,276.5,0,587.55,587.55,SKIPPED,555.75,555.75,587.55,587.55,587.55,291.29,175.83,175.83,0,87.28,297.23,297.23,587.55
4260014,402,93924,,,,,,,ART. DOP. REST&STRESS,783.43,313.37,0,705.76,665.92,SKIPPED,705.76,705.76,665.92,665.92,665.92,330.13,333.21,333.21,0,87.28,336.87,336.87,665.92
4260016,402,76770,,,,,,,RENAL ULTRASOUND,783.43,313.37,0,665.92,665.92,SKIPPED,581.46,581.46,665.92,665.92,665.92,330.13,137.3,137.3,0,73.48,336.87,336.87,665.92
4260019,402,76770,,,,,,,LYMPH NODE ULTRASOUND,783.43,313.37,0,665.92,665.92,SKIPPED,581.46,581.46,665.92,665.92,665.92,330.13,137.3,137.3,0,73.48,336.87,336.87,665.92
4260020,402,,,,,,,,TDCJ NO SHOW FEE,82.16,32.86,0,69.84,69.84,SKIPPED,62.44,62.44,69.84,69.84,69.84,34.62,40.26,40.26,0,24.65,35.33,35.33,69.84
4260021,921,93925,,,,,,,DUP LOW EXT ART BI,1395.77,558.31,0,1186.4,1186.4,SKIPPED,1077.4,1077.4,1186.4,1186.4,1186.4,588.18,289.96,289.96,0,148.02,600.18,600.18,1186.4
4260022,921,93926,,,,,,,DUP LOW EXT ART UNI,58.19,23.28,0,58.19,49.46,SKIPPED,58.19,58.19,49.46,49.46,49.46,24.52,58.19,58.19,0,58.19,25.02,25.02,49.46
4260025,921,93976,,,,,,,RENAL ARTERY INFLOW,95.63,38.25,0,95.63,81.29,SKIPPED,95.63,95.63,81.29,81.29,81.29,40.3,95.63,95.63,0,72.23,41.12,41.12,81.29
4260044,921,93970,,,,,,,VENOUS DOPPLER BILATERAL LOWER EXTREMITI,1522.55,609.02,0,1294.17,1294.17,SKIPPED,789.26,789.26,1294.17,1294.17,1294.17,641.61,289.96,289.96,0,148.02,654.7,654.7,1294.17
4260045,921,93971,,,,,,,VENOUS DOPPLER UNILATERAL LOWER EXTREMIT,53.98,21.59,0,53.98,45.88,SKIPPED,53.98,53.98,45.88,45.88,45.88,22.75,53.98,53.98,0,53.98,23.21,23.21,45.88
4260046,921,93971,,,,,,,VENOUS DOPPLER UNILATERAL UPPER EXTREMIT,53.98,21.59,0,53.98,45.88,SKIPPED,53.98,53.98,45.88,45.88,45.88,22.75,53.98,53.98,0,53.98,23.21,23.21,45.88
4260099,921,93970,,,,,,,VENOUS DOPPLER BILATERAL UPPER EXTREMITI,1522.55,609.02,0,1294.17,1294.17,SKIPPED,789.26,789.26,1294.17,1294.17,1294.17,641.61,289.96,289.96,0,148.02,654.7,654.7,1294.17
4262023,402,76700,,,,,,,ABD COMPLETE ECHO,848.69,339.48,0,721.39,721.39,SKIPPED,581.46,581.46,721.39,721.39,721.39,357.64,137.3,137.3,0,73.48,364.94,364.94,721.39
4263013,402,76705,,,,,,,ABDOMINAL LIMITED ECHO,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4263023,402,76705,,,,,,,BLADDER SONO,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4263024,402,76641,,,,,,,US BILAT BREAST SONO COMPLETE,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4263033,921,93880,,,,,,,CAROTID DOPPLER/BILAT,342.11,136.84,0,342.11,290.79,SKIPPED,342.11,342.11,290.79,290.79,290.79,144.17,289.96,289.96,0,148.02,147.11,147.11,290.79
4263034,402,76882,,,,,,,EXTREMITY ECHO NON VAS,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,59.11,304.82,304.82,602.56
4263037,402,45300,,,,,,,US OF APPENDIX,702.74,281.1,296.14,597.33,597.33,SKIPPED,453.15,453.15,597.33,597.33,597.33,296.14,344.34,344.34,SKIPPED,SKIPPED,302.18,302.18,597.33
4263039,402,76942,,,,,,,US GUIDED CORE BIOPSY BREAST UNILATERAL,1144.85,457.94,0,973.12,973.12,SKIPPED,142.19,142.19,973.12,973.12,973.12,482.44,560.98,560.98,0,343.46,492.29,492.29,973.12
4263046,402,76705,,,,,,,GALLBLADDER ECHO,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4263057,402,76705,,,,,,,HEPATIC ECHO,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4263080,402,76705,,,,,,,PANCREAS ECHO,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4263091,402,76856,,,,,,,PELVIC ECHO,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,98.6,304.82,304.82,602.56
4263101,402,76882,,,,,,,ULTRASOUND OF HUMERUS NON-VASC,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,59.11,304.82,304.82,602.56
4263102,402,76882,,,,,,,ULTRASOUND OF ELBOW NON-VASC,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,59.11,304.82,304.82,602.56
4263103,402,76882,,,,,,,ULTRASOUND OF FOREARM NON-VASC,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,59.11,304.82,304.82,602.56
4263104,402,76882,,,,,,,ULTRASOUND OF WRIST NON-VASC,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,59.11,304.82,304.82,602.56
4263105,402,76882,,,,,,,ULTRASOUND OF HAND NON-VASC,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,59.11,304.82,304.82,602.56
4263106,402,76882,,,,,,,ULTRASOUND OF HIP NON-VASC,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,59.11,304.82,304.82,602.56
4263107,402,76882,,,,,,,ULTRASOUND OF KNEE NON-VASC,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,59.11,304.82,304.82,602.56
4263109,402,76882,,,,,,,ULTRASOUND OF LOWER LEG NON-VASC,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,59.11,304.82,304.82,602.56
4263110,402,76882,,,,,,,ULTRASOUND OF ANKLE NON-VASC,431.56,172.62,0,431.56,366.83,SKIPPED,431.56,431.56,366.83,366.83,366.83,181.86,137.3,137.3,0,59.11,185.57,185.57,366.83
4263111,402,76882,,,,,,,ULTRASOUND OF FOOT NON-VASC,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,59.11,304.82,304.82,602.56
4263112,402,76942,,,,,,,US GUIDED WIRE LOCALIZATION BIL BREAST,1144.85,457.94,0,973.12,973.12,SKIPPED,142.19,142.19,973.12,973.12,973.12,482.44,560.98,560.98,0,343.46,492.29,492.29,973.12
4263113,402,76942,,,,,,,US GUIDED CORE BIOPSY BREAST BIL BREAST,1144.85,457.94,0,973.12,973.12,SKIPPED,142.19,142.19,973.12,973.12,973.12,482.44,560.98,560.98,0,343.46,492.29,492.29,973.12
4263114,402,76942,,,,,,,US GUIDED WIRE LOCAL UNILAT BREAST MULTI,1144.85,457.94,0,973.12,973.12,SKIPPED,142.19,142.19,973.12,973.12,973.12,482.44,560.98,560.98,0,343.46,492.29,492.29,973.12
4263115,402,76801,,,,,,,OB ECHO <14WK P/GESTATION,466.79,186.72,0,396.77,396.77,SKIPPED,382.88,382.88,396.77,396.77,396.77,196.71,137.3,137.3,0,73.48,200.72,200.72,396.77
4263117,402,76942,,,,,,,US GUIDED CORE BIO BREAST UNILAT MULTI,1144.85,457.94,0,973.12,973.12,SKIPPED,142.19,142.19,973.12,973.12,973.12,482.44,560.98,560.98,0,343.46,492.29,492.29,973.12
4263148,402,76805,,,,,,,OB ECHO > 14W P/GESTATION,620.61,248.24,0,527.52,527.52,SKIPPED,477.67,477.67,527.52,527.52,527.52,261.52,137.3,137.3,0,73.48,266.86,266.86,527.52
4263150,402,76815,,,,,,,OB ECHO LIMITED,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4263193,402,76705,,,,,,,SPLEEN ECHO,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4263196,402,76870,,,,,,,US SCROTUN & CONTENTS,950.93,380.37,0,808.29,808.29,SKIPPED,581.46,581.46,808.29,808.29,808.29,400.72,137.3,137.3,0,73.48,408.9,408.9,808.29
4263206,402,76536,,,,,,,THYROID ECHO,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4263215,402,76942,,,,,,,US GUIDANCE CYST,816,326.4,0,693.6,693.6,SKIPPED,142.19,142.19,693.6,693.6,693.6,343.86,399.84,399.84,0,244.8,350.88,350.88,693.6
4263216,402,76942,,,,,,,US GUIDED WIRE LOCALIZATION BREAST 1 ARE,1144.85,457.94,0,973.12,973.12,SKIPPED,142.19,142.19,973.12,973.12,973.12,482.44,560.98,560.98,0,343.46,492.29,492.29,973.12
4263225,402,76830,,,,,,,TRANSVAG US NON PREG UT,705.83,282.33,0,599.96,599.96,SKIPPED,453.95,453.95,599.96,599.96,599.96,297.44,137.3,137.3,0,73.48,303.51,303.51,599.96
4263230,921,93931,,,,,,,ART UPPER EXTREM UNILAT,59.03,23.61,0,59.03,50.18,SKIPPED,59.03,59.03,50.18,50.18,50.18,24.87,59.03,59.03,0,59.03,25.38,25.38,50.18
4263231,921,93880,,,,,,,CAROTID DUP EXTRCRANIAL,96.16,38.46,0,96.16,81.74,SKIPPED,96.16,96.16,81.74,81.74,81.74,40.52,96.16,96.16,0,96.16,41.35,41.35,81.74
4263260,402,76604,,,,,,,US SOFT TISSUE CHEST,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4263265,510,10005,,,,,,,FNA W/IMAGE,1159.9,463.96,0,985.92,985.92,SKIPPED,338.91,338.91,985.92,985.92,0,488.78,568.35,568.35,0,347.97,498.76,498.76,985.92
4263630,402,76942,,,,,,,US GUIDANCE FOR NERVE BLOCK,1154.32,461.73,0,981.17,981.17,SKIPPED,142.19,142.19,981.17,981.17,981.17,486.43,565.62,565.62,0,346.3,496.36,496.36,981.17
4263631,402,76942,,,,,,,US GUIDANCE FOR THYROID CYST,1154.32,461.73,0,981.17,981.17,SKIPPED,142.19,142.19,981.17,981.17,981.17,486.43,565.62,565.62,0,346.3,496.36,496.36,981.17
4263632,402,76641,,,,,,,US RIGHT BREAST SONO COMPLETE,663.55,265.42,0,581.46,564.02,SKIPPED,581.46,581.46,564.02,564.02,564.02,279.62,137.3,137.3,0,73.48,285.33,285.33,564.02
4263633,402,76641,,,,,,,US LEFT BREAST SONO COMPLETE,708.89,283.56,0,602.56,602.56,SKIPPED,581.46,581.46,602.56,602.56,602.56,298.72,137.3,137.3,0,73.48,304.82,304.82,602.56
4263634,402,76642,,,,,,,US BILAT BREAST SONO LIMIT,468.56,187.42,0,398.28,398.28,SKIPPED,315.57,315.57,398.28,398.28,398.28,197.45,101.93,101.93,0,39.88,201.48,201.48,398.28
4263635,402,76642,,,,,,,US RIGHT BREAST SONO LIMITED,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4263636,402,76642,,,,,,,US LEFT BREAST SONO LIMITED,384.73,153.89,0,327.02,327.02,SKIPPED,315.57,315.57,327.02,327.02,327.02,162.12,101.93,101.93,0,39.88,165.43,165.43,327.02
4263637,402,93990,,,,,,,RT DUPLEX SCAN FOR HEMODIALYSIS,695.68,278.27,0,591.33,591.33,SKIPPED,543.68,543.68,591.33,591.33,591.33,293.16,137.3,137.3,0,72.23,299.14,299.14,591.33
4263638,402,93990,,,,,,,LT DUPLEX SCAN FOR HEMODIALYSIS,695.68,278.27,0,591.33,591.33,SKIPPED,543.68,543.68,591.33,591.33,591.33,293.16,137.3,137.3,0,72.23,299.14,299.14,591.33
4263639,402,93990,,,,,,,BILAT DUPLEX SCAN FOR HEMODIALYSIS,695.68,278.27,0,591.33,591.33,SKIPPED,543.68,543.68,591.33,591.33,591.33,293.16,137.3,137.3,0,72.23,299.14,299.14,591.33
4263640,402,93985,,,,,,,RT VESSEL MAPPING FOR HEMODIALYSIS,1030,412,0,1030,875.5,SKIPPED,1030,1030,875.5,875.5,875.5,434.04,504.7,504.7,0,309,442.9,442.9,875.5
4263641,402,93985,,,,,,,LT VESSEL MAPPING FOR HEMODIALYSIS,1030,412,0,1030,875.5,SKIPPED,1030,1030,875.5,875.5,875.5,434.04,504.7,504.7,0,309,442.9,442.9,875.5
4263642,402,93985,,,,,,,BILAT VESSEL MAPPING FOR HEMODIALYSIS,1504.91,601.96,0,1279.17,1279.17,SKIPPED,1177.75,1177.75,1279.17,1279.17,1279.17,634.17,737.41,737.41,0,451.47,647.11,647.11,1279.17
4263643,402,76942,,,,,,,ECHO GUIDE FOR BIOPSY,989,395.6,0,840.65,840.65,SKIPPED,142.19,142.19,840.65,840.65,840.65,416.76,484.61,484.61,0,296.7,425.27,425.27,840.65
4263644,921,93930,,,,,,,ART UPPER EXTREM BILAT.,96.05,38.42,0,96.05,81.64,SKIPPED,96.05,96.05,81.64,81.64,81.64,40.47,96.05,96.05,0,96.05,41.3,41.3,81.64
4263645,402,76805,,,,,,,OB US >/= 14 WKS SNGL FETUS,962.2,384.88,0,817.87,817.87,SKIPPED,477.67,477.67,817.87,817.87,817.87,405.48,137.3,137.3,0,73.48,413.75,413.75,817.87
4263646,921,93922,,,,,,,UPR/L XTREMITY ART 2 LEVELS,30.25,12.1,0,30.25,25.71,SKIPPED,30.25,30.25,25.71,25.71,25.71,12.75,14.82,14.82,0,9.08,13.01,13.01,25.71
4263647,402,76942,,,,,,,US RENAL BX-ECHO GUIDE,989,395.6,0,840.65,840.65,SKIPPED,142.19,142.19,840.65,840.65,840.65,416.76,484.61,484.61,0,296.7,425.27,425.27,840.65
4263648,402,93975,,,,,,,US Penis Art/Venous,1317.33,526.93,0,1119.73,1119.73,SKIPPED,1096.11,1096.11,1119.73,1119.73,1119.73,555.12,289.96,289.96,0,148.02,566.45,566.45,1119.73
4263649,402,76857,,,,,,,US Penis,579.09,231.64,0,579.09,492.23,SKIPPED,579.09,579.09,492.23,492.23,492.23,244.03,137.3,137.3,0,59.11,249.01,249.01,492.23
4270001,480,93306,,,,,,,ECHOCARDIOGRAM COMPLETE,3487.33,1394.93,0,2964.23,2964.23,SKIPPED,658.02,658.02,2964.23,2964.23,2964.23,1469.56,1708.79,1708.79,0,1046.2,1499.55,1499.55,2964.23
4270002,480,93320,,,,,,,PW & CW DOPPLER,850.16,340.06,0,722.64,722.64,SKIPPED,173.9,173.9,722.64,722.64,722.64,358.26,416.58,416.58,0,255.05,365.57,365.57,722.64
4270003,480,93325,,,,,,,COLOR FLOW DOPPLER,674.88,269.95,0,573.65,573.65,SKIPPED,109.11,109.11,573.65,573.65,573.65,284.4,330.69,330.69,0,202.46,290.2,290.2,573.65
4270006,480,93350,,,,,,,DOB STRESS ECHO,1255.02,502.01,0,1066.77,1066.77,SKIPPED,659.73,659.73,1066.77,1066.77,1066.77,528.87,608.44,608.44,0,319.39,539.66,539.66,1066.77
4270007,480,93351,,,,,,,STRESS ECHO,1065.77,426.31,0,905.9,905.9,SKIPPED,719.39,719.39,905.9,905.9,905.9,449.11,522.23,522.23,0,319.73,458.28,458.28,905.9
4270008,761,99211,,,,,,,TREATMENT RM 5-15MINS,37.25,14.9,0,37.25,31.66,SKIPPED,37.25,37.25,31.66,31.66,31.66,15.7,18.25,18.25,0,11.18,16.02,16.02,31.66
4270009,761,99212,,,,,,,TREATMENT RM 16-30MINS,96.22,38.49,0,96.22,81.79,SKIPPED,96.22,96.22,81.79,81.79,81.79,40.54,47.15,47.15,0,28.87,41.37,41.37,81.79
4270013,480,93308,,,,,,,ECHOCARDIOGRAM LTD/FU,1509.35,603.74,0,1282.95,1282.95,SKIPPED,386.98,386.98,1282.95,1282.95,1282.95,636.04,289.96,289.96,0,148.02,649.02,649.02,1282.95
4270014,480,,,,,,,,CONSULT,273.14,109.26,0,232.17,232.17,SKIPPED,207.59,207.59,232.17,232.17,232.17,115.1,133.84,133.84,0,81.94,117.45,117.45,232.17
4270015,480,93312,,,,,,,CU TEE TRANSESOPHAGEAL ECHO,2782.29,1112.92,0,2364.95,2364.95,SKIPPED,668.23,668.23,2364.95,2364.95,2364.95,1172.45,608.44,608.44,0,319.39,1196.38,1196.38,2364.95
4270016,480,93356,,,,,,,MYOCCARDIAL STRAIN IMAGE(ADD-ON),589.13,235.65,0,500.76,500.76,SKIPPED,61.98,61.98,500.76,500.76,500.76,248.26,288.67,288.67,0,176.74,253.33,253.33,500.76
4300001,341,78582,,,,,,,LUNG SCAN PERF/VENT,2213.84,885.54,0,1881.76,1881.76,SKIPPED,1513.23,1513.23,1881.76,1881.76,1881.76,932.91,616.64,616.64,0,275.5,951.95,951.95,1881.76
4300005,341,78264,,,,,,,GASTRIC EMPTYING STUDY,1944.87,777.95,0,1653.14,1653.14,SKIPPED,1595.27,1595.27,1653.14,1653.14,1653.14,819.56,475.17,475.17,0,213.84,836.29,836.29,1653.14
4300015,341,78452,,,,,,,STRESS & REST PERFUSION,3144.54,1257.82,0,2672.86,2672.86,SKIPPED,2123.95,2123.95,2672.86,2672.86,2672.86,1325.11,1645.48,1645.48,0,731.2,1352.15,1352.15,2672.86
4300016,341,78451,,,,,,,NM CARDIAC STRESS ONLY,3516.16,1406.46,0,2988.74,2988.74,SKIPPED,1471.27,1471.27,2988.74,2988.74,2988.74,1481.71,1645.48,1645.48,0,731.2,1511.95,1511.95,2988.74
4300025,341,78805,,,,,,,CERETEC BONE SCAN,2170.3,868.12,0,1844.76,1844.76,SKIPPED,1649.43,1649.43,1844.76,1844.76,1844.76,914.57,1063.45,1063.45,0,731.2,933.23,933.23,1844.76
4300026,341,A9569,,,,,,,CERETEC TC99M,3068.43,1227.37,0,2608.17,2608.17,SKIPPED,1450.14,1450.14,2608.17,2608.17,2608.17,1293.03,1503.53,1503.53,0,920.53,1319.42,1319.42,2608.17
4300032,761,99211,,,,,,,TREATMENT RM 5-15MINS,37.25,14.9,0,37.25,31.66,SKIPPED,37.25,37.25,31.66,31.66,31.66,15.7,18.25,18.25,0,11.18,16.02,16.02,31.66
4300040,340,A9541,,,,,,,Tc99m SULFUR COLLOID,181.59,72.64,0,154.35,154.35,SKIPPED,53.26,53.26,154.35,154.35,154.35,76.52,88.98,88.98,0,54.48,78.08,78.08,154.35
4300041,761,A9520,,,,,,,LYMPHOSEEK,1095.3,438.12,0,931,931,SKIPPED,466.99,466.99,931,931,931,461.56,536.7,536.7,0,328.59,470.98,470.98,931
4300455,340,78070,,,,,,,PARATHYROID SCAN,1709.23,683.69,0,1452.85,1452.85,SKIPPED,1401.98,1401.98,1452.85,1452.85,1452.85,720.27,475.17,475.17,0,213.84,734.97,734.97,1452.85
4300457,343,A9500,,,,,,,CARDIOLITE,153.58,61.43,0,136.13,130.54,SKIPPED,136.13,136.13,130.54,130.54,130.54,64.72,75.25,75.25,0,46.07,66.04,66.04,130.54
4304010,341,78306,,,,,,,BONE IMAGING WHOLE B,1709.23,683.69,0,1452.85,1452.85,SKIPPED,1401.98,1401.98,1452.85,1452.85,1452.85,720.27,475.17,475.17,0,213.84,734.97,734.97,1452.85
4304015,341,78315,,,,,,,BONE IMAGING 3 PHASE,1940.42,776.17,0,1649.36,1649.36,SKIPPED,1591.61,1591.61,1649.36,1649.36,1649.36,817.69,475.17,475.17,0,213.84,834.38,834.38,1649.36
4304025,341,78305,,,,,,,BONE SCAN/MULTIPLE A,1573.66,629.46,0,1337.61,1337.61,SKIPPED,1290.78,1290.78,1337.61,1337.61,1337.61,663.14,475.17,475.17,0,213.84,676.67,676.67,1337.61
4304127,341,78278,,,,,,,G I BLEED SCAN,973.67,389.47,0,973.67,827.62,SKIPPED,973.67,973.67,827.62,827.62,827.62,410.31,475.17,475.17,0,213.84,418.68,418.68,827.62
4304138,341,78227,,,,,,,HEPATOBILIARY SYSTEM,2642.81,1057.12,0,2246.39,2246.39,SKIPPED,2167.74,2167.74,2246.39,2246.39,2246.39,1113.68,616.64,616.64,0,275.5,1136.41,1136.41,2246.39
4304160,250,J2805,,,,,,,KINEVAC,139.63,55.85,0,118.69,118.69,SKIPPED,101.17,101.17,118.69,118.69,118.69,58.84,68.42,68.42,0,41.89,60.04,60.04,118.69
4304426,340,78999,,,,,,,CALL BACK CHARGE,2164.19,865.68,0,1839.56,1839.56,SKIPPED,1775.16,1775.16,1839.56,1839.56,1839.56,911.99,475.17,475.17,0,213.84,930.6,930.6,1839.56
4304450,300,36410,,,,,,,VENIPUNCTURE NON-ROUT,26.86,10.74,0,22.83,22.83,SKIPPED,0,0,22.83,22.83,22.83,16.87,13.16,13.16,0,8.06,17.21,17.21,22.83
4305087,343,A9560,,,,,,,TC 99M ULTRA TAG,125.27,50.11,0,106.48,106.48,SKIPPED,93.03,93.03,106.48,106.48,106.48,52.79,61.38,61.38,0,37.58,53.87,53.87,106.48
4305305,343,A9540,,,,,,,TC 99M MAA,159.88,63.95,0,135.9,135.9,SKIPPED,19.87,19.87,135.9,135.9,135.9,67.38,78.34,78.34,0,47.96,68.75,68.75,135.9
4305306,343,A9561,,,,,,,TC 99M MDP,151.96,60.78,0,129.17,129.17,SKIPPED,43.82,43.82,129.17,129.17,129.17,64.03,74.46,74.46,0,45.59,65.34,65.34,129.17
4305307,343,A9539,,,,,,,TC 99M DTPA,133.35,53.34,0,113.35,113.35,SKIPPED,31.21,31.21,113.35,113.35,113.35,56.19,65.34,65.34,0,40,57.34,57.34,113.35
4305308,343,A9537,,,,,,,TC 99M CHOLETEC,200.08,80.03,0,170.07,170.07,SKIPPED,55.1,55.1,170.07,170.07,170.07,84.31,98.04,98.04,0,60.02,86.03,86.03,170.07
4305309,250,A9541,,,,,,,TC 99M SULFUR COLLOI,141.13,56.45,0,119.96,119.96,SKIPPED,53.26,53.26,119.96,119.96,119.96,59.48,69.15,69.15,0,42.34,60.69,60.69,119.96
4305310,343,A9567,,,,,,,DTPA (AEROSOL),269.89,107.96,0,229.41,229.41,SKIPPED,205.12,205.12,229.41,229.41,229.41,113.73,132.25,132.25,0,80.97,116.05,116.05,229.41
4305400,340,78707,,,,,,,RENAL FLOW/FUNCT IMAGE W/O DRUG,1298.43,519.37,0,1103.67,1103.67,SKIPPED,1000.91,1000.91,1103.67,1103.67,1103.67,547.15,616.64,616.64,0,275.5,558.32,558.32,1103.67
4305405,340,78226,,,,,,,HIDA NO EF,1927.11,770.84,0,1638.04,1638.04,SKIPPED,1580.69,1580.69,1638.04,1638.04,1638.04,812.09,475.17,475.17,0,213.84,828.66,828.66,1638.04
4305416,340,78195,,,,,,,LYMPHOSCINTIGRAPHY,2950.5,1180.2,0,2507.92,2507.92,SKIPPED,1598.88,1598.88,2507.92,2507.92,2507.92,1243.35,616.64,616.64,0,275.5,1268.72,1268.72,2507.92
4305417,340,78071,,,,,,,NM Parathyroid with SPECT,1958.2,783.28,0,1664.47,1664.47,SKIPPED,1606.19,1606.19,1664.47,1664.47,1664.47,825.19,475.17,475.17,0,213.84,842.03,842.03,1664.47
4305418,340,78830,,,,,,,RADIO PHARMA LOC TUMOR(SPECT),3500.7,1400.28,0,3500.7,2975.6,SKIPPED,3500.7,3500.7,2975.6,2975.6,2975.6,1475.19,1645.48,1645.48,0,1050.21,1505.3,1505.3,2975.6
4320001,402,76700,,,,,,,TDCJ ABDOMEN US,260.37,104.15,0,260.37,221.31,SKIPPED,260.37,260.37,221.31,221.31,221.31,109.72,137.3,137.3,0,73.48,111.96,111.96,221.31
4320002,402,76805,,,,,,,TDCJ OB US,260.37,104.15,0,260.37,221.31,SKIPPED,260.37,260.37,221.31,221.31,221.31,109.72,137.3,137.3,0,73.48,111.96,111.96,221.31
4320003,402,76705,,,,,,,TDCJ LIVER US,216.97,86.79,0,216.97,184.42,SKIPPED,216.97,216.97,184.42,184.42,184.42,91.43,137.3,137.3,0,73.48,93.3,93.3,184.42
4320004,402,76705,,,,,,,TDCJ GALLBLADDER US,216.97,86.79,0,216.97,184.42,SKIPPED,216.97,216.97,184.42,184.42,184.42,91.43,137.3,137.3,0,73.48,93.3,93.3,184.42
4320006,402,76856,,,,,,,TDCJ PELVIC US,216.97,86.79,0,216.97,184.42,SKIPPED,216.97,216.97,184.42,184.42,184.42,91.43,137.3,137.3,0,98.6,93.3,93.3,184.42
4320007,402,76830,,,,,,,TDCJ INTRAVAG US,260.37,104.15,0,260.37,221.31,SKIPPED,260.37,260.37,221.31,221.31,221.31,109.72,137.3,137.3,0,73.48,111.96,111.96,221.31
4320008,402,76705,,,,,,,TDCJ RENAL US,216.97,86.79,0,216.97,184.42,SKIPPED,216.97,216.97,184.42,184.42,184.42,91.43,137.3,137.3,0,73.48,93.3,93.3,184.42
4320010,402,,,,,,,,TDCJ MISC US,216.97,86.79,0,184.42,184.42,SKIPPED,164.9,164.9,184.42,184.42,184.42,91.43,106.32,106.32,0,65.09,93.3,93.3,184.42
4320011,402,,,,,,,,TDCJ NO SHOW FEE,60.78,24.31,0,51.66,51.66,SKIPPED,46.19,46.19,51.66,51.66,51.66,25.62,29.78,29.78,0,18.23,26.14,26.14,51.66
4331238,250,J0561,,,,,,,BICILLIN LA 1.2MU IN,42,16.8,0,35.7,35.7,SKIPPED,11.94,11.94,35.7,35.7,35.7,17.7,20.58,20.58,0,12.6,18.06,18.06,35.7
4334585,250,J3010,,,,,,,SUBLIMAZE 5ML INJ,19,7.6,0,16.15,16.15,SKIPPED,0.39,0.39,16.15,16.15,16.15,8.01,9.31,9.31,0,5.7,8.17,8.17,16.15
4335594,250,J0150,,,,,,,ADENOCARD 6MG VIAL,86,34.4,0,73.1,73.1,SKIPPED,65.36,65.36,73.1,73.1,73.1,36.24,42.14,42.14,0,25.8,36.98,36.98,73.1
4337289,250,,,,,,,,SUBLIMAZE 2ML INJ,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341001,252,J0840,,,,,,,ANTIVENIN CROTALIDAE FAB(,10208.02,4083.21,0,8676.82,8676.82,SKIPPED,2971,2971,8676.82,8676.82,8676.82,4301.66,5001.93,5001.93,0,3062.41,4389.45,4389.45,8676.82
4341002,250,J0696,,,,,,,CEFTRIAXONE SODIUM INJ [1,14,5.6,0,11.9,11.9,SKIPPED,2.53,2.53,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341003,250,J1040,,,,,,,METHYLPREDNISOLONE ACETAT,62.94,25.18,0,53.5,53.5,SKIPPED,7.17,7.17,53.5,53.5,53.5,26.52,30.84,30.84,0,18.88,27.06,27.06,53.5
4341004,252,J1650,,,,,,,ENOXAPARIN SODIUM INJ [10,47.88,19.15,0,40.7,40.7,SKIPPED,0.27,0.27,40.7,40.7,40.7,20.18,23.46,23.46,0,14.36,20.59,20.59,40.7
4341005,250,J3490,,,,,,,CYTOTEC 200MCG TABLET,7.25,2.9,0,6.16,6.16,SKIPPED,5.51,5.51,6.16,6.16,6.16,3.06,3.55,3.55,0,2.18,3.12,3.12,6.16
4341006,252,J1650,,,,,,,ENOXAPARIN SODIUM INJ,47.88,19.15,0,40.7,40.7,SKIPPED,0.27,0.27,40.7,40.7,40.7,20.18,23.46,23.46,0,14.36,20.59,20.59,40.7
4341007,252,J3490,,,,,,,DESFLURANE,511.42,204.57,0,434.71,434.71,SKIPPED,388.68,388.68,434.71,434.71,434.71,215.51,250.6,250.6,0,153.43,219.91,219.91,434.71
4341008,250,J2543,,,,,,,ZOSYN 3.375 GM INJ VIAL,33.38,13.35,0,28.37,28.37,SKIPPED,2.56,2.56,28.37,28.37,28.37,14.06,16.36,16.36,0,10.01,14.35,14.35,28.37
4341009,252,J0456,,,,,,,AZITHROMYCIN INJ [500 MG],52.67,21.07,0,44.77,44.77,SKIPPED,4.15,4.15,44.77,44.77,44.77,22.2,25.81,25.81,0,15.8,22.65,22.65,44.77
4341011,258,J1956,,,,,,,LEVOFLOXACIN/DEXTROSE 5%-,115,46,0,97.75,97.75,SKIPPED,1.72,1.72,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4341012,258,J3490,,,,,,,NS 0.9% FLUSH 2ML VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341013,252,J1650,,,,,,,ENOXAPARIN SODIUM INJ,47.88,19.15,0,40.7,40.7,SKIPPED,0.27,0.27,40.7,40.7,40.7,20.18,23.46,23.46,0,14.36,20.59,20.59,40.7
4341014,252,J1650,,,,,,,ENOXAPARIN SODIUM INJ,47.88,19.15,0,40.7,40.7,SKIPPED,0.27,0.27,40.7,40.7,40.7,20.18,23.46,23.46,0,14.36,20.59,20.59,40.7
4341015,252,Q0144,,,,,,,AZITHROMYCIN TABLET [250,20.68,8.27,0,17.58,17.58,SKIPPED,16.78,16.78,17.58,17.58,17.58,8.71,10.13,10.13,0,6.2,8.89,8.89,17.58
4341016,252,J0150,,,,,,,ADENOSINE INJ [6 MG/2ML],34.95,13.98,0,29.71,29.71,SKIPPED,26.56,26.56,29.71,29.71,29.71,14.73,17.13,17.13,0,10.48,15.03,15.03,29.71
4341017,250,J1162,,,,,,,DIGOXIN IMMUNE FAB INJ,14115.02,5646.01,0,11997.77,11997.77,SKIPPED,3381,3381,11997.77,11997.77,11997.77,5948.07,6916.36,6916.36,0,4234.51,6069.46,6069.46,11997.77
4341018,250,J0295,,,,,,,AMPICILLIN SODIUM/SULBACT,26.08,10.43,0,22.17,22.17,SKIPPED,2.69,2.69,22.17,22.17,22.17,10.99,12.78,12.78,0,7.82,11.21,11.21,22.17
4341019,252,J3490,,,,,,,FLUTICASONE/SALMETEROL IN,1257.44,502.98,0,1068.82,1068.82,SKIPPED,955.65,955.65,1068.82,1068.82,1068.82,529.89,616.15,616.15,0,377.23,540.7,540.7,1068.82
4341020,250,J2930,,,,,,,METHYLPREDNISOLONE SOD SU,31.08,12.43,0,26.42,26.42,SKIPPED,4.81,4.81,26.42,26.42,26.42,13.09,15.23,15.23,0,9.32,13.36,13.36,26.42
4341021,252,J3490,,,,,,,LEVOFLOXACIN TABLETS [500,44.74,17.9,0,38.03,38.03,SKIPPED,34,34,38.03,38.03,38.03,18.86,21.92,21.92,0,13.42,19.24,19.24,38.03
4341022,250,J3490,,,,,,,KETOROLAC 0.5% OPTH SOL 3ML,113.71,45.48,0,96.65,96.65,SKIPPED,86.42,86.42,96.65,96.65,96.65,47.92,55.72,55.72,0,34.11,48.9,48.9,96.65
4341023,250,J2550,,,,,,,PROMETHAZINE AMP 25MG,14,5.6,0,11.9,11.9,SKIPPED,1.28,1.28,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341024,252,J1956,,,,,,,LEVOFLOXACIN INJ VIAL [50,119.01,47.6,0,101.16,101.16,SKIPPED,1.72,1.72,101.16,101.16,101.16,50.15,58.31,58.31,0,35.7,51.17,51.17,101.16
4341025,252,J3490,,,,,,,ESMOLOL HCL INJ [2500MG/1,1492.82,597.13,0,1268.9,1268.9,SKIPPED,1134.54,1134.54,1268.9,1268.9,1268.9,629.07,731.48,731.48,0,447.85,641.91,641.91,1268.9
4341026,252,J2543,,,,,,,PIPERACILL NA/TAZOBACTAM,33.38,13.35,0,28.37,28.37,SKIPPED,2.56,2.56,28.37,28.37,28.37,14.06,16.36,16.36,0,10.01,14.35,14.35,28.37
4341027,252,J3490,,,,,,,VANCOMYCIN HCL CAPSULE [2,153.52,61.41,0,130.49,130.49,SKIPPED,116.68,116.68,130.49,130.49,130.49,64.69,75.22,75.22,0,46.06,66.01,66.01,130.49
4341030,252,90636,,,,,,,HEP A/ B VIR VACC RECOMB,371.99,148.8,0,316.19,316.19,SKIPPED,97.46,97.46,316.19,316.19,316.19,156.76,182.28,182.28,0,111.6,159.96,159.96,316.19
4341031,252,J2405,,,,,,,ONDANSETRON HCL INJ [4MG/,14,5.6,0,11.9,11.9,SKIPPED,0.59,0.59,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341032,252,J3490,,,,,,,FLUTICASONE/SALMETEROL IN,1653.78,661.51,0,1405.71,1405.71,SKIPPED,1256.87,1256.87,1405.71,1405.71,1405.71,696.91,810.35,810.35,0,496.13,711.13,711.13,1405.71
4341033,252,J3490,,,,,,,CLOPIDOGREL BISULFATE TAB,11.6,4.64,0,9.86,9.86,SKIPPED,8.82,8.82,9.86,9.86,9.86,4.89,5.68,5.68,0,3.48,4.99,4.99,9.86
4341034,252,J3490,,,,,,,OLANZAPINE TABLET [2.5MG],29.78,11.91,0,25.31,25.31,SKIPPED,22.63,22.63,25.31,25.31,25.31,12.55,14.59,14.59,0,8.93,12.81,12.81,25.31
4341035,250,J3490,,,,,,,FLUMAZENIL INJ,21.64,8.66,0,18.39,18.39,SKIPPED,16.45,16.45,18.39,18.39,18.39,9.12,10.6,10.6,0,6.49,9.31,9.31,18.39
4341037,252,J3490,,,,,,,PANTOPRAZOLE SODIUM TABLE,14.01,5.6,0,11.91,11.91,SKIPPED,10.65,10.65,11.91,11.91,11.91,5.9,6.86,6.86,0,4.2,6.02,6.02,11.91
4341041,250,90732,,,,,,,PNEUMOCOCCAL 23-VAL P-SAC,373.72,149.49,0,317.66,317.66,SKIPPED,68.02,68.02,317.66,317.66,317.66,157.49,183.12,183.12,0,112.12,160.7,160.7,317.66
4341042,252,J0743,,,,,,,IMIPENEM/CILASTATIN SODIU,87.4,34.96,0,74.29,74.29,SKIPPED,4.49,4.49,74.29,74.29,74.29,36.83,42.83,42.83,0,26.22,37.58,37.58,74.29
4341044,250,J1110,,,,,,,DIHYDROERGOTAMINE MESYLAT,3756.2,1502.48,0,3192.77,3192.77,SKIPPED,172.5,172.5,3192.77,3192.77,3192.77,1582.87,1840.54,1840.54,0,1126.86,1615.17,1615.17,3192.77
4341048,250,J3490,,,,,,,ROCURONIUM BROMIDE INJ [1,22.34,8.94,0,18.99,18.99,SKIPPED,16.98,16.98,18.99,18.99,18.99,9.42,10.95,10.95,0,6.7,9.61,9.61,18.99
4341049,250,J3490,,,,,,,CIPROFLOXACIN HCL TAB [50,13.57,5.43,0,11.53,11.53,SKIPPED,10.31,10.31,11.53,11.53,11.53,5.72,6.65,6.65,0,4.07,5.84,5.84,11.53
4341052,250,J2274,,,,,,,MORPHINE SULFATE PCA 30MG,25.47,10.19,0,21.65,21.65,SKIPPED,4.27,4.27,21.65,21.65,21.65,10.73,12.48,12.48,0,7.64,10.95,10.95,21.65
4341054,250,J0595,,,,,,,BUTORPHANOL TARTRATE INJ,19.78,7.91,0,16.81,16.81,SKIPPED,1.04,1.04,16.81,16.81,16.81,8.34,9.69,9.69,0,5.93,8.51,8.51,16.81
4341055,250,J0561,,,,,,,PENICILLIN G BENZATHINE I,664.93,265.97,0,565.19,565.19,SKIPPED,11.94,11.94,565.19,565.19,565.19,280.2,325.82,325.82,0,199.48,285.92,285.92,565.19
4341056,252,J2780,,,,,,,RANITIDINE HCL/0.5 NS BAG,115,46,0,97.75,97.75,SKIPPED,4.46,4.46,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4341058,250,J7613,,,,,,,ALBUTEROL SULFATE INH AMP,7,2.8,0,5.95,5.95,SKIPPED,0.08,0.08,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341059,252,J3490,,,,,,,ESMOLOL HCL/NACL ISO OSM,1492.82,597.13,0,1268.9,1268.9,SKIPPED,1134.54,1134.54,1268.9,1268.9,1268.9,629.07,731.48,731.48,0,447.85,641.91,641.91,1268.9
4341060,252,J3490,,,,,,,CEFPROZIL SUS [250MG/5ML],103.98,41.59,0,88.38,88.38,SKIPPED,79.02,79.02,88.38,88.38,88.38,43.82,50.95,50.95,0,31.19,44.71,44.71,88.38
4341061,252,J3490,,,,,,,ZOLPIDEM TARTRATE TABLET,12.36,4.94,0,10.51,10.51,SKIPPED,9.39,9.39,10.51,10.51,10.51,5.2,6.06,6.06,0,3.71,5.31,5.31,10.51
4341062,252,J3490,,,,,,,FLUTICASONE/SALMETEROL IN,484.33,193.73,0,411.68,411.68,SKIPPED,368.09,368.09,411.68,411.68,411.68,204.09,237.32,237.32,0,145.3,208.26,208.26,411.68
4341064,252,J3490,,,,,,,ESOMEPRAZOLE MAG TRIHYDRA,24,9.6,0,20.4,20.4,SKIPPED,18.24,18.24,20.4,20.4,20.4,10.11,11.76,11.76,0,7.2,10.32,10.32,20.4
4341066,252,J3490,,,,,,,FLUTICASONE PROPIONATE NA,226.79,90.72,0,192.77,192.77,SKIPPED,172.36,172.36,192.77,192.77,192.77,95.57,111.13,111.13,0,68.04,97.52,97.52,192.77
4341067,250,J3490,,,,,,,PAROXETINE HCL TABLET [20,7.42,2.97,0,6.31,6.31,SKIPPED,5.64,5.64,6.31,6.31,6.31,3.13,3.64,3.64,0,2.23,3.19,3.19,6.31
4341068,250,J3490,,,,,,,QUETIAPINE FUMARATE TABLE,10.54,4.22,0,8.96,8.96,SKIPPED,8.01,8.01,8.96,8.96,8.96,4.44,5.16,5.16,0,3.16,4.53,4.53,8.96
4341070,250,S0164,,,,,,,PANTOPRAZOLE SODIUM INJ [,22.61,9.04,0,19.22,19.22,SKIPPED,3.67,3.67,19.22,19.22,19.22,9.53,11.08,11.08,0,6.78,9.72,9.72,19.22
4341072,250,J0713,,,,,,,CEFTAZIDIME PENTAHYDRATE,14,5.6,0,11.9,11.9,SKIPPED,1.68,1.68,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341073,252,J3490,,,,,,,SIMVASTATIN TABLET [20MG],13.09,5.24,0,11.13,11.13,SKIPPED,9.95,9.95,11.13,11.13,11.13,5.52,6.41,6.41,0,3.93,5.63,5.63,11.13
4341074,250,J3490,,,,,,,FENTANYL PATCH (75),106.96,42.78,0,90.92,90.92,SKIPPED,81.29,81.29,90.92,90.92,90.92,45.07,52.41,52.41,0,32.09,45.99,45.99,90.92
4341075,252,J3490,,,,,,,RABEPRAZOLE SODIUM TABLET,30.45,12.18,0,25.88,25.88,SKIPPED,23.14,23.14,25.88,25.88,25.88,12.83,14.92,14.92,0,9.14,13.09,13.09,25.88
4341076,250,J3490,,,,,,,GABAPENTIN CAPSULE [300MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341077,250,J0744,,,,,,,CIPROFLOXACIN LACTATE/D5W,115,46,0,97.75,97.75,SKIPPED,1.17,1.17,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4341080,252,J1650,,,,,,,ENOXAPARIN SODIUM INJ,47.88,19.15,0,40.7,40.7,SKIPPED,0.27,0.27,40.7,40.7,40.7,20.18,23.46,23.46,0,14.36,20.59,20.59,40.7
4341081,250,J3490,,,,,,,NITROGLYCERIN SPRAY,964.36,385.74,0,819.71,819.71,SKIPPED,732.91,732.91,819.71,819.71,819.71,406.38,472.54,472.54,0,289.31,414.67,414.67,819.71
4341082,250,J3490,,,,,,,FENTANYL PATCH (50),7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341085,252,J3490,,,,,,,FOSPHENYTOIN 500MG PE/10M,153.22,61.29,0,130.24,130.24,SKIPPED,116.45,116.45,130.24,130.24,130.24,64.56,75.08,75.08,0,45.97,65.88,65.88,130.24
4341086,252,J3490,,,,,,,AZITHROMYCIN SUSP [200 MG,92.78,37.11,0,78.86,78.86,SKIPPED,70.51,70.51,78.86,78.86,78.86,39.1,45.46,45.46,0,27.83,39.9,39.9,78.86
4341088,250,J2543,,,,,,,PIPERACILL NA/TAZOBACTAM,21.92,8.77,0,18.63,18.63,SKIPPED,2.56,2.56,18.63,18.63,18.63,9.24,10.74,10.74,0,6.58,9.43,9.43,18.63
4341089,252,J3490,,,,,,,ATORVASTATIN CALCIUM TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341090,250,90675,,,,,,,RABIES VAC CHICK-EMB CELL,1293.29,517.32,0,1099.3,1099.3,SKIPPED,254.76,254.76,1099.3,1099.3,1099.3,544.99,633.71,633.71,0,387.99,556.11,556.11,1099.3
4341091,252,J3490,,,,,,,AZITHROMYCIN SUSP [100 MG,84.75,33.9,0,72.04,72.04,SKIPPED,64.41,64.41,72.04,72.04,72.04,35.71,41.53,41.53,0,25.42,36.44,36.44,72.04
4341092,250,J3105,,,,,,,TERBUTALINE SULFATE INJ [,57.42,22.97,0,48.81,48.81,SKIPPED,2.76,2.76,48.81,48.81,48.81,24.2,28.14,28.14,0,17.23,24.69,24.69,48.81
4341094,250,J0561,,,,,,,PENICILLIN G BENZATHINE I,383.92,153.57,0,326.33,326.33,SKIPPED,11.94,11.94,326.33,326.33,326.33,161.79,188.12,188.12,0,115.18,165.09,165.09,326.33
4341095,258,J3490,,,,,,,NS 0.9% BAG [100ML,115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4341096,250,J3490,,,,,,,AMOX TR/POTASSIUM CLAVULA,15.74,6.3,0,13.38,13.38,SKIPPED,11.96,11.96,13.38,13.38,13.38,6.63,7.71,7.71,0,4.72,6.77,6.77,13.38
4341097,252,J3030,,,,,,,SUMATRIPTAN SUCCINATE INJ,226.1,90.44,0,192.18,192.18,SKIPPED,24.19,24.19,192.18,192.18,192.18,95.28,110.79,110.79,0,67.83,97.22,97.22,192.18
4341100,250,J3490,,,,,,,ESMOLOL HCL INJ,38.81,15.52,0,32.99,32.99,SKIPPED,29.5,29.5,32.99,32.99,32.99,16.36,19.02,19.02,0,11.64,16.69,16.69,32.99
4341101,252,J3490,,,,,,,SEVOFLURANE INHALTION,600.1,240.04,0,510.08,510.08,SKIPPED,456.08,456.08,510.08,510.08,510.08,252.88,294.05,294.05,0,180.03,258.04,258.04,510.08
4341102,252,J3490,,,,,,,BETAXOLOL HCL GTTS,1040.78,416.31,0,884.66,884.66,SKIPPED,790.99,790.99,884.66,884.66,884.66,438.59,509.98,509.98,0,312.23,447.54,447.54,884.66
4341103,250,J3490,,,,,,,NIFEDIPINE TABLET [60MG],8.03,3.21,0,6.83,6.83,SKIPPED,6.1,6.1,6.83,6.83,6.83,3.38,3.93,3.93,0,2.41,3.45,3.45,6.83
4341104,252,J3490,,,,,,,SERTRALINE HCL TABLET [10,7.21,2.88,0,6.13,6.13,SKIPPED,5.48,5.48,6.13,6.13,6.13,3.04,3.53,3.53,0,2.16,3.1,3.1,6.13
4341107,250,J3490,,,,,,,CEFUROXIME AXETIL TABLET,11.96,4.78,0,10.17,10.17,SKIPPED,9.09,9.09,10.17,10.17,10.17,5.04,5.86,5.86,0,3.59,5.14,5.14,10.17
4341108,252,J3490,,,,,,,ATORVASTATIN CALCIUM TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341109,252,J3490,,,,,,,LATANOPROST OPT (0.005%),252.7,101.08,0,214.8,214.8,SKIPPED,192.05,192.05,214.8,214.8,214.8,106.49,123.82,123.82,0,75.81,108.66,108.66,214.8
4341110,250,J3490,,,,,,,CYCLOBENZAPRINE HCL TABLE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341111,250,J3490,,,,,,,LORATADINE TABLET [10MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341112,252,J1610,,,,,,,GLUCAGON HUMAN RECOMBINAN,896.31,358.52,0,761.86,761.86,SKIPPED,114.91,114.91,761.86,761.86,761.86,377.7,439.19,439.19,0,268.89,385.41,385.41,761.86
4341113,252,J0694,,,,,,,CEFOXITIN SODIUM INJ [1GM,31.76,12.7,0,27,27,SKIPPED,3.85,3.85,27,27,27,13.39,15.56,15.56,0,9.53,13.66,13.66,27
4341114,252,J3490,,,,,,,FLUTICASONE PROPIONATE IN,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341115,250,J3490,,,,,,,OXYCODONE HCL CR TABLET [,28.45,11.38,0,24.18,24.18,SKIPPED,21.62,21.62,24.18,24.18,24.18,11.99,13.94,13.94,0,8.54,12.23,12.23,24.18
4341116,250,J2060,,,,,,,LORAZEPAM INJ [2MG/ML],14,5.6,0,11.9,11.9,SKIPPED,0.32,0.32,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341117,250,J3535,,,,,,,IPRATROPIUM BROMIDE INH (,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341118,252,J3535,,,,,,,ALBUTEROL SULFATE/IPRATRO,1472.31,588.92,0,1251.46,1251.46,SKIPPED,1118.96,1118.96,1251.46,1251.46,1251.46,620.43,721.43,721.43,0,441.69,633.09,633.09,1251.46
4341120,250,J2175,,,,,,,MEPERIDINE PCA [300MG/30M,26.62,10.65,0,22.63,22.63,SKIPPED,0.94,0.94,22.63,22.63,22.63,11.22,13.04,13.04,0,7.99,11.45,11.45,22.63
4341125,250,J2270,,,,,,,MORPHINE SULFATE INJ [2MG,14,5.6,0,11.9,11.9,SKIPPED,0.07,0.07,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341126,252,J3490,,,,,,,CALCITONIN SALMON SYNTHET,315.32,126.13,0,268.02,268.02,SKIPPED,239.64,239.64,268.02,268.02,268.02,132.88,154.51,154.51,0,94.6,135.59,135.59,268.02
4341127,250,J1885,,,,,,,KETOROLAC TROMETHAMINE IN,20.24,8.1,0,17.2,17.2,SKIPPED,0.22,0.22,17.2,17.2,17.2,8.53,9.92,9.92,0,6.07,8.7,8.7,17.2
4341128,250,J2540,,,,,,,PENICILLIN G POTASSIUM IN,14,5.6,0,11.9,11.9,SKIPPED,1.26,1.26,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341129,252,J7608,,,,,,,ACETYLCYSTEINE INHALATION,66.52,26.61,0,56.54,56.54,SKIPPED,4.2,4.2,56.54,56.54,56.54,28.03,32.59,32.59,0,19.96,28.6,28.6,56.54
4341130,250,J3535,,,,,,,ALBUTEROL MDI INHALER (RT,254.51,101.8,0,216.33,216.33,SKIPPED,193.43,193.43,216.33,216.33,216.33,107.25,124.71,124.71,0,76.35,109.44,109.44,216.33
4341134,250,J1800,,,,,,,PROPRANOLOL HCL INJ [1MG/,25.54,10.22,0,21.71,21.71,SKIPPED,5.76,5.76,21.71,21.71,21.71,10.76,12.51,12.51,0,7.66,10.98,10.98,21.71
4341135,252,J3370,,,,,,,VANCOMYCIN HCL INJ [1GM],51.46,20.58,0,43.74,43.74,SKIPPED,4.47,4.47,43.74,43.74,43.74,21.69,25.22,25.22,0,15.44,22.13,22.13,43.74
4341136,252,J3490,,,,,,,MEMANTINE HCL TABLET [5MG,23.66,9.46,0,20.11,20.11,SKIPPED,17.98,17.98,20.11,20.11,20.11,9.97,11.59,11.59,0,7.1,10.17,10.17,20.11
4341139,252,J3490,,,,,,,METRONIDAZOLE/SODIUM CHLO,115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4341140,250,J0558,,,,,,,PEN G BENZ/PEN G PROCAINE,265.02,106.01,0,225.27,225.27,SKIPPED,4.6,4.6,225.27,225.27,225.27,111.68,129.86,129.86,0,79.51,113.96,113.96,225.27
4341141,250,J3490,,,,,,,TETANUS/DIPHTHERIA TOXOID,120.23,48.09,0,102.2,102.2,SKIPPED,91.37,91.37,102.2,102.2,102.2,50.67,58.91,58.91,0,36.07,51.7,51.7,102.2
4341145,250,J3490,,,,,,,RISPERIDONE TABLET [1MG],12.08,4.83,0,10.27,10.27,SKIPPED,9.18,9.18,10.27,10.27,10.27,5.09,5.92,5.92,0,3.62,5.19,5.19,10.27
4341147,250,J0295,,,,,,,AMPICILLIN SODIUM/SULBACT,17.56,7.02,0,14.93,14.93,SKIPPED,2.69,2.69,14.93,14.93,14.93,7.4,8.6,8.6,0,5.27,7.55,7.55,14.93
4341150,250,J3480,,,,,,,POTASSIUM CHL BAG[K-BY-SC,115,46,0,97.75,97.75,SKIPPED,0.04,0.04,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4341151,250,J3490,,,,,,,DOCUSATE SODIUM SYR(BULK,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341152,252,J3490,,,,,,,DOXAPRAM HCL INJ [20MG/ML,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341156,252,J3490,,,,,,,VENLAFAXINE HCL TABLET [7,11.16,4.46,0,9.49,9.49,SKIPPED,8.48,8.48,9.49,9.49,9.49,4.7,5.47,5.47,0,3.35,4.8,4.8,9.49
4341157,252,J3490,,,,,,,RISPERIDONE TABLET,10.46,4.18,0,8.89,8.89,SKIPPED,7.95,7.95,8.89,8.89,8.89,4.41,5.13,5.13,0,3.14,4.5,4.5,8.89
4341160,250,J1885,,,,,,,KETOROLAC TROMETHAMINE IN,14,5.6,0,11.9,11.9,SKIPPED,0.22,0.22,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341162,252,J3490,,,,,,,MONTELUKAST SODIUM TABLET,14.65,5.86,0,12.45,12.45,SKIPPED,11.13,11.13,12.45,12.45,12.45,6.17,7.18,7.18,0,4.4,6.3,6.3,12.45
4341164,252,J3490,,,,,,,AMLODIPINE BESYLATE TAB [,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341165,258,J1644,,,,,,,HEPARIN SODIUM PORCINE IN,14,5.6,0,11.9,11.9,SKIPPED,0.19,0.19,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341166,250,J3490,,,,,,,MOXIFLOXACIN HCL TABLET [,71.59,28.64,0,60.85,60.85,SKIPPED,54.41,54.41,60.85,60.85,60.85,30.16,35.08,35.08,0,21.48,30.78,30.78,60.85
4341167,250,J3301,,,,,,,TRIAMCINOLONE ACETONIDE I,29.87,11.95,0,25.39,25.39,SKIPPED,1.71,1.71,25.39,25.39,25.39,12.58,14.64,14.64,0,8.96,12.84,12.84,25.39
4341168,252,J3490,,,,,,,DONEPEZIL HCL TABLET [5MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341169,250,J3490,,,,,,,LAMOTRIGINE TABLET [100MG,12.64,5.06,0,10.74,10.74,SKIPPED,9.61,9.61,10.74,10.74,10.74,5.33,6.19,6.19,0,3.79,5.44,5.44,10.74
4341171,252,J7626,,,,,,,BUDESONIDE INHALANT 0 .5M,32.74,13.1,0,27.83,27.83,SKIPPED,6.38,6.38,27.83,27.83,27.83,13.8,16.04,16.04,0,9.82,14.08,14.08,27.83
4341172,250,J3230,,,,,,,CHLORPROMAZINE HCL INJ [2,26.42,10.57,0,22.46,22.46,SKIPPED,19.84,19.84,22.46,22.46,22.46,11.13,12.95,12.95,0,7.93,11.36,11.36,22.46
4341173,636,90375,,,,,,,RABIES IMMUNE GLOBULIN/TH,2751.61,1100.64,0,2338.87,2338.87,SKIPPED,324.12,324.12,2338.87,2338.87,2338.87,1159.53,1348.29,1348.29,0,825.48,1183.19,1183.19,2338.87
4341174,250,J3490,,,,,,,SILDENAFIL CITRATE TABLET,26.01,10.4,0,22.11,22.11,SKIPPED,19.77,19.77,22.11,22.11,22.11,10.96,12.74,12.74,0,7.8,11.18,11.18,22.11
4341175,250,J3490,,,,,,,PHENYTOIN SUSP [125MG/5ML,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341177,252,J3490,,,,,,,PRAVASTATIN SODIUM TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341179,250,J3490,,,,,,,MEGESTROL ACETATE SOL [40,11.3,4.52,0,9.6,9.6,SKIPPED,8.59,8.59,9.6,9.6,9.6,4.76,5.54,5.54,0,3.39,4.86,4.86,9.6
4341181,250,J3490,,,,,,,PROPAFENONE HCL TABLET [1,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341182,250,J2310,,,,,,,NALOXONE HCL INJ [1MG/2ML,52.67,21.07,0,44.77,44.77,SKIPPED,11.4,11.4,44.77,44.77,44.77,22.2,25.81,25.81,0,15.8,22.65,22.65,44.77
4341187,252,J3490,,,,,,,SERTRALINE HCL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341189,250,J3490,,,,,,,RIVASTIGMINE TARTRATE TAB,7.15,2.86,0,6.08,6.08,SKIPPED,5.43,5.43,6.08,6.08,6.08,3.01,3.5,3.5,0,2.14,3.07,3.07,6.08
4341190,250,J2270,,,,,,,MORPHINE SULFATE INJ,14,5.6,0,11.9,11.9,SKIPPED,0.07,0.07,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341191,250,J3490,,,,,,,BUPIVACAINE HCL/EPINEPHRI,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341192,250,J3490,,,,,,,OFLOXACIN OPT. SOL,55.7,22.28,0,47.34,47.34,SKIPPED,42.33,42.33,47.34,47.34,47.34,23.47,27.29,27.29,0,16.71,23.95,23.95,47.34
4341193,250,S0077,,,,,,,CLINDAMYCIN PHOSPHATE INJ,14,5.6,0,11.9,11.9,SKIPPED,0.86,0.86,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341194,250,J3490,,,,,,,CITALOPRAM HYDROBROMIDE T,7.16,2.86,0,6.09,6.09,SKIPPED,5.44,5.44,6.09,6.09,6.09,3.02,3.51,3.51,0,2.15,3.08,3.08,6.09
4341195,252,J3490,,,,,,,CLONIDINE-TTS-3 PATCH,540.99,216.4,0,459.84,459.84,SKIPPED,411.15,411.15,459.84,459.84,459.84,227.98,265.09,265.09,0,162.3,232.63,232.63,459.84
4341196,252,J3490,,,,,,,CELECOXIB CAPSULE [200MG],7.61,3.04,0,6.47,6.47,SKIPPED,5.78,5.78,6.47,6.47,6.47,3.2,3.73,3.73,0,2.28,3.27,3.27,6.47
4341198,252,J3490,,,,,,,ASPIRIN/DIPYRIDAMOLE CAPS,30,12,0,25.5,25.5,SKIPPED,22.8,22.8,25.5,25.5,25.5,12.64,14.7,14.7,0,9,12.9,12.9,25.5
4341201,250,J3490,,,,,,,NEOMY SULF/POLYMYX B SULF,267.81,107.12,0,227.64,227.64,SKIPPED,203.54,203.54,227.64,227.64,227.64,112.86,131.23,131.23,0,80.34,115.16,115.16,227.64
4341203,252,J3490,,,,,,,FEXOFENADINE HCL TABLET [,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341204,258,J1642,,,,,,,HEPARIN SODIUM PORCINE IN,14,5.6,0,11.9,11.9,SKIPPED,0.02,0.02,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341206,250,J3490,,,,,,,CALCIUM TABLET [500MG/D],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341207,252,J3490,,,,,,,FLUTICASONE PROPIONATE IN,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341209,252,J3490,,,,,,,BIMATOPROST OPTHLAMIC SOL,1455.07,582.03,0,1236.81,1236.81,SKIPPED,1105.85,1105.85,1236.81,1236.81,1236.81,613.17,712.98,712.98,0,436.52,625.68,625.68,1236.81
4341210,250,J1030,,,,,,,METHYLPREDNISOLONE ACETAT,36.29,14.52,0,30.85,30.85,SKIPPED,3.59,3.59,30.85,30.85,30.85,15.29,17.78,17.78,0,10.89,15.6,15.6,30.85
4341211,250,J3490,,,,,,,AMOX TR/POTASSIUM CLAVULA,105.74,42.3,0,89.88,89.88,SKIPPED,80.36,80.36,89.88,89.88,89.88,44.56,51.81,51.81,0,31.72,45.47,45.47,89.88
4341213,250,J3490,,,,,,,METOPROLOL SUCCINATE TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341215,250,J3430,,,,,,,PHYTONADIONE INJ [10MG/ML,156.3,62.52,0,132.86,132.86,SKIPPED,3.86,3.86,132.86,132.86,132.86,65.87,76.59,76.59,0,46.89,67.21,67.21,132.86
4341218,252,J3490,,,,,,,SIMVASTATIN TABLET,7.5,3,0,6.38,6.38,SKIPPED,5.7,5.7,6.38,6.38,6.38,3.17,3.68,3.68,0,2.25,3.23,3.23,6.38
4341219,250,J3490,,,,,,,RANITIDINE 150mg/10ml syrup,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341220,252,J3490,,,,,,,HYDROMORPHONE 2MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341222,250,J3490,,,,,,,MINERAL OIL/PET HY-PHL,18.1,7.24,0,15.38,15.38,SKIPPED,13.76,13.76,15.38,15.38,15.38,7.62,8.87,8.87,0,5.43,7.78,7.78,15.38
4341223,250,J2175,,,,,,,MEPERIDINE HCL INJ [25MG/,14,5.6,0,11.9,11.9,SKIPPED,0.94,0.94,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341224,250,J3490,,,,,,,GUAIFENESIN TABLET [600M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341225,250,J0690,,,,,,,CEFAZOLIN SODIUM INJ [1GM,14,5.6,0,11.9,11.9,SKIPPED,0.16,0.16,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341226,250,J7644,,,,,,,IPRATROPIUM BROMIDE INHAL,7,2.8,0,5.95,5.95,SKIPPED,0.51,0.51,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341228,252,J3490,,,,,,,ESCITALOPRAM OXALATE TABL,11.65,4.66,0,9.9,9.9,SKIPPED,8.85,8.85,9.9,9.9,9.9,4.91,5.71,5.71,0,3.5,5.01,5.01,9.9
4341231,252,J3490,,,,,,,AZTREONAM INJ [1 GM],92.57,37.03,0,78.68,78.68,SKIPPED,70.35,70.35,78.68,78.68,78.68,39.01,45.36,45.36,0,27.77,39.81,39.81,78.68
4341232,250,J3490,,,,,,,METAXALONE TABLET [800MG],33.92,13.57,0,28.83,28.83,SKIPPED,25.78,25.78,28.83,28.83,28.83,14.3,16.62,16.62,0,10.18,14.59,14.59,28.83
4341233,250,J3490,,,,,,,LORAZEPAM TABLET [0.5MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341234,250,J3490,,,,,,,D50W ABBOJECT INJ [50ML],14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341235,250,J3490,,,,,,,POTASSIUM CHLORID,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341239,250,J0171,,,,,,,EPINEPHRINE INJ,31.44,12.58,0,26.72,26.72,SKIPPED,0.14,0.14,26.72,26.72,26.72,13.25,15.41,15.41,0,9.43,13.52,13.52,26.72
4341240,252,J3490,,,,,,,LANSOPRAZOLE CAPSULE,15.06,6.02,0,12.8,12.8,SKIPPED,11.45,11.45,12.8,12.8,12.8,6.35,7.38,7.38,0,4.52,6.48,6.48,12.8
4341242,250,J3490,,,,,,,NICOTINE PATCH [21MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341244,250,J3490,,,,,,,LIDOCAINE HCL/EPINEPHRINE,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341246,250,J3490,,,,,,,PROMETHAZINE SUPP 25MG,47.1,18.84,0,40.04,40.04,SKIPPED,35.8,35.8,40.04,40.04,40.04,19.84,23.08,23.08,0,14.13,20.25,20.25,40.04
4341247,252,J2997,,,,,,,ALTEPLASE INJ [2 MG],512.98,205.19,0,436.03,436.03,SKIPPED,36.2,36.2,436.03,436.03,436.03,216.17,251.36,251.36,0,153.89,220.58,220.58,436.03
4341248,250,J3490,,,,,,,AMOX TR/POTASSIUM CLAVULA,13.44,5.38,0,11.42,11.42,SKIPPED,10.21,10.21,11.42,11.42,11.42,5.66,6.59,6.59,0,4.03,5.78,5.78,11.42
4341249,252,J3490,,,,,,,TAMSULOSIN HCL CAPSULE [0,11.21,4.48,0,9.53,9.53,SKIPPED,8.52,8.52,9.53,9.53,9.53,4.72,5.49,5.49,0,3.36,4.82,4.82,9.53
4341252,250,J3490,,,,,,,ISOSORBIDE MONONITRATE TA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341253,258,J7120,,,,,,,LR BAG [1000 ML],20,8,0,17,17,SKIPPED,5.3,5.3,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4341254,252,J3490,,,,,,,TOLTERODINE TARTRATE TABL,32.19,12.88,0,27.36,27.36,SKIPPED,24.46,24.46,27.36,27.36,27.36,13.56,15.77,15.77,0,9.66,13.84,13.84,27.36
4341256,250,J3490,,,,,,,ACTIVATED CHARCOAL PELLET,46.95,18.78,0,39.91,39.91,SKIPPED,35.68,35.68,39.91,39.91,39.91,19.79,23.01,23.01,0,14.08,20.19,20.19,39.91
4341257,250,J3490,,,,,,,METOPROLOL TARTRATE INJ [,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341259,250,J0460,,,,,,,ATROPINE SULFATE INJECTIO,22.39,8.96,0,19.03,19.03,SKIPPED,17.02,17.02,19.03,19.03,19.03,9.44,10.97,10.97,0,6.72,9.63,9.63,19.03
4341260,252,J3490,,,,,,,CELECOXIB CAPSULE [100MG],12.29,4.92,0,10.45,10.45,SKIPPED,9.34,9.34,10.45,10.45,10.45,5.17,6.02,6.02,0,3.69,5.28,5.28,10.45
4341261,252,J3490,,,,,,,CARVEDILOL TAB [3.125MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341262,252,J1815,,,,,,,INSULIN GLARGINE HUM.REC.,90.51,36.2,0,76.93,76.93,SKIPPED,0.14,0.14,76.93,76.93,76.93,38.14,44.35,44.35,0,27.15,38.92,38.92,76.93
4341264,250,J3490,,,,,,,AMOX TR/POTASSIUM CLAVULA,196.97,78.79,0,167.42,167.42,SKIPPED,149.7,149.7,167.42,167.42,167.42,83.01,96.52,96.52,0,59.09,84.7,84.7,167.42
4341265,250,J3490,,,,,,,GABAPENTIN CAPLET [400MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341273,252,J3490,,,,,,,VALSARTAN TABLET [80MG],12.36,4.94,0,10.51,10.51,SKIPPED,9.39,9.39,10.51,10.51,10.51,5.2,6.06,6.06,0,3.71,5.31,5.31,10.51
4341276,250,J3490,,,,,,,DEXTRAN 70/HYPROMELLOSE O,10.08,4.03,0,8.57,8.57,SKIPPED,7.66,7.66,8.57,8.57,8.57,4.24,4.94,4.94,0,3.02,4.33,4.33,8.57
4341279,250,J3490,,,,,,,DILTIAZEM HCL INJ [50MG/1,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341282,250,J3490,,,,,,,VECURONIUM BROMIDE INJ [1,23.43,9.37,0,19.92,19.92,SKIPPED,17.81,17.81,19.92,19.92,19.92,9.87,11.48,11.48,0,7.03,10.07,10.07,19.92
4341284,252,J3490,,,,,,,TICARCILLIN/K CLAVULANATE,42.56,17.02,0,36.18,36.18,SKIPPED,32.35,32.35,36.18,36.18,36.18,17.93,20.85,20.85,0,12.77,18.3,18.3,36.18
4341287,250,J3490,,,,,,,NEOMYCIN SULFATE TABLET [,7.7,3.08,0,6.54,6.54,SKIPPED,5.85,5.85,6.54,6.54,6.54,3.24,3.77,3.77,0,2.31,3.31,3.31,6.54
4341288,250,J3490,,,,,,,METOPROLOL SUCCINATE TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341296,250,J3490,,,,,,,LANOLIN/MIN OIL/PETROLAT,27.4,10.96,0,23.29,23.29,SKIPPED,20.82,20.82,23.29,23.29,23.29,11.54,13.43,13.43,0,8.22,11.78,11.78,23.29
4341297,250,J3490,,,,,,,RAMIPRIL TABLET [5MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341298,250,J3490,,,,,,,METFORMIN HCL TABLET [850,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341299,250,J3490,,,,,,,DOXYCYCLINE HYCLATE INJ [,84.05,33.62,0,71.44,71.44,SKIPPED,63.88,63.88,71.44,71.44,71.44,35.42,41.18,41.18,0,25.22,36.14,36.14,71.44
4341301,252,J3490,,,,,,,RISEDRONATE SODIUM TABLET,88.02,35.21,0,74.82,74.82,SKIPPED,66.9,66.9,74.82,74.82,74.82,37.09,43.13,43.13,0,26.41,37.85,37.85,74.82
4341303,250,J3490,,,,,,,PHENYTOIN SODIUM EXTENDED,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341304,252,J3490,,,,,,,ALENDRONATE SODIUM TAB [7,54.3,21.72,0,46.16,46.16,SKIPPED,41.27,41.27,46.16,46.16,46.16,22.88,26.61,26.61,0,16.29,23.35,23.35,46.16
4341305,250,J3490,,,,,,,RIFAMPIN CAP [300MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341306,252,J3490,,,,,,,AMLODIPINE BESYLATE TAB [,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341307,250,J3490,,,,,,,GENTAMICIN SULFATE OINTME,103.61,41.44,0,88.07,88.07,SKIPPED,78.74,78.74,88.07,88.07,88.07,43.66,50.77,50.77,0,31.08,44.55,44.55,88.07
4341309,250,J3490,,,,,,,FELODIPINE ER TABLET [5MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341310,250,J1200,,,,,,,DIPHENHYDRAMINE HCL INJ [,14,5.6,0,11.9,11.9,SKIPPED,0.83,0.83,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341311,250,J3490,,,,,,,LIDOCAINE HCL INJ 2% ABJ,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341312,252,J1815,,,,,,,INSULIN LISPRO HUMAN-HUMA,7,2.8,0,5.95,5.95,SKIPPED,0.14,0.14,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341315,250,J3490,,,,,,,RAMIPRIL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341316,252,J1815,,,,,,,INSULIN NPH HUMAN RECOM,7,2.8,0,5.95,5.95,SKIPPED,0.14,0.14,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341319,252,J3490,,,,,,,ETOMIDATE INJ [20MG/10ML],19.85,7.94,0,16.87,16.87,SKIPPED,15.09,15.09,16.87,16.87,16.87,8.37,9.73,9.73,0,5.96,8.54,8.54,16.87
4341321,250,J3490,,,,,,,MUPIROCIN CALCIUM CREAM,113.71,45.48,0,96.65,96.65,SKIPPED,86.42,86.42,96.65,96.65,96.65,47.92,55.72,55.72,0,34.11,48.9,48.9,96.65
4341322,250,J3490,,,,,,,KETOCONAZOLE CREAM,82.19,32.88,0,69.86,69.86,SKIPPED,62.46,62.46,69.86,69.86,69.86,34.63,40.27,40.27,0,24.66,35.34,35.34,69.86
4341325,250,J3490,,,,,,,OXYCODONE HCL CR TABLET,15.27,6.11,0,12.98,12.98,SKIPPED,11.61,11.61,12.98,12.98,12.98,6.44,7.48,7.48,0,4.58,6.57,6.57,12.98
4341326,252,J3490,,,,,,,FLUTICASONE PROPIONATE (R,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341327,252,J3490,,,,,,,BRIMONIDINE TARTRATE OPTH,630.15,252.06,0,535.63,535.63,SKIPPED,478.91,478.91,535.63,535.63,535.63,265.54,308.77,308.77,0,189.04,270.96,270.96,535.63
4341331,250,J3430,,,,,,,PHYTONADIONE INJ,15.15,6.06,0,12.88,12.88,SKIPPED,3.86,3.86,12.88,12.88,12.88,6.38,7.42,7.42,0,4.54,6.51,6.51,12.88
4341332,250,J3490,,,,,,,PHYTONADIONE TABLET [5MG],187.56,75.02,0,159.43,159.43,SKIPPED,142.55,142.55,159.43,159.43,159.43,79.04,91.9,91.9,0,56.27,80.65,80.65,159.43
4341335,250,J3490,,,,,,,SODIUM BICARBONATE INJ PE,44.85,17.94,0,38.12,38.12,SKIPPED,34.09,34.09,38.12,38.12,38.12,18.9,21.98,21.98,0,13.46,19.29,19.29,38.12
4341336,250,J2250,,,,,,,MIDAZOLAM HCL INJ,14,5.6,0,11.9,11.9,SKIPPED,0.11,0.11,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341338,250,J3490,,,,,,,QUINAPRIL HCL TABLET [5MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341339,250,J7613,,,,,,,ALBUTEROL SULFATE INH. SO,7,2.8,0,5.95,5.95,SKIPPED,0.08,0.08,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341340,258,J1265,,,,,,,DOPAMINE HCL/DEXTROSE 5%-,73.59,29.44,0,62.55,62.55,SKIPPED,0.12,0.12,62.55,62.55,62.55,31.01,36.06,36.06,0,22.08,31.64,31.64,62.55
4341341,250,J3490,,,,,,,BISACODYL SUPP. [10MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341348,250,S0106,,,,,,,BUPROPION HCL TABLET [150,7,2.8,0,7,5.95,SKIPPED,7,7,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341349,250,J7510,,,,,,,PREDNISOLONE SOLUTION BUL,10.64,4.26,0,9.04,9.04,SKIPPED,0.1,0.1,9.04,9.04,9.04,4.49,5.21,5.21,0,3.19,4.58,4.58,9.04
4341350,250,J3490,,,,,,,NITROGLYCERIN PASTE UNIT,7.33,2.93,0,6.23,6.23,SKIPPED,5.57,5.57,6.23,6.23,6.23,3.09,3.59,3.59,0,2.2,3.15,3.15,6.23
4341352,250,J1050,,,,,,,MEDROXYPROGESTERONE ACET,260.28,104.11,0,221.24,221.24,SKIPPED,0.51,0.51,221.24,221.24,221.24,109.68,127.54,127.54,0,78.08,111.92,111.92,221.24
4341353,250,J3490,,,,,,,BENAZEPRIL HCL TABLET [10,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341354,250,J3490,,,,,,,AMIODARONE HCL TAB [200 M,21.13,8.45,0,17.96,17.96,SKIPPED,16.06,16.06,17.96,17.96,17.96,8.91,10.35,10.35,0,6.34,9.09,9.09,17.96
4341355,252,J3490,,,,,,,CONJUGATED ESTROGENS TABL,20.38,8.15,0,17.32,17.32,SKIPPED,15.49,15.49,17.32,17.32,17.32,8.58,9.99,9.99,0,6.11,8.76,8.76,17.32
4341356,250,J3490,,,,,,,PROMETHAZINE SUPP 12.5MG,47.1,18.84,0,40.04,40.04,SKIPPED,35.8,35.8,40.04,40.04,40.04,19.84,23.08,23.08,0,14.13,20.25,20.25,40.04
4341357,250,J3490,,,,,,,GLIMEPIRIDE TABLET [4MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341358,250,J3490,,,,,,,ASPIRIN CHEW TAB [81 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341360,250,J2175,,,,,,,MEPERIDINE HCL INJ [50MG/,14,5.6,0,11.9,11.9,SKIPPED,0.94,0.94,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341361,250,J7644,,,,,,,IPRATROPIUM BROMIDE NASA,121.38,48.55,0,103.17,103.17,SKIPPED,0.51,0.51,103.17,103.17,103.17,51.15,59.48,59.48,0,36.41,52.19,52.19,103.17
4341362,250,86580,,,,,,,TUBERCULIN PURIF.PROT.DER,30.07,12.03,0,30.07,25.56,SKIPPED,30.07,30.07,25.56,25.56,25.56,12.67,14.73,14.73,0,9.02,12.93,12.93,25.56
4341363,252,J3490,,,,,,,PIOGLITAZONE HCL 15MG TAB,15.11,6.04,0,12.84,12.84,SKIPPED,11.48,11.48,12.84,12.84,12.84,6.37,7.4,7.4,0,4.53,6.5,6.5,12.84
4341364,250,J1160,,,,,,,DIGOXIN INJ [0.25MG/ML],19.88,7.95,0,16.9,16.9,SKIPPED,3.8,3.8,16.9,16.9,16.9,8.38,9.74,9.74,0,5.96,8.55,8.55,16.9
4341366,250,J3490,,,,,,,BUPROPION HCL TABLET [100,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341368,250,J0171,,,,,,,EPINEPHRINE 1:1000 (1ML),47.75,19.1,0,40.59,40.59,SKIPPED,0.14,0.14,40.59,40.59,40.59,20.12,23.4,23.4,0,14.32,20.53,20.53,40.59
4341369,250,J2765,,,,,,,METOCLOPRAMIDE HCL INJ [1,14,5.6,0,11.9,11.9,SKIPPED,0.62,0.62,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341370,250,J3490,,,,,,,LEVOTHYROXINE SODIUM TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341373,252,J3490,,,,,,,DULOXETINE HCL CAPSULE [6,20.48,8.19,0,17.41,17.41,SKIPPED,15.56,15.56,17.41,17.41,17.41,8.63,10.04,10.04,0,6.14,8.81,8.81,17.41
4341374,250,J3490,,,,,,,BETA-CAROTENE(A) W-C & E/,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341376,250,J3490,,,,,,,NAPHAZOLINE HCL/PHENIR MA,23.99,9.6,0,20.39,20.39,SKIPPED,18.23,18.23,20.39,20.39,20.39,10.11,11.76,11.76,0,7.2,10.32,10.32,20.39
4341377,250,J1165,,,,,,,PHENYTOIN SODIUM INJ [250,14,5.6,0,11.9,11.9,SKIPPED,0.4,0.4,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341378,250,J3490,,,,,,,MECLIZINE HCL TABLET [12.,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341379,250,J3490,,,,,,,ATROPINE SULFATE OPTH [1%,155.29,62.12,0,132,132,SKIPPED,118.02,118.02,132,132,132,65.43,76.09,76.09,0,46.59,66.77,66.77,132
4341380,250,J1940,,,,,,,FUROSEMIDE INJ [20 MG/2ML,14,5.6,0,11.9,11.9,SKIPPED,1.65,1.65,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341382,250,J1940,,,,,,,FUROSEMIDE INJ,14,5.6,0,11.9,11.9,SKIPPED,1.65,1.65,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341383,250,J1100,,,,,,,DEXAMETHASONE SOD PHOSPHA,14,5.6,0,11.9,11.9,SKIPPED,0.03,0.03,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341384,250,J1940,,,,,,,FUROSEMIDE INJ,14,5.6,0,11.9,11.9,SKIPPED,1.65,1.65,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341385,250,J3490,,,,,,,FLURBIPROFEN SODIUM OPTH,136.99,54.8,0,116.44,116.44,SKIPPED,104.11,104.11,116.44,116.44,116.44,57.73,67.13,67.13,0,41.1,58.91,58.91,116.44
4341389,250,S0077,,,,,,,CLINDAMYCIN PHOSPHATE INJ,14,5.6,0,11.9,11.9,SKIPPED,0.86,0.86,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341390,250,J3490,,,,,,,DIGOXIN TABLET [0.125MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341391,252,J3490,,,,,,,TIOTROPIUM BROMIDE INHALE,1586.8,634.72,0,1348.78,1348.78,SKIPPED,1205.97,1205.97,1348.78,1348.78,1348.78,668.67,777.53,777.53,0,476.04,682.32,682.32,1348.78
4341394,250,J2550,,,,,,,PROMETHAZINE INJ 50MG,14,5.6,0,11.9,11.9,SKIPPED,1.28,1.28,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341396,258,J7060,,,,,,,D5W BAG [50ML],115,46,0,97.75,97.75,SKIPPED,7.26,7.26,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4341397,250,J3490,,,,,,,LIDOCAINE HCL JELLY,341.41,136.56,0,290.2,290.2,SKIPPED,259.47,259.47,290.2,290.2,290.2,143.87,167.29,167.29,0,102.42,146.81,146.81,290.2
4341398,250,J3490,,,,,,,SULFACETAMIDE SODIUM,162.26,64.9,0,137.92,137.92,SKIPPED,123.32,123.32,137.92,137.92,137.92,68.37,79.51,79.51,0,48.68,69.77,69.77,137.92
4341403,252,J3490,,,,,,,RALOXIFENE HCL TABLET [60,18.96,7.58,0,16.12,16.12,SKIPPED,14.41,14.41,16.12,16.12,16.12,7.99,9.29,9.29,0,5.69,8.15,8.15,16.12
4341404,250,J3490,,,,,,,LEVOTHYROXINE SODIUM TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341406,250,J0500,,,,,,,DICYCLOMINE HCL INJ [20MG,134.16,53.66,0,114.04,114.04,SKIPPED,42.72,42.72,114.04,114.04,114.04,56.54,65.74,65.74,0,40.25,57.69,57.69,114.04
4341407,250,J3490,,,,,,,LEVOTHYROXINE SODIUM TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341408,250,J3490,,,,,,,NIFEDIPINE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341409,250,J3490,,,,,,,SODIUM BICARBONATE INJ,31.08,12.43,0,26.42,26.42,SKIPPED,23.62,23.62,26.42,26.42,26.42,13.09,15.23,15.23,0,9.32,13.36,13.36,26.42
4341410,250,J3490,,,,,,,DILTIAZEM HCL CD CAPSULE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341411,258,J1642,,,,,,,HEPARIN SODIUM PORCINE FL,14,5.6,0,11.9,11.9,SKIPPED,0.02,0.02,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341415,250,J3490,,,,,,,MORPHINE SULFATE EXTENDED,8.99,3.6,0,7.64,7.64,SKIPPED,6.83,6.83,7.64,7.64,7.64,3.79,4.41,4.41,0,2.7,3.87,3.87,7.64
4341418,250,J3490,,,,,,,MICONAZOLE NITRATE CREAM,19.15,7.66,0,16.28,16.28,SKIPPED,14.55,14.55,16.28,16.28,16.28,8.07,9.38,9.38,0,5.74,8.23,8.23,16.28
4341419,252,J3490,,,,,,,GUAIFENESIN/D-METHORPHAN,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341422,250,J3490,,,,,,,TRAMADOL HCL TABLET [50MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341423,250,J3490,,,,,,,SULINDAC TABLET [200MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341424,250,J3490,,,,,,,CARBIDOPA/LEVODOPA TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341425,258,J3490,,,,,,,NS 0.9% DILUENT 10ML VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341430,250,J3490,,,,,,,DICYCLOMINE HCL SYRUP[BUL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341431,250,J3490,,,,,,,NAFCILLIN SODIUM INJ [2 G,75.33,30.13,0,64.03,64.03,SKIPPED,57.25,57.25,64.03,64.03,64.03,31.74,36.91,36.91,0,22.6,32.39,32.39,64.03
4341432,250,J3490,,,,,,,LISINOPRIL TABLET [10MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341433,250,J3490,,,,,,,NYSTATIN POWDER,143.16,57.26,0,121.69,121.69,SKIPPED,108.8,108.8,121.69,121.69,121.69,60.33,70.15,70.15,0,42.95,61.56,61.56,121.69
4341434,250,J3490,,,,,,,CEPHALEXIN MONOHYDRATE CA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341436,250,J3490,,,,,,,PROPARACAINE HCL OPTH,116.72,46.69,0,99.21,99.21,SKIPPED,88.71,88.71,99.21,99.21,99.21,49.19,57.19,57.19,0,35.02,50.19,50.19,99.21
4341437,250,J2001,,,,,,,LIDOCAINE HCL INJ 1% VIAL,14,5.6,0,11.9,11.9,SKIPPED,0.02,0.02,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341438,250,J3490,,,,,,,PRAMIPEXOLE DI-HCL TABLET,8.62,3.45,0,7.33,7.33,SKIPPED,6.55,6.55,7.33,7.33,7.33,3.64,4.22,4.22,0,2.59,3.71,3.71,7.33
4341440,250,J3490,,,,,,,ACETAMINOPHEN TAB [500 MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341442,250,J3490,,,,,,,CALCIUM CHLORIDE INJ,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341444,250,J3490,,,,,,,FOLIC ACID 10ML VIAL [5M,156.99,62.8,0,133.44,133.44,SKIPPED,119.31,119.31,133.44,133.44,133.44,66.16,76.93,76.93,0,47.1,67.51,67.51,133.44
4341446,252,J3490,,,,,,,OMEPRAZOLE CAPSULE [20MG],7.77,3.11,0,6.6,6.6,SKIPPED,5.91,5.91,6.6,6.6,6.6,3.27,3.81,3.81,0,2.33,3.34,3.34,6.6
4341447,250,J3490,,,,,,,SULFAMETHOXAZOLE/TRIMETHO,115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4341448,250,J3490,,,,,,,CEFUROXIME AXETIL SUS [25,348.19,139.28,0,295.96,295.96,SKIPPED,264.62,264.62,295.96,295.96,295.96,146.73,170.61,170.61,0,104.46,149.72,149.72,295.96
4341451,250,J0895,,,,,,,DEFEROXAMINE MESYLATE INJ,30.19,12.08,0,25.66,25.66,SKIPPED,5.46,5.46,25.66,25.66,25.66,12.72,14.79,14.79,0,9.06,12.98,12.98,25.66
4341452,250,J0282,,,,,,,AMIODARONE HCL INJ [150MG,14,5.6,0,11.9,11.9,SKIPPED,0.2,0.2,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341456,250,J3411,,,,,,,THIAMINE HCL INJ [100MG/M,31.76,12.7,0,27,27,SKIPPED,3.07,3.07,27,27,27,13.39,15.56,15.56,0,9.53,13.66,13.66,27
4341458,250,J3490,,,,,,,CARISOPRODOL TABLET [350M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341459,250,J3490,,,,,,,BACLOFEN TABLET [20 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341460,250,J3490,,,,,,,LOVASTATIN TABLET [20MG],7.73,3.09,0,6.57,6.57,SKIPPED,5.87,5.87,6.57,6.57,6.57,3.25,3.79,3.79,0,2.32,3.32,3.32,6.57
4341461,250,J3490,,,,,,,SODIUM POLYSTYRENE SULFON,66.83,26.73,0,56.81,56.81,SKIPPED,50.79,50.79,56.81,56.81,56.81,28.17,32.75,32.75,0,20.05,28.74,28.74,56.81
4341463,250,J3490,,,,,,,BISACODYL TABLET [5MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341464,250,J3490,,,,,,,METOCLOPRAMIDE HCL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341465,250,J3490,,,,,,,FUROSEMIDE TABLET [40MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341471,250,J3490,,,,,,,FLUDROCORTISONE ACETATE T,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341475,250,J3490,,,,,,,LOPERAMIDE HCL CAPSULE [2,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341476,250,J2590,,,,,,,OXYTOCIN [10 UNITS/ML],14,5.6,0,11.9,11.9,SKIPPED,0.65,0.65,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341477,250,J0780,,,,,,,PROCHLORPERAZINE EDISYLAT,28.73,11.49,0,24.42,24.42,SKIPPED,12.79,12.79,24.42,24.42,24.42,12.1,14.08,14.08,0,8.62,12.35,12.35,24.42
4341481,250,J3490,,,,,,,SULFAMETHOXAZOLE/TRIMETHO,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341482,250,J3490,,,,,,,ACETAMINOPHEN ARTHRITIS C,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341483,250,J3490,,,,,,,MULTIVITAMINS W-MINERALS/,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341485,252,J3490,,,,,,,MOMETASONE FUROATE [50MCG,802.58,321.03,0,682.19,682.19,SKIPPED,609.96,609.96,682.19,682.19,682.19,338.21,393.26,393.26,0,240.77,345.11,345.11,682.19
4341487,250,J3490,,,,,,,KETAMINE HCL INJ [50MG/10,26.54,10.62,0,22.56,22.56,SKIPPED,20.17,20.17,22.56,22.56,22.56,11.18,13,13,0,7.96,11.41,11.41,22.56
4341488,250,J3490,,,,,,,NITROGLYCERIN SUB-L TABLE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341489,250,J1580,,,,,,,GENTAMICIN SULFATE INJ [8,14,5.6,0,11.9,11.9,SKIPPED,0.82,0.82,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341490,250,J3490,,,,,,,FLUPHENAZINE 2.5mg/ml INJ,613.08,245.23,0,521.12,521.12,SKIPPED,465.94,465.94,521.12,521.12,521.12,258.35,300.41,300.41,0,183.92,263.62,263.62,521.12
4341493,250,J3490,,,,,,,LEVOTHYROXINE SODIUM TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341494,250,J3490,,,,,,,METOCLOPRAMIDE HCL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341496,250,J3490,,,,,,,DOXYCYCLINE HYCLATE TABLE,14.86,5.94,0,12.63,12.63,SKIPPED,11.29,11.29,12.63,12.63,12.63,6.26,7.28,7.28,0,4.46,6.39,6.39,12.63
4341497,250,J3490,,,,,,,NAPROXEN SODIUM CAPLET[22,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341499,250,J3490,,,,,,,SODIUM CHLORIDE OPTH SOL,39.21,15.68,0,33.33,33.33,SKIPPED,29.8,29.8,33.33,33.33,33.33,16.52,19.21,19.21,0,11.76,16.86,16.86,33.33
4341500,250,J3490,,,,,,,VERAPAMIL HCL INJ [5MG/2M,93.79,37.52,0,79.72,79.72,SKIPPED,71.28,71.28,79.72,79.72,79.72,39.52,45.96,45.96,0,28.14,40.33,40.33,79.72
4341502,250,J3490,,,,,,,LISINOPRIL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341503,250,J3490,,,,,,,MAGNESIUM CHLORIDE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341505,250,J3490,,,,,,,METOPROLOL TARTRATE TABLE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341508,250,J3490,,,,,,,PANCRELIPASE CAPSULE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341511,250,,,,,,,,TETRACAINE/BENZOCAINE/BUT,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341512,250,J3490,,,,,,,NITROGLYCERIN TRANSDERMA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341513,250,A4216,,,,,,,STERILE WATER DILUENT [10,14,5.6,0,11.9,11.9,SKIPPED,0.06,0.06,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341515,250,J3360,,,,,,,DIAZEPAM INJ [10MG],88.8,35.52,0,75.48,75.48,SKIPPED,2.27,2.27,75.48,75.48,75.48,37.42,43.51,43.51,0,26.64,38.18,38.18,75.48
4341516,250,J3490,,,,,,,BUPIVACAINE HCL INJ 0.5%,35.75,14.3,0,30.39,30.39,SKIPPED,27.17,27.17,30.39,30.39,30.39,15.06,17.52,17.52,0,10.72,15.37,15.37,30.39
4341520,250,J1720,,,,,,,HYDROCORTISONE SOD SUCCIN,59.08,23.63,0,50.22,50.22,SKIPPED,2,2,50.22,50.22,50.22,24.89,28.95,28.95,0,17.72,25.4,25.4,50.22
4341522,250,J3490,,,,,,,DILTIAZEM HCL ER CAPSULE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341523,250,J3490,,,,,,,KETOROLAC TROMETHAMINE TA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341527,250,J3490,,,,,,,CLONIDINE HCL TABLET [0.1,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341528,250,J3010,,,,,,,FENTANYL 50MCG/ML 2ML AMP,14,5.6,0,11.9,11.9,SKIPPED,0.39,0.39,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341529,250,J3490,,,,,,,HYDROCODONE/APAP 5/500 TA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341530,250,J3490,,,,,,,CLINDAMYCIN HCL CAPSULE [,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341533,252,J3490,,,,,,,NOREPINEPHRINE BITARTRATE,57.52,23.01,0,48.89,48.89,SKIPPED,43.72,43.72,48.89,48.89,48.89,24.24,28.18,28.18,0,17.26,24.73,24.73,48.89
4341534,250,J3490,,,,,,,TERBUTALINE 5mg TABLET,8.84,3.54,0,7.51,7.51,SKIPPED,6.72,6.72,7.51,7.51,7.51,3.72,4.33,4.33,0,2.65,3.8,3.8,7.51
4341535,250,J3490,,,,,,,HYDROCODONE/APAP 10/325 T,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341539,250,J3490,,,,,,,FLECAINIDE ACETATE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341541,252,J3490,,,,,,,DORZOLAMIDE/TIMOLOL OPTH,326.12,130.45,0,277.2,277.2,SKIPPED,247.85,247.85,277.2,277.2,277.2,137.43,159.8,159.8,0,97.84,140.23,140.23,277.2
4341547,250,J3490,,,,,,,DICYCLOMINE HCL TABLET [2,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341548,250,J3490,,,,,,,POTASSIUM CHLORIDE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341549,250,J3490,,,,,,,INDOMETHACIN CAPSULE [25M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341550,252,J3490,,,,,,,NITROGLYCERIN/D5W [25MG/2,65.39,26.16,0,55.58,55.58,SKIPPED,49.7,49.7,55.58,55.58,55.58,27.56,32.04,32.04,0,19.62,28.12,28.12,55.58
4341551,250,J1630,,,,,,,HALOPERIDOL LACTATE INJ,19.12,7.65,0,16.25,16.25,SKIPPED,4.06,4.06,16.25,16.25,16.25,8.06,9.37,9.37,0,5.74,8.22,8.22,16.25
4341552,250,J3490,,,,,,,TRIAMTERENE/HYDROCHLOROTH,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341553,250,J0698,,,,,,,CEFOTAXIME SODIUM INJ [1G,14,5.6,0,11.9,11.9,SKIPPED,1.52,1.52,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341554,250,J3490,,,,,,,SUCRALFATE SUS [1GM/10ML],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341555,250,J3490,,,,,,,CODEINE PHOS/ACETAMINOPHE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341559,250,J3490,,,,,,,ACETAZOLAMIDE TAB [250MG],8.76,3.5,0,7.45,7.45,SKIPPED,6.66,6.66,7.45,7.45,7.45,3.69,4.29,4.29,0,2.63,3.77,3.77,7.45
4341561,250,J3490,,,,,,,NICOTINE PATCH,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341562,250,J3490,,,,,,,"BACITRACIN INJ [50,000 UN",35.59,14.24,0,30.25,30.25,SKIPPED,27.05,27.05,30.25,30.25,30.25,14.99,17.44,17.44,0,10.68,15.3,15.3,30.25
4341566,252,J3490,,,,,,,CEFDINIR SUS [125MG/5ML],135.66,54.26,0,115.31,115.31,SKIPPED,103.1,103.1,115.31,115.31,115.31,57.16,66.47,66.47,0,40.7,58.33,58.33,115.31
4341569,250,J3490,,,,,,,VERAPAMIL HCL ER 180 MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341570,252,J3490,,,,,,,OLMESARTAN MEDOXOMIL,25.55,10.22,0,21.72,21.72,SKIPPED,19.42,19.42,21.72,21.72,21.72,10.77,12.52,12.52,0,7.66,10.99,10.99,21.72
4341572,250,J3490,,,,,,,MEGESTROL ACETATE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341576,250,J3490,,,,,,,GLIPIZIDE XL TABLET [5MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341577,250,J3490,,,,,,,SILVERSULFADIAZINE JAR [,151.12,60.45,0,128.45,128.45,SKIPPED,114.85,114.85,128.45,128.45,128.45,63.68,74.05,74.05,0,45.34,64.98,64.98,128.45
4341578,250,J3490,,,,,,,ACETAMINOPHEN TAB [325 MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341584,250,J3490,,,,,,,LIDOCAINE/PRILOCAINE CREA,23.56,9.42,0,20.03,20.03,SKIPPED,17.91,17.91,20.03,20.03,20.03,9.93,11.54,11.54,0,7.07,10.13,10.13,20.03
4341585,250,J3490,,,,,,,MAGNESIUM CITRATE [10OZ],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341586,250,J2690,,,,,,,PROCAINAMIDE HCL INJ 1000,232.26,92.9,0,197.42,197.42,SKIPPED,54.56,54.56,197.42,197.42,197.42,97.87,113.81,113.81,0,69.68,99.87,99.87,197.42
4341588,250,J3490,,,,,,,MORPHINE SULFATE EXTENDED,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341590,250,J3490,,,,,,,ASPIRIN EC [81 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341591,250,J3490,,,,,,,PROMETHAZINE TABLET 25MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341594,250,J3490,,,,,,,SODIUM/POTASSIUM/SOD CHL,93.62,37.45,0,79.58,79.58,SKIPPED,71.15,71.15,79.58,79.58,79.58,39.45,45.87,45.87,0,28.09,40.26,40.26,79.58
4341597,250,J3490,,,,,,,SODIUM CHLORIDE 0.9 INHAL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341598,250,J3490,,,,,,,ADVIL TAB [200 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341600,250,J3490,,,,,,,BENZTROPINE MESYLATE TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341602,250,J3490,,,,,,,SILVERSULFADIAZINE JAR [5,44.21,17.68,0,37.58,37.58,SKIPPED,33.6,33.6,37.58,37.58,37.58,18.63,21.66,21.66,0,13.26,19.01,19.01,37.58
4341604,250,J0515,,,,,,,BENZTROPINE MESYLATE INJ,99.75,39.9,0,84.79,84.79,SKIPPED,19.01,19.01,84.79,84.79,84.79,42.03,48.88,48.88,0,29.92,42.89,42.89,84.79
4341605,250,J3490,,,,,,,GEMFIBROZIL TABLET [600MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341606,250,J3490,,,,,,,RANITIDINE HCL TABLET [15,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341609,250,J3490,,,,,,,CYCLOBENZAPRINE HCL TABLE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341610,250,J3490,,,,,,,MAGNESIUM HYDROXIDE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341612,250,J3490,,,,,,,ACETAMINOPHEN SUPP [650 M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341613,250,J3490,,,,,,,PRIMIDONE TABLET [50MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341617,250,J3490,,,,,,,HYDROCODONE BIT/ACETAMINO,26.4,10.56,0,22.44,22.44,SKIPPED,20.06,20.06,22.44,22.44,22.44,11.12,12.94,12.94,0,7.92,11.35,11.35,22.44
4341623,250,J3490,,,,,,,FLUOXETINE HCL CAPSULE [2,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341624,250,J3490,,,,,,,CHLORPROMAZINE HCL TABLET,25.43,10.17,0,21.62,21.62,SKIPPED,19.33,19.33,21.62,21.62,21.62,10.71,12.46,12.46,0,7.63,10.93,10.93,21.62
4341629,252,J3490,,,,,,,CARBAMAZEPINE TABLET [100,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341631,258,J3490,,,,,,,NS 0.9% CONT IRR BAG [200,26.25,10.5,0,22.31,22.31,SKIPPED,19.95,19.95,22.31,22.31,22.31,11.06,12.86,12.86,0,7.88,11.29,11.29,22.31
4341632,250,J3490,,,,,,,PRAZOSIN HCL CAPSULE [5MG,11.46,4.58,0,9.74,9.74,SKIPPED,8.71,8.71,9.74,9.74,9.74,4.83,5.62,5.62,0,3.44,4.93,4.93,9.74
4341633,250,J3490,,,,,,,RACEPINEPHRINE HCL INHL (,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341634,250,J2001,,,,,,,LIDOCAINE HCL,14,5.6,0,11.9,11.9,SKIPPED,0.02,0.02,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341635,250,J3490,,,,,,,HALOPERIDOL TABLET [5MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341637,252,J3490,,,,,,,TERBINAFINE HCL CREAM,23.91,9.56,0,20.32,20.32,SKIPPED,18.17,18.17,20.32,20.32,20.32,10.07,11.72,11.72,0,7.17,10.28,10.28,20.32
4341640,250,J3490,,,,,,,CEPASTAT LOZENGES,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341641,250,J3490,,,,,,,CO-EMZYME Q10 CAPSULE 100,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341642,250,J3490,,,,,,,DIPHENHYDRAMINE HCL CAPSU,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341645,250,J3490,,,,,,,PHENOL/ORAL ANESTHETIC TH,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341649,250,J3490,,,,,,,LEVOTHYROXINE SODIUM TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341653,250,J3490,,,,,,,BENZONATATE CAPLET [100MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341656,250,J3490,,,,,,,ATENOLOL TABLET [25 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341657,250,J3490,,,,,,,ANTIPYRINE/BENZOCAINE/GLY,31.79,12.72,0,27.02,27.02,SKIPPED,24.16,24.16,27.02,27.02,27.02,13.4,15.58,15.58,0,9.54,13.67,13.67,27.02
4341658,250,J2720,,,,,,,PROTAMINE SULFATE INJ [25,128.82,51.53,0,109.5,109.5,SKIPPED,1.06,1.06,109.5,109.5,109.5,54.28,63.12,63.12,0,38.65,55.39,55.39,109.5
4341660,250,J3490,,,,,,,IBUPROFEN TABLET [600MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341661,250,J3490,,,,,,,POTASSIUM CHLORIDE LIQ,49.48,19.79,0,42.06,42.06,SKIPPED,37.6,37.6,42.06,42.06,42.06,20.85,24.25,24.25,0,14.84,21.28,21.28,42.06
4341665,250,J3490,,,,,,,GLUTOSE 15 ORAL GEL,10.51,4.2,0,8.93,8.93,SKIPPED,7.99,7.99,8.93,8.93,8.93,4.43,5.15,5.15,0,3.15,4.52,4.52,8.93
4341670,250,J3490,,,,,,,AMOXICILLIN TRIHYDRATE CA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341673,250,J3490,,,,,,,LIDOCAINE HCL,35.11,14.04,0,29.84,29.84,SKIPPED,26.68,26.68,29.84,29.84,29.84,14.8,17.2,17.2,0,10.53,15.1,15.1,29.84
4341674,250,J3490,,,,,,,CLONAZEPAM TABLET [0.5MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341675,250,J3490,,,,,,,LIDOCAINE HCL/EPINEPHRINE,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341676,252,J1815,,,,,,,INSULIN NPH/REG INSULIN H,7,2.8,0,5.95,5.95,SKIPPED,0.14,0.14,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341677,250,J3490,,,,,,,DIGOXIN TABLET [0.25MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341678,250,J3490,,,,,,,TIMOLOL MALEATE OPT SOL,86.05,34.42,0,73.14,73.14,SKIPPED,65.4,65.4,73.14,73.14,73.14,36.26,42.16,42.16,0,25.82,37,37,73.14
4341680,250,J3490,,,,,,,HALOPERIDOL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341682,258,J7040,,,,,,,NS 0.9% BAG (500ML),20,8,0,17,17,SKIPPED,8.27,8.27,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4341683,250,J3490,,,,,,,LACTULOSE SOL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341684,250,J3490,,,,,,,LABETALOL HCL INJ [5MG/ML,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341686,250,J3490,,,,,,,FOLVITE TABLET [1MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341692,250,J3490,,,,,,,LIDOCAINE HCL OIN,798,319.2,0,678.3,678.3,SKIPPED,606.48,606.48,678.3,678.3,678.3,336.28,391.02,391.02,0,239.4,343.14,343.14,678.3
4341695,250,J3490,,,,,,,FUROSEMIDE TABLET [20MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341696,250,J2560,,,,,,,PHENOBARBITAL SODIUM INJ,84.11,33.64,0,71.49,71.49,SKIPPED,26.62,26.62,71.49,71.49,71.49,35.45,41.21,41.21,0,25.23,36.17,36.17,71.49
4341697,250,J3490,,,,,,,BUPIVACAINE HCL/EPINEPHRI,32.85,13.14,0,27.92,27.92,SKIPPED,24.97,24.97,27.92,27.92,27.92,13.85,16.1,16.1,0,9.86,14.13,14.13,27.92
4341700,250,J3490,,,,,,,DOCUSATE SODIUM,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341702,252,J3490,,,,,,,DORZOLAMIDE HCL OPT,177.69,71.08,0,151.04,151.04,SKIPPED,135.04,135.04,151.04,151.04,151.04,74.88,87.07,87.07,0,53.31,76.41,76.41,151.04
4341703,250,J3490,,,,,,,ACETAMINOPHEN ADULT LIQUI,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341704,250,J3490,,,,,,,DIPYRIDAMOLE TABLET [75 M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341705,250,J3490,,,,,,,ACTIVATED CHARCOAL (50 GM,62.91,25.16,0,53.47,53.47,SKIPPED,47.81,47.81,53.47,53.47,53.47,26.51,30.83,30.83,0,18.87,27.05,27.05,53.47
4341706,250,J3490,,,,,,,HYDROCORTISONE CR,232.3,92.92,0,197.46,197.46,SKIPPED,176.55,176.55,197.46,197.46,197.46,97.89,113.83,113.83,0,69.69,99.89,99.89,197.46
4341709,250,J3490,,,,,,,SALINE NASAL SPRAY,8.33,3.33,0,7.08,7.08,SKIPPED,6.33,6.33,7.08,7.08,7.08,3.51,4.08,4.08,0,2.5,3.58,3.58,7.08
4341711,250,J3490,,,,,,,HYDROXYCHLOROQUINE SULFAT,11.68,4.67,0,9.93,9.93,SKIPPED,8.88,8.88,9.93,9.93,9.93,4.92,5.72,5.72,0,3.5,5.02,5.02,9.93
4341713,250,J3490,,,,,,,SILVERSULFADIAZINE TB [20,27.9,11.16,0,23.72,23.72,SKIPPED,21.2,21.2,23.72,23.72,23.72,11.76,13.67,13.67,0,8.37,12,12,23.72
4341714,250,J3490,,,,,,,CYCLOPENTOLATE OPH SOL,19.64,7.86,0,16.69,16.69,SKIPPED,14.93,14.93,16.69,16.69,16.69,8.28,9.62,9.62,0,5.89,8.45,8.45,16.69
4341715,250,J3490,,,,,,,NA PHOS M-B/NA PHOS DI-BA,7.95,3.18,0,6.76,6.76,SKIPPED,6.04,6.04,6.76,6.76,6.76,3.35,3.9,3.9,0,2.38,3.42,3.42,6.76
4341716,250,J3490,,,,,,,VERAPAMIL HCL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341717,250,J3490,,,,,,,ENALAPRILAT DIHYDRATE INJ,16.95,6.78,0,14.41,14.41,SKIPPED,12.88,12.88,14.41,14.41,14.41,7.14,8.31,8.31,0,5.08,7.29,7.29,14.41
4341719,250,J3490,,,,,,,GOLYTELY 4-LITER SINGLE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341721,250,J3490,,,,,,,LEVOTHYROXINE SODIUM TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341722,250,J7512,,,,,,,PREDNISONE TABLET [50MG],7,2.8,0,5.95,5.95,SKIPPED,0.01,0.01,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341726,250,J3420,,,,,,,CYANOCOBALAMIN INJ [1000M,22.09,8.84,0,18.78,18.78,SKIPPED,4.43,4.43,18.78,18.78,18.78,9.31,10.82,10.82,0,6.63,9.5,9.5,18.78
4341728,250,J3490,,,,,,,NAPROXEN TABLET [250MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341730,250,J3490,,,,,,,ACETAMINOPHEN/DP-HYDRAM H,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341731,250,J3490,,,,,,,GLYCOPYRROLATE INJ [0.2MG,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341732,258,J7050,,,,,,,NS 0.9% BAG (250ML),20,8,0,17,17,SKIPPED,4.13,4.13,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4341733,250,J2650,,,,,,,PREDNISOLONE ACETATE OPT,147.15,58.86,0,125.08,125.08,SKIPPED,111.83,111.83,125.08,125.08,125.08,62,72.1,72.1,0,44.14,63.27,63.27,125.08
4341736,250,J3490,,,,,,,GLYBURIDE TABLET [5MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341739,250,J3490,,,,,,,IBUPROFEN TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341740,250,J3490,,,,,,,CLOTRIMAZOLE/BETAMET DIPR,90.97,36.39,0,77.32,77.32,SKIPPED,69.14,69.14,77.32,77.32,77.32,38.34,44.58,44.58,0,27.29,39.12,39.12,77.32
4341741,250,J3490,,,,,,,CALCIUM CITRATE 630MG/VIT,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341744,250,J3490,,,,,,,SODIUM BICARBONATE INJ,34.51,13.8,0,29.33,29.33,SKIPPED,26.23,26.23,29.33,29.33,29.33,14.54,16.91,16.91,0,10.35,14.84,14.84,29.33
4341745,250,J3490,,,,,,,THIOTHIXENE TABLET [5MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341747,252,J3490,,,,,,,HYPROMELLOSE OP,21.55,8.62,0,18.32,18.32,SKIPPED,16.38,16.38,18.32,18.32,18.32,9.08,10.56,10.56,0,6.46,9.27,9.27,18.32
4341749,250,J0290,,,,,,,AMPICILLIN SODIUM INJ [1,23.94,9.58,0,20.35,20.35,SKIPPED,2.04,2.04,20.35,20.35,20.35,10.08,11.73,11.73,0,7.18,10.29,10.29,20.35
4341751,250,J3490,,,,,,,DEXAMETHASONE SOD PHOSPHA,172.05,68.82,0,146.24,146.24,SKIPPED,130.76,130.76,146.24,146.24,146.24,72.5,84.3,84.3,0,51.62,73.98,73.98,146.24
4341754,250,J3490,,,,,,,DIPHENHYDRAMINE HCL CAPSU,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341756,250,J2310,,,,,,,NALOXONE HCL INJ,50.53,20.21,0,42.95,42.95,SKIPPED,11.4,11.4,42.95,42.95,42.95,21.3,24.76,24.76,0,15.16,21.73,21.73,42.95
4341757,250,J3490,,,,,,,DOCUSATE CALCIUM CAP [240,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341758,250,J3490,,,,,,,METRONIDAZOLE TABLET [500,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341760,250,J3490,,,,,,,THIORIDAZINE 25mg TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341761,250,J3490,,,,,,,IBUPROFEN [100MG/5ML],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341763,250,J0460,,,,,,,ATROPINE SULFATE INJ 0.4 INJ,25.54,10.22,0,21.71,21.71,SKIPPED,19.41,19.41,21.71,21.71,21.71,10.76,12.51,12.51,0,7.66,10.98,10.98,21.71
4341764,250,J3490,,,,,,,ROBITUSSIN DM DIABETIC [B,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341765,250,J3490,,,,,,,THEOPHYLLINE ANHYDROUS TA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341766,250,J3490,,,,,,,GENTAMICIN SULFATE OPTH,51.02,20.41,0,43.37,43.37,SKIPPED,38.78,38.78,43.37,43.37,43.37,21.5,25,25,0,15.31,21.94,21.94,43.37
4341767,250,J3490,,,,,,,ISOSORBIDE MONOITRATE TAB,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341768,250,J7509,,,,,,,METHYLPREDNISOLONE TABLET,7,2.8,0,5.95,5.95,SKIPPED,0.33,0.33,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341769,250,J3490,,,,,,,OXYBUTYNIN CHLORIDE TABLE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341770,250,J3490,,,,,,,AMITRIPTYLINE HCL TAB [25,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341772,250,J3490,,,,,,,ERYTHROMYCIN BASE OPTH OI,49.61,19.84,0,42.17,42.17,SKIPPED,37.7,37.7,42.17,42.17,42.17,20.9,24.31,24.31,0,14.88,21.33,21.33,42.17
4341776,250,J3490,,,,,,,LACTOBACILLUS PACKET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341777,250,J2001,,,,,,,LIDOCAINE HCL,14,5.6,0,11.9,11.9,SKIPPED,0.02,0.02,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341791,250,J3490,,,,,,,CAPTOPRIL TABLET [25MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341792,250,J3490,,,,,,,PHENYLEPHRINE HCL SPRAY,10.11,4.04,0,8.59,8.59,SKIPPED,7.68,7.68,8.59,8.59,8.59,4.26,4.95,4.95,0,3.03,4.35,4.35,8.59
4341793,250,J3490,,,,,,,THEOPHYLLINE ANHYDROUS TA,13.83,5.53,0,11.76,11.76,SKIPPED,10.51,10.51,11.76,11.76,11.76,5.83,6.78,6.78,0,4.15,5.95,5.95,11.76
4341795,250,J3490,,,,,,,ACTIVATED CHARCOAL [25 GM,44.42,17.77,0,37.76,37.76,SKIPPED,33.76,33.76,37.76,37.76,37.76,18.72,21.77,21.77,0,13.33,19.1,19.1,37.76
4341796,250,J3490,,,,,,,DOXAZOSIN MESYLATE TABLET,10.49,4.2,0,8.92,8.92,SKIPPED,7.97,7.97,8.92,8.92,8.92,4.42,5.14,5.14,0,3.15,4.51,4.51,8.92
4341797,250,J3490,,,,,,,EPHEDRIN SULFATE INJ(50MG,92.7,37.08,0,78.8,78.8,SKIPPED,70.45,70.45,78.8,78.8,78.8,39.06,45.42,45.42,0,27.81,39.86,39.86,78.8
4341800,250,J3490,,,,,,,CAPTOPRIL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341801,250,J3490,,,,,,,HYOSCYAMINE SULFATE TABLE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341802,250,J3490,,,,,,,ENALAPRIL TABLET [10MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341803,250,J3490,,,,,,,DIGOXIN ELIXIR [0.05MG/1M,7.45,2.98,0,6.33,6.33,SKIPPED,5.66,5.66,6.33,6.33,6.33,3.14,3.65,3.65,0,2.24,3.2,3.2,6.33
4341810,250,J3490,,,,,,,SODIUM CHLORIDE TABLET [1,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341813,250,J3490,,,,,,,AMOXICILLIN TRIHYDRATE SU,8.3,3.32,0,7.06,7.06,SKIPPED,6.31,6.31,7.06,7.06,7.06,3.5,4.07,4.07,0,2.49,3.57,3.57,7.06
4341826,250,J3490,,,,,,,NORTRIPTYLINE HCL CAPSULE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341827,250,J3490,,,,,,,METFORMIN HCL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341828,250,J3490,,,,,,,MULTIVITS TH W-CA FE OTH,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341829,250,J0330,,,,,,,SUCCINYLCHOLINE CHLORIDE,61.84,24.74,0,52.56,52.56,SKIPPED,0.17,0.17,52.56,52.56,52.56,26.06,30.3,30.3,0,18.55,26.59,26.59,52.56
4341830,250,J3490,,,,,,,METAMUCIL PACKET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341831,250,J3480,,,,,,,POTASSIUM CHLORIDE INJ,14,5.6,0,11.9,11.9,SKIPPED,0.04,0.04,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341834,250,J0171,,,,,,,EPINEPHRINE,799.81,319.92,0,679.84,679.84,SKIPPED,0.14,0.14,679.84,679.84,679.84,337.04,391.91,391.91,0,239.94,343.92,343.92,679.84
4341836,250,J3490,,,,,,,BACITRACIN ZINC OINT,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341839,250,J3490,,,,,,,SULFASALAZINE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341840,250,J1165,,,,,,,PHENYTOIN SODIUM INJ,14,5.6,0,11.9,11.9,SKIPPED,0.4,0.4,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341841,250,J3490,,,,,,,MECLIZINE HCL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341842,250,,,,,,,,ERY E-SUCC/SULFISOXAZOLE,42.56,17.02,0,36.18,36.18,SKIPPED,32.35,32.35,36.18,36.18,36.18,17.93,20.85,20.85,0,12.77,18.3,18.3,36.18
4341845,250,J3490,,,,,,,TRAZODONE HCL TABLET [50M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341849,250,J3490,,,,,,,ATENOLOL TABLET [100 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341850,250,J3490,,,,,,,CHLORDIAZEPOXIDE HCL CAPS,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341852,250,J1170,,,,,,,HYDROMORPHONE HCL 4MG INJ,14,5.6,0,11.9,11.9,SKIPPED,0.4,0.4,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341853,250,J0460,,,,,,,ATROPINE SULFATE INJ [0.4,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341855,250,J3490,,,,,,,ASCORBIC ACID TABLET [500,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341856,250,J3490,,,,,,,MAGNESIUM CHLORIDE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341857,250,J3490,,,,,,,MAGNESIUM HYDROXIDE/AL HY,12.16,4.86,0,10.34,10.34,SKIPPED,9.24,9.24,10.34,10.34,10.34,5.13,5.96,5.96,0,3.65,5.23,5.23,10.34
4341858,250,J3490,,,,,,,CEPHALEXIN MONOHYDRATE CA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341862,252,J3490,,,,,,,FAMOTIDINE TABLET [20MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341863,250,Q9968,,,,,,,METHYLENE BLUE,831.29,332.52,0,706.6,706.6,SKIPPED,1.16,1.16,706.6,706.6,706.6,350.3,407.33,407.33,0,249.39,357.45,357.45,706.6
4341864,250,J3490,,,,,,,SODIUM PHOS 15ml vial,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341865,250,J0610,,,,,,,CALCIUM GLUCONATE INJ 1GM,31.97,12.79,0,27.17,27.17,SKIPPED,2.07,2.07,27.17,27.17,27.17,13.48,15.67,15.67,0,9.59,13.75,13.75,27.17
4341866,250,J3490,,,,,,,LEVOTHYROXINE SODIUM TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341869,250,J3490,,,,,,,NYSTATIN SUSPENSION,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341870,250,J3490,,,,,,,NEO/POLYMYX B SULF/DEXAME,117.04,46.82,0,99.48,99.48,SKIPPED,88.95,88.95,99.48,99.48,99.48,49.32,57.35,57.35,0,35.11,50.33,50.33,99.48
4341874,250,J3490,,,,,,,FUROSEMIDE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341875,250,J3490,,,,,,,ACETAMINOPHEN ELIX CHILD,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341876,250,J3490,,,,,,,METRONIDAZOLE TABLET [250,3,1.2,0,2.55,2.55,SKIPPED,2.28,2.28,2.55,2.55,2.55,1.26,1.47,1.47,0,0.9,1.29,1.29,2.55
4341879,250,J3490,,,,,,,COLCHICINE TABLET[0.6MG],22.95,9.18,0,19.51,19.51,SKIPPED,17.44,17.44,19.51,19.51,19.51,9.67,11.25,11.25,0,6.88,9.87,9.87,19.51
4341882,250,J3490,,,,,,,BISMUTH SUBSALICYLATE LI,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341883,250,J3490,,,,,,,WARFARIN SODIUM TABLET 6M,9.51,3.8,0,8.08,8.08,SKIPPED,7.23,7.23,8.08,8.08,8.08,4.01,4.66,4.66,0,2.85,4.09,4.09,8.08
4341884,250,J3490,,,,,,,POTASSIUM PHOS M-BASIC-D-,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341888,250,J3490,,,,,,,SODIUM CHLORIDE 23.4% INJ,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341890,250,J3490,,,,,,,DOXAZOSIN MESYLATE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341892,250,J3475,,,,,,,MAGNESIUM 50% 10ML VIAL,25.12,10.05,0,21.35,21.35,SKIPPED,0.07,0.07,21.35,21.35,21.35,10.58,12.31,12.31,0,7.54,10.8,10.8,21.35
4341893,250,J3490,,,,,,,SODIUM NITROPRUSSIDE INJ,207.48,82.99,0,176.36,176.36,SKIPPED,157.68,157.68,176.36,176.36,176.36,87.44,101.67,101.67,0,62.24,89.22,89.22,176.36
4341899,250,J3490,,,,,,,ACYCLOVIR TAB [400 MG],9.96,3.98,0,8.47,8.47,SKIPPED,7.57,7.57,8.47,8.47,8.47,4.19,4.88,4.88,0,2.99,4.28,4.28,8.47
4341903,250,J3490,,,,,,,SENNOSIDES TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341905,250,J3490,,,,,,,BUPIVACAINE-MPF HCL 0.75%,15.16,6.06,0,12.89,12.89,SKIPPED,11.52,11.52,12.89,12.89,12.89,6.39,7.43,7.43,0,4.55,6.52,6.52,12.89
4341906,250,J7512,,,,,,,PREDNISONE TABLET,7,2.8,0,5.95,5.95,SKIPPED,0.01,0.01,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341911,250,J3490,,,,,,,TEMAZEPAM CAPSULE [15MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341916,250,J3490,,,,,,,FLUOXETINE 10MG TAB,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341920,250,J3490,,,,,,,ALLOPURINOL TAB [100 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341921,250,J1790,,,,,,,DROPERIDOL INJ [5MG/2ML],14,5.6,0,11.9,11.9,SKIPPED,1.67,1.67,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341926,250,J3490,,,,,,,SIMETHICONE TABLET [125MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341928,250,J3490,,,,,,,PROPRANOLOL HCL TABLET [2,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341929,250,J0280,,,,,,,THEOPHYLLINE INJ [500MG/2,14,5.6,0,11.9,11.9,SKIPPED,4.98,4.98,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341930,250,J3490,,,,,,,CYANOCOBALIM TABLET [500M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341931,250,J3490,,,,,,,CALCIUM CARBONATE/VITAMIN,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341932,250,J3490,,,,,,,DOXEPIN HCL CAP [25MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341934,250,J3490,,,,,,,TERAZOSIN HCL CAPSUAL [5M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341936,250,J3490,,,,,,,DIPHENHYDRAMINE CREAM,11.57,4.63,0,9.83,9.83,SKIPPED,8.79,8.79,9.83,9.83,9.83,4.88,5.67,5.67,0,3.47,4.98,4.98,9.83
4341938,250,J3490,,,,,,,LISINOPRIL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341939,250,J3490,,,,,,,LEVOTHYROXINE SODIUM TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341941,250,J3490,,,,,,,GUAIFENESIN PLAIN SYRUP[B,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341943,250,J3490,,,,,,,LIDOCAINE HCL/EPINEPHRINE,28.5,11.4,0,24.22,24.22,SKIPPED,21.66,21.66,24.22,24.22,24.22,12.01,13.96,13.96,0,8.55,12.26,12.26,24.22
4341948,250,J3490,,,,,,,NITROGLYCERIN CAPSULE [2.,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341952,250,J3490,,,,,,,LIDOCAINE HCL/EPINEPHRINE,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4341955,250,J3490,,,,,,,METHOCARBAMOL TABLET [500,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341956,250,J3490,,,,,,,EXCEDRIN MIGRAIN CPL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341959,250,J3490,,,,,,,ATENOLOL TABLET [50 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341965,250,J3490,,,,,,,RANITIDINE HCL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341967,250,J3490,,,,,,,DESONIDE CR. .05% (15G T,213.57,85.43,0,181.53,181.53,SKIPPED,162.31,162.31,181.53,181.53,181.53,90,104.65,104.65,0,64.07,91.84,91.84,181.53
4341970,250,J3490,,,,,,,SIMETHICONE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341972,250,J3490,,,,,,,HYDROXYZINE PAMOATEC CAPS,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341976,250,J3490,,,,,,,TRIAMCINOLONE ACETONIDE,22.34,8.94,0,18.99,18.99,SKIPPED,16.98,16.98,18.99,18.99,18.99,9.42,10.95,10.95,0,6.7,9.61,9.61,18.99
4341978,250,J3490,,,,,,,BELLADONNA ALKALOIDS/PHEN,59.85,23.94,0,50.87,50.87,SKIPPED,45.49,45.49,50.87,50.87,50.87,25.23,29.33,29.33,0,17.96,25.74,25.74,50.87
4341980,250,J3490,,,,,,,VITAMIN E CAPSULE [400 IU,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341982,250,J3490,,,,,,,CALCIUM CARBONATE/VITAMIN,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341983,250,J3490,,,,,,,CALCIUM CARBONATE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341986,250,J3490,,,,,,,PHENYLEPHRINE HCL NASAL,10.11,4.04,0,8.59,8.59,SKIPPED,7.68,7.68,8.59,8.59,8.59,4.26,4.95,4.95,0,3.03,4.35,4.35,8.59
4341988,250,J3490,,,,,,,PHENOBARBITAL TABLET [30M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341990,250,J3490,,,,,,,ASPIRIN TABLET EC [325 MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341991,250,J3490,,,,,,,DIAZEPAM TABLET [2MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341996,250,J3490,,,,,,,AMITRIPTYLINE HCL TAB [10,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4341998,250,J3490,,,,,,,PILOCARPINE HCL OPTH SOL,268.15,107.26,0,227.93,227.93,SKIPPED,203.79,203.79,227.93,227.93,227.93,112.99,131.39,131.39,0,80.44,115.3,115.3,227.93
4341999,250,J3490,,,,,,,CEPHALEXIN MONOHYDRATE SU,76.48,30.59,0,65.01,65.01,SKIPPED,58.12,58.12,65.01,65.01,65.01,32.23,37.48,37.48,0,22.94,32.89,32.89,65.01
4342003,250,J3490,,,,,,,ALPRAZOLAM TABLET [0.25 M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342004,250,J3490,,,,,,,DICYCLOMINE HCL CAPSUAL [,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342008,250,J3490,,,,,,,SIMETHICONEDROPS [40MG/0.,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342011,250,J7512,,,,,,,PREDNISONE TABLET,7,2.8,0,5.95,5.95,SKIPPED,0.01,0.01,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342012,250,J3490,,,,,,,DIPHENHYDRAMINE HCL ELIXI,12.1,4.84,0,10.28,10.28,SKIPPED,9.2,9.2,10.28,10.28,10.28,5.1,5.93,5.93,0,3.63,5.2,5.2,10.28
4342013,250,J3490,,,,,,,BISOPROL/HCTZ 5-6.25 TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342016,250,J3490,,,,,,,ISOSORBIDE DINITRATE TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342018,250,J3490,,,,,,,CALCIUM POLYCARBOPHIL TAB,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342019,250,J3490,,,,,,,NYSTATIN CREAM,69.82,27.93,0,59.35,59.35,SKIPPED,53.06,53.06,59.35,59.35,59.35,29.42,34.21,34.21,0,20.95,30.02,30.02,59.35
4342022,250,J3490,,,,,,,FLURBIPROFEN SODIUM OPT,23.22,9.29,0,19.74,19.74,SKIPPED,17.65,17.65,19.74,19.74,19.74,9.78,11.38,11.38,0,6.97,9.98,9.98,19.74
4342023,250,J3490,,,,,,,CHLORPHENIRAMINE MALEATE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342025,250,J3490,,,,,,,FERROUS SULFATE TABLET [3,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342026,250,J3490,,,,,,,MAG HYDROX/AL HYDROX/SIME,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342027,250,J3490,,,,,,,SULFAMETHOXAZOLE/TRIMETHO,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342030,250,J3490,,,,,,,GLIPIZIDE TABLET [5MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342031,252,J3490,,,,,,,WARFARIN SODIUM TABLET 5M,7.38,2.95,0,6.27,6.27,SKIPPED,5.61,5.61,6.27,6.27,6.27,3.11,3.62,3.62,0,2.21,3.17,3.17,6.27
4342032,250,J3490,,,,,,,GLYBURIDE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342034,252,J3490,,,,,,,WARFARIN SODIUM TABLET 4M,7.13,2.85,0,6.06,6.06,SKIPPED,5.42,5.42,6.06,6.06,6.06,3.01,3.49,3.49,0,2.14,3.07,3.07,6.06
4342035,252,J3490,,,,,,,WARFARIN SODIUM TABLET 3M,7.11,2.84,0,6.04,6.04,SKIPPED,5.4,5.4,6.04,6.04,6.04,3,3.48,3.48,0,2.13,3.06,3.06,6.04
4342036,250,J3490,,,,,,,BUPIVACAINE HCL/EPINEPHRI,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342038,252,J3490,,,,,,,WARFARIN SODIUM TABLET 2.,7.08,2.83,0,6.02,6.02,SKIPPED,5.38,5.38,6.02,6.02,6.02,2.98,3.47,3.47,0,2.12,3.04,3.04,6.02
4342039,250,J3490,,,,,,,HYDROCORTISONE CREAM,501.3,200.52,0,426.1,426.1,SKIPPED,380.99,380.99,426.1,426.1,426.1,211.25,245.64,245.64,0,150.39,215.56,215.56,426.1
4342042,252,J3490,,,,,,,WARFARIN SODIUM TABLET 2M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342044,252,J3490,,,,,,,WARFARIN SODIUM TABLET 1M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342046,250,J3490,,,,,,,GUAIFENESIN/CODEINE PHOS,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342049,250,J3490,,,,,,,SENNOSIDES/DOCUSATE SODIU,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342051,250,J3490,,,,,,,PHENAZOPYRIDINE HCL TABLE,7.18,2.87,0,6.1,6.1,SKIPPED,5.46,5.46,6.1,6.1,6.1,3.03,3.52,3.52,0,2.15,3.09,3.09,6.1
4342052,250,J3490,,,,,,,METOPROLOL TARTRATE TABLE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342054,250,J3490,,,,,,,LIDOCAINE HCL TOPICAL,127.68,51.07,0,108.53,108.53,SKIPPED,97.04,97.04,108.53,108.53,108.53,53.8,62.56,62.56,0,38.3,54.9,54.9,108.53
4342056,250,J3490,,,,,,,HYDROCORTISONE CR,19.15,7.66,0,16.28,16.28,SKIPPED,14.55,14.55,16.28,16.28,16.28,8.07,9.38,9.38,0,5.74,8.23,8.23,16.28
4342058,250,J3490,,,,,,,HYDRALAZINE HCL TABLET [1,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342063,250,J3490,,,,,,,ACETAMINOPHEN SUPP [120 M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342065,250,J3490,,,,,,,METOCLOPRAMIDE HCL SYRUP[,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342070,250,J3490,,,,,,,PILOCARPINE HCL OPTH SOL,262.17,104.87,0,222.84,222.84,SKIPPED,199.25,199.25,222.84,222.84,222.84,110.48,128.46,128.46,0,78.65,112.73,112.73,222.84
4342072,250,J3490,,,,,,,ASPIRIN SUPP [300 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342078,250,J3490,,,,,,,ESTRADIOL TABLET [1MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342079,250,J3490,,,,,,,PYRIDOXINE HCL TABLET [10,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342083,250,J3490,,,,,,,NEOMYCIN AND POLYMYXIN B,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342085,250,J3490,,,,,,,BISMUTH SUBSALICYLATE TAB,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342087,250,J3490,,,,,,,FOLIC ACID TABLET [400MCG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342089,250,J3490,,,,,,,MICONAZOLE NITRATE VAG CR,25.11,10.04,0,21.34,21.34,SKIPPED,19.08,19.08,21.34,21.34,21.34,10.58,12.3,12.3,0,7.53,10.8,10.8,21.34
4342090,250,J3490,,,,,,,NYSTATIN/TRIAMCIN CREAM,297.76,119.1,0,253.1,253.1,SKIPPED,226.3,226.3,253.1,253.1,253.1,125.48,145.9,145.9,0,89.33,128.04,128.04,253.1
4342095,250,J3490,,,,,,,HYDROCHLOROTHIAZIDE TABLE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342098,250,J3490,,,,,,,VITAMIN B COMPLEX TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342101,250,J2440,,,,,,,PAPAVERINE 30MG/ML INJ,132.18,52.87,0,112.35,112.35,SKIPPED,3.46,3.46,112.35,112.35,112.35,55.7,64.77,64.77,0,39.65,56.84,56.84,112.35
4342103,250,J3490,,,,,,,NIACIN TABLET [500MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342106,250,J3490,,,,,,,HYDROCORTISONE ACETATE [2,60.24,24.1,0,51.2,51.2,SKIPPED,45.78,45.78,51.2,51.2,51.2,25.38,29.52,29.52,0,18.07,25.9,25.9,51.2
4342107,250,J3490,,,,,,,NEOMY SULF/BACITRA/POLYMY,20.27,8.11,0,17.23,17.23,SKIPPED,15.41,15.41,17.23,17.23,17.23,8.55,9.93,9.93,0,6.08,8.72,8.72,17.23
4342110,250,J3490,,,,,,,CARBAMIDE PEROXIDE OTIC,20.85,8.34,0,17.72,17.72,SKIPPED,15.85,15.85,17.72,17.72,17.72,8.79,10.22,10.22,0,6.26,8.97,8.97,17.72
4342118,250,J3490,,,,,,,THIAMINE HCL TABLET [100M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342121,250,J3490,,,,,,,TRIAMCINOLONE ACETONIDE,29.53,11.81,0,25.1,25.1,SKIPPED,22.44,22.44,25.1,25.1,25.1,12.45,14.47,14.47,0,8.86,12.7,12.7,25.1
4342122,250,J3490,,,,,,,AMMONIA INHALANTS,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342124,250,J3490,,,,,,,ACETAMINOPHEN INFANT DROP,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342125,250,J3490,,,,,,,GLYCERIN CHILD SUPPOSITOR,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342126,250,J3490,,,,,,,NIACIN TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342127,250,J3490,,,,,,,CETACAINE SPRAY,18.99,7.6,0,16.14,16.14,SKIPPED,14.43,14.43,16.14,16.14,16.14,8.01,9.31,9.31,0,5.7,8.17,8.17,16.14
4342131,250,J3490,,,,,,,QUININE SULFATE 324MG TAB,14.08,5.63,0,11.97,11.97,SKIPPED,10.7,10.7,11.97,11.97,11.97,5.93,6.9,6.9,0,4.22,6.05,6.05,11.97
4342132,252,J3490,,,,,,,PRAMIPEXOLE DI-HCL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342133,252,J3490,,,,,,,TETANUS DIPHTHERIA TOXOID,215.41,86.16,0,183.1,183.1,SKIPPED,163.71,163.71,183.1,183.1,183.1,90.78,105.55,105.55,0,64.62,92.63,92.63,183.1
4342134,252,J1442,,,,,,,FILGRASTIM INJ,554.54,221.82,0,471.36,471.36,SKIPPED,0.98,0.98,471.36,471.36,471.36,233.68,271.72,271.72,0,166.36,238.45,238.45,471.36
4342142,250,J3490,,,,,,,MVI ADULT [UNIT VIAL MUL,37.13,14.85,0,31.56,31.56,SKIPPED,28.22,28.22,31.56,31.56,31.56,15.65,18.19,18.19,0,11.14,15.97,15.97,31.56
4342150,250,J3490,,,,,,,ASPIRIN/CALCIUM CARBONATE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342157,252,J3490,,,,,,,TROPICAMIDE OPTH SOL,71.15,28.46,0,60.48,60.48,SKIPPED,54.07,54.07,60.48,60.48,60.48,29.98,34.86,34.86,0,21.34,30.59,30.59,60.48
4342160,250,J3490,,,,,,,NEOMY SULF/GRAMICID D/POL,162.95,65.18,0,138.51,138.51,SKIPPED,123.84,123.84,138.51,138.51,138.51,68.67,79.85,79.85,0,48.88,70.07,70.07,138.51
4342162,258,J7070,,,,,,,D5W MINI BAG [50ML],115,46,0,97.75,97.75,SKIPPED,14.52,14.52,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342168,258,J7030,,,,,,,NS 0.9% BAG 1000ML,20,8,0,17,17,SKIPPED,16.53,16.53,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342169,250,J3490,,,,,,,ALPRAZOLAM TABLET [O.5 MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342170,252,J1815,,,,,,,INSULIN REGULAR HUMAN R--,47.47,18.99,0,40.35,40.35,SKIPPED,0.14,0.14,40.35,40.35,40.35,20,23.26,23.26,0,14.24,20.41,20.41,40.35
4342171,252,J1815,,,,,,,INSULIN REGULAR HUMAN R--,47.47,18.99,0,40.35,40.35,SKIPPED,0.14,0.14,40.35,40.35,40.35,20,23.26,23.26,0,14.24,20.41,20.41,40.35
4342172,252,J1815,,,,,,,INSULIN REGULAR HUMAN R--,47.47,18.99,0,40.35,40.35,SKIPPED,0.14,0.14,40.35,40.35,40.35,20,23.26,23.26,0,14.24,20.41,20.41,40.35
4342179,258,J7070,,,,,,,D5W BAG [100ML],115,46,0,97.75,97.75,SKIPPED,14.52,14.52,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342180,258,J3490,,,,,,,D10W BAG 1000ML,24.1,9.64,0,20.48,20.48,SKIPPED,18.32,18.32,20.48,20.48,20.48,10.15,11.81,11.81,0,7.23,10.36,10.36,20.48
4342181,250,J3490,,,,,,,STERILE WATER BAG [1000ML,14.42,5.77,0,12.26,12.26,SKIPPED,10.96,10.96,12.26,12.26,12.26,6.08,7.07,7.07,0,4.33,6.2,6.2,12.26
4342182,258,J1644,,,,,,,HEPARIN SODIUM PORCINE/D5,20,8,0,17,17,SKIPPED,0.19,0.19,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342183,250,J2001,,,,,,,LIDOCAINE 0.4% BAG,21.71,8.68,0,18.45,18.45,SKIPPED,0.02,0.02,18.45,18.45,18.45,9.15,10.64,10.64,0,6.51,9.34,9.34,18.45
4342184,258,J7042,,,,,,,D5NS BAG [1000ML],20,8,0,17,17,SKIPPED,1.6,1.6,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342185,258,J3490,,,,,,,D51/2NS BAG [1000ML],20,8,0,17,17,SKIPPED,15.2,15.2,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342186,258,J3490,,,,,,,D51/4 NS BAG [1000ML],20,8,0,17,17,SKIPPED,15.2,15.2,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342187,258,J3490,,,,,,,NS 0.9% BAG 50 ML,115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342189,258,J3490,,,,,,,NS 0.45 BAG [1000ML],20,8,0,17,17,SKIPPED,15.2,15.2,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342191,258,J3490,,,,,,,D51/2NS KCL 20MEQ BAG [10,20,8,0,17,17,SKIPPED,15.2,15.2,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342192,258,J3490,,,,,,,D5W 1/2NS KCL 40MEQ BAG,31.2,12.48,0,26.52,26.52,SKIPPED,23.71,23.71,26.52,26.52,26.52,13.15,15.29,15.29,0,9.36,13.42,13.42,26.52
4342193,258,J3490,,,,,,,NS KCL 20MEQ BAG [1000ML],31.15,12.46,0,26.48,26.48,SKIPPED,23.67,23.67,26.48,26.48,26.48,13.12,15.26,15.26,0,9.34,13.39,13.39,26.48
4342194,258,J3490,,,,,,,NS KCL 40MEQ BAG [1000ML],20,8,0,17,17,SKIPPED,15.2,15.2,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342195,258,J3490,,,,,,,D5NS KCL 20MEQ BAG [1000M,31.15,12.46,0,26.48,26.48,SKIPPED,23.67,23.67,26.48,26.48,26.48,13.12,15.26,15.26,0,9.34,13.39,13.39,26.48
4342197,258,J7131,,,,,,,NS 3% BAG [500ML],115,46,0,97.75,97.75,SKIPPED,0.01,0.01,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342198,258,J7121,,,,,,,D5LR BAG [1000ML],20,8,0,17,17,SKIPPED,0.01,0.01,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342199,258,J3490,,,,,,,NS BAG [2000 ML],17.62,7.05,0,14.98,14.98,SKIPPED,13.39,13.39,14.98,14.98,14.98,7.43,8.63,8.63,0,5.29,7.58,7.58,14.98
4342200,250,J3490,,,,,,,STERILE WATER IRRIGATION,12.69,5.08,0,10.79,10.79,SKIPPED,9.64,9.64,10.79,10.79,10.79,5.35,6.22,6.22,0,3.81,5.46,5.46,10.79
4342201,250,J3490,,,,,,,STERILE WATER IRRIGATION,16.76,6.7,0,14.25,14.25,SKIPPED,12.74,12.74,14.25,14.25,14.25,7.07,8.21,8.21,0,5.03,7.21,7.21,14.25
4342202,258,J7040,,,,,,,NS IRRIG BTL 500MG,20,8,0,17,17,SKIPPED,8.27,8.27,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342203,258,J3490,,,,,,,NS IRRIG BTL [1000 ML,12.82,5.13,0,10.9,10.9,SKIPPED,9.74,9.74,10.9,10.9,10.9,5.4,6.28,6.28,0,3.85,5.51,5.51,10.9
4342206,258,J3490,,,,,,,NS1/2 KCL 20MEQ BAG [100,23.09,9.24,0,19.63,19.63,SKIPPED,17.55,17.55,19.63,19.63,19.63,9.73,11.31,11.31,0,6.93,9.93,9.93,19.63
4342207,258,J3490,,,,,,,NS MINI BAG [50ML],115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342208,258,J7040,,,,,,,NS MINI BAG [100 ML],115,46,0,97.75,97.75,SKIPPED,8.27,8.27,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342209,258,J7070,,,,,,,D5W MINI BAG [100ML],115,46,0,97.75,97.75,SKIPPED,14.52,14.52,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342211,250,J3490,,,,,,,BUMETANIDE TAB [1MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342212,250,J3490,,,,,,,BUSPIRONE TAB [15MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342213,252,J3490,,,,,,,CARVEDILOL TAB [12.5MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342215,250,J3490,,,,,,,BENAZEPRIL HCL TABLET [20,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342216,252,J3490,,,,,,,CLARITHROMYCIN TAB [500MG,26.15,10.46,0,22.23,22.23,SKIPPED,19.87,19.87,22.23,22.23,22.23,11.02,12.81,12.81,0,7.84,11.24,11.24,22.23
4342217,250,J8540,,,,,,,DEXAMETHASONE TAB [4MG],7,2.8,0,5.95,5.95,SKIPPED,0.01,0.01,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342218,250,J3490,,,,,,,DILTIAZEM HCL CD CAPSULE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342219,250,J3490,,,,,,,DILTIAZEM HCL CD CAPSULE,7.13,2.85,0,6.06,6.06,SKIPPED,5.42,5.42,6.06,6.06,6.06,3.01,3.49,3.49,0,2.14,3.07,3.07,6.06
4342220,250,J3490,,,,,,,DILTIAZEM HCL TABLET [30M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342221,250,J3490,,,,,,,DILTIAZEM HCL TABLET [60M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342224,250,J3490,,,,,,,ERYTHROMYCIN TAB [250MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342226,250,J3490,,,,,,,ERYTHROMYCIN TAB [400MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342227,250,J3490,,,,,,,ETODOLAC TAB [400MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342229,250,J3490,,,,,,,GLIPIZIDE ER TAB [10MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342232,250,J1720,,,,,,,HYDROCORTISONE SOD. SUCCI,50.65,20.26,0,43.05,43.05,SKIPPED,2,2,43.05,43.05,43.05,21.34,24.82,24.82,0,15.2,21.78,21.78,43.05
4342234,250,J3490,,,,,,,ISOSORBIDE MONONITRATE ER,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342235,250,J3490,,,,,,,LABETALOL HCL TAB [100MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342236,250,J3490,,,,,,,LABETALOL HCL TAB [200MG],9.28,3.71,0,7.89,7.89,SKIPPED,7.05,7.05,7.89,7.89,7.89,3.91,4.55,4.55,0,2.78,3.99,3.99,7.89
4342237,250,J3490,,,,,,,LORAZEPAM TAB [1MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342238,250,J3490,,,,,,,METFORMIN HCL TAB [1000MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342239,250,J3490,,,,,,,METFORMIN HCL ER TAB [500,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342240,250,J3490,,,,,,,METHYLPREDNISOLONE SOD. S,265.28,106.11,0,225.49,225.49,SKIPPED,201.61,201.61,225.49,225.49,225.49,111.79,129.99,129.99,0,79.58,114.07,114.07,225.49
4342241,250,J3490,,,,,,,NITROFURANTOIN MONOHYDRAT,13.57,5.43,0,11.53,11.53,SKIPPED,10.31,10.31,11.53,11.53,11.53,5.72,6.65,6.65,0,4.07,5.84,5.84,11.53
4342242,250,J3490,,,,,,,NITROFURANTOIN CAP [50MG],11.75,4.7,0,9.99,9.99,SKIPPED,8.93,8.93,9.99,9.99,9.99,4.95,5.76,5.76,0,3.52,5.05,5.05,9.99
4342243,250,J3490,,,,,,,PROMETHAZINE/DEXTROMETHOR,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342244,250,J3490,,,,,,,PROMETHAZINE WITH CODEINE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342245,250,J3490,,,,,,,PROMETHAZINE PLAIN SYRUP,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342248,250,J3490,,,,,,,AMOXICILLIN TRIHYDRATE CA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342249,250,J3490,,,,,,,CARBAMAZIPINE TABLET [200,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342251,250,J3490,,,,,,,CIPROFLOXACIN HCL TAB [2,14.52,5.81,0,12.34,12.34,SKIPPED,11.04,11.04,12.34,12.34,12.34,6.12,7.11,7.11,0,4.36,6.24,6.24,12.34
4342252,252,J3490,,,,,,,CLONIDINE TTS-1 PATCH,88.11,35.24,0,74.89,74.89,SKIPPED,66.96,66.96,74.89,74.89,74.89,37.13,43.17,43.17,0,26.43,37.89,37.89,74.89
4342254,250,J3490,,,,,,,CONJUGATED ESTROGEN TABLE,20.38,8.15,0,17.32,17.32,SKIPPED,15.49,15.49,17.32,17.32,17.32,8.58,9.99,9.99,0,6.11,8.76,8.76,17.32
4342257,252,J3490,,,,,,,FEXOFENADINE HYDROCHLORID,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342258,250,J3490,,,,,,,FLECAINIDE ACETATE TABLET,9.52,3.81,0,8.09,8.09,SKIPPED,7.24,7.24,8.09,8.09,8.09,4.01,4.66,4.66,0,2.86,4.09,4.09,8.09
4342259,250,J3490,,,,,,,GABAPENTIN CAPSULE [100MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342261,250,J3490,,,,,,,GUAIFENESIN DAC BULK BTL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342263,250,J3490,,,,,,,NITROGLYCERIN TRANSDERMAL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342265,250,J3490,,,,,,,NITROGLYCERIN ER CAPSULE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342268,250,J3490,,,,,,,QUINAPRIL HCL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342269,250,J3490,,,,,,,QUINAPRIL HCL TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342270,252,J3490,,,,,,,TOLTERODINE TARTRATE ER C,32.27,12.91,0,27.43,27.43,SKIPPED,24.53,24.53,27.43,27.43,27.43,13.6,15.81,15.81,0,9.68,13.88,13.88,27.43
4342272,252,J3490,,,,,,,VENLAFAXINE XR HCL TAB [3,9.95,3.98,0,8.46,8.46,SKIPPED,7.56,7.56,8.46,8.46,8.46,4.19,4.88,4.88,0,2.98,4.28,4.28,8.46
4342273,252,J3490,,,,,,,VENLAFAXINE XR HCL CAPSU,13.52,5.41,0,11.49,11.49,SKIPPED,10.28,10.28,11.49,11.49,11.49,5.69,6.62,6.62,0,4.06,5.81,5.81,11.49
4342274,250,J3490,,,,,,,ENALAPRIL MALEATE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342275,250,J3490,,,,,,,ALBUTEROL SULFATE SYRUP B,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342277,250,J3490,,,,,,,AMPICILLIN CAP [250 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342278,250,J3490,,,,,,,AMPICILLIN CAP [500 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342279,250,J3490,,,,,,,BUSPIRONE HCL TAB [5MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342280,250,J3490,,,,,,,DILTIAZEM HCL SR CAPSULE,8.44,3.38,0,7.17,7.17,SKIPPED,6.41,6.41,7.17,7.17,7.17,3.56,4.14,4.14,0,2.53,3.63,3.63,7.17
4342281,250,J3490,,,,,,,CORTISONE ACETATE TAB [25,8.31,3.32,0,7.06,7.06,SKIPPED,6.32,6.32,7.06,7.06,7.06,3.5,4.07,4.07,0,2.49,3.57,3.57,7.06
4342282,250,J3490,,,,,,,NADOLOL TABLET [40MG],15.66,6.26,0,13.31,13.31,SKIPPED,11.9,11.9,13.31,13.31,13.31,6.6,7.67,7.67,0,4.7,6.73,6.73,13.31
4342283,252,J3490,,,,,,,WARFARIN SODIUM TABLET 7.,9.84,3.94,0,8.36,8.36,SKIPPED,7.48,7.48,8.36,8.36,8.36,4.15,4.82,4.82,0,2.95,4.23,4.23,8.36
4342285,250,J3490,,,,,,,TORSEMIDE TABLET [20MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342286,250,J3490,,,,,,,DIVALPROEX SODIUM ER TABL,10.84,4.34,0,9.21,9.21,SKIPPED,8.24,8.24,9.21,9.21,9.21,4.57,5.31,5.31,0,3.25,4.66,4.66,9.21
4342287,250,J3490,,,,,,,FERROUS SULFATE TABLET [1,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342290,250,J3490,,,,,,,HYDROXYZINE HCL TABLET [1,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342291,250,J3490,,,,,,,HYDROXYZINE HCL TABLET [2,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342292,250,J3490,,,,,,,HYDROCORTISONE TABLET [20,10.27,4.11,0,8.73,8.73,SKIPPED,7.81,7.81,8.73,8.73,8.73,4.33,5.03,5.03,0,3.08,4.42,4.42,8.73
4342293,250,J3490,,,,,,,TERAZOSIN HCL CAPSULE [1M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342294,250,J3490,,,,,,,PROPRANOLOL HCL CAP [80MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342295,250,J3490,,,,,,,PROPRANOLOL HCL LA CAPSUL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342296,250,J3490,,,,,,,ISOSORBIDE DINITRATE TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342299,250,J3490,,,,,,,DIPHENOXYLATE HCL/ATROPIN,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342301,250,J3490,,,,,,,PRAZOSIN HCL CAPSULE [1MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342302,250,J3490,,,,,,,FOSINOPRIL SODIUM TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342304,250,J3490,,,,,,,POTASSIUM PHOS M/SODIUM P,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342306,252,J3490,,,,,,,AMLODIPINE BESYLATE [10 M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342307,250,J3490,,,,,,,PENICILLIN V POTASSIUM TA,3,1.2,0,2.55,2.55,SKIPPED,2.28,2.28,2.55,2.55,2.55,1.26,1.47,1.47,0,0.9,1.29,1.29,2.55
4342308,250,J3490,,,,,,,PENICILLIN V POTASSIUM TA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342310,250,J3490,,,,,,,FELODIPINE ER TABLETS [10,7.22,2.89,0,6.14,6.14,SKIPPED,5.49,5.49,6.14,6.14,6.14,3.04,3.54,3.54,0,2.17,3.1,3.1,6.14
4342311,250,J7512,,,,,,,PREDNISONE TABLET,7,2.8,0,5.95,5.95,SKIPPED,0.01,0.01,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342314,250,J3490,,,,,,,DOXEPIN HCL CAP [10MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342315,250,J3490,,,,,,,POTASSIUM CHLORIDE ER TAB,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342317,250,J3490,,,,,,,SPIRONOLACTONE TABLET [25,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342318,250,J3490,,,,,,,LEVOTHYROXINE SODIUM TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342322,250,J3490,,,,,,,THYROID 1GRAIN TAB ( 60MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342323,250,J3490,,,,,,,IMIPRAMINE TABLET [25MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342325,250,J3490,,,,,,,PENTOXIFYLLINE ER TAB [40,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342328,250,J3490,,,,,,,FLAVOXATE HCL TAB [100MG],4.02,1.61,0,3.42,3.42,SKIPPED,3.06,3.06,3.42,3.42,3.42,1.7,1.97,1.97,0,1.21,1.73,1.73,3.42
4342329,250,J3490,,,,,,,VITAMIN C TAB [500MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342330,250,J3490,,,,,,,ZINC SULFATE CAPSULE [220,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342331,250,J3490,,,,,,,ZINC GLUCONATE CAPLET [50,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342332,250,J3490,,,,,,,ALLOPURINOL TAB [300 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342333,250,J3490,,,,,,,METOLAZONE TAB [2.5MG],8.74,3.5,0,7.43,7.43,SKIPPED,6.64,6.64,7.43,7.43,7.43,3.68,4.28,4.28,0,2.62,3.76,3.76,7.43
4342334,252,J0133,,,,,,,ACYCLOVIR INJ [500 MG],111.72,44.69,0,94.96,94.96,SKIPPED,0.05,0.05,94.96,94.96,94.96,47.08,54.74,54.74,0,33.52,48.04,48.04,94.96
4342335,250,J1451,,,,,,,FOMEPIZOLE INJ [1GM],3277.55,1311.02,0,2785.92,2785.92,SKIPPED,7.43,7.43,2785.92,2785.92,2785.92,1381.16,1606,1606,0,983.26,1409.35,1409.35,2785.92
4342336,250,J0360,,,,,,,HYDRALAZINE HCL INJ [20MG,45.71,18.28,0,38.85,38.85,SKIPPED,6.35,6.35,38.85,38.85,38.85,19.27,22.4,22.4,0,13.71,19.66,19.66,38.85
4342337,250,J0460,,,,,,,ATROPINE SULFATE INJ [0.5,35.13,14.05,0,29.86,29.86,SKIPPED,26.7,26.7,29.86,29.86,29.86,14.81,17.21,17.21,0,10.54,15.11,15.11,29.86
4342340,250,J0744,,,,,,,CIPROFLOXACIN INJ [400MG,79.8,31.92,0,67.83,67.83,SKIPPED,1.17,1.17,67.83,67.83,67.83,33.62,39.1,39.1,0,23.94,34.31,34.31,67.83
4342344,250,J1250,,,,,,,DOBUTAMINE INJ [250MG/20M,17.98,7.19,0,15.28,15.28,SKIPPED,2.85,2.85,15.28,15.28,15.28,7.58,8.81,8.81,0,5.39,7.73,7.73,15.28
4342346,250,J3410,,,,,,,HYDROXYZINE INJ [25MG/ML,74.12,29.65,0,63,63,SKIPPED,0.49,0.49,63,63,63,31.23,36.32,36.32,0,22.24,31.87,31.87,63
4342347,250,J3490,,,,,,,LIDOCAINE HCL INJ [50MG/5,27,10.8,0,22.95,22.95,SKIPPED,20.52,20.52,22.95,22.95,22.95,11.38,13.23,13.23,0,8.1,11.61,11.61,22.95
4342348,250,J2150,,,,,,,MANNITOL INJ [12.5GM/50ML,15.51,6.2,0,13.18,13.18,SKIPPED,1.49,1.49,13.18,13.18,13.18,6.54,7.6,7.6,0,4.65,6.67,6.67,13.18
4342349,250,J3490,,,,,,,NAFCILLIN SODIUM INJ [1 G,38.57,15.43,0,32.78,32.78,SKIPPED,29.31,29.31,32.78,32.78,32.78,16.26,18.9,18.9,0,11.57,16.59,16.59,32.78
4342350,250,J3260,,,,,,,TOBRAMYCIN INJ [80MG/2ML],14,5.6,0,11.9,11.9,SKIPPED,1.15,1.15,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342351,250,J2710,,,,,,,NEOSTIGMINE METHYLSULFATE,89.38,35.75,0,75.97,75.97,SKIPPED,0.18,0.18,75.97,75.97,75.97,37.66,43.8,43.8,0,26.81,38.43,38.43,75.97
4342352,250,J2300,,,,,,,NALBUPHINE HCL INJ [20MG/,20.18,8.07,0,17.15,17.15,SKIPPED,1.65,1.65,17.15,17.15,17.15,8.51,9.89,9.89,0,6.05,8.68,8.68,17.15
4342353,250,J2300,,,,,,,NALBUPHINE HCL INJ [10MG,14,5.6,0,11.9,11.9,SKIPPED,1.65,1.65,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342354,250,J3490,,,,,,,PHYSOSTIGMINE SALICYLATE,249.89,99.96,0,212.41,212.41,SKIPPED,189.92,189.92,212.41,212.41,212.41,105.3,122.45,122.45,0,74.97,107.45,107.45,212.41
4342355,250,J1165,,,,,,,PHENYTOIN SODIUM INJ [100,14,5.6,0,11.9,11.9,SKIPPED,0.4,0.4,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342356,250,J2370,,,,,,,PHENYLEPHRINE HCL INJ [1,14,5.6,0,11.9,11.9,SKIPPED,0.89,0.89,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342359,250,J2730,,,,,,,PRALIDOXIME CHLORIDE INJ,276.75,110.7,0,235.24,235.24,SKIPPED,86.7,86.7,235.24,235.24,235.24,116.62,135.61,135.61,0,83.02,119,119,235.24
4342361,250,J2800,,,,,,,METHOCARBAMOL INJ [100MG/,89.38,35.75,0,75.97,75.97,SKIPPED,39.46,39.46,75.97,75.97,75.97,37.66,43.8,43.8,0,26.81,38.43,38.43,75.97
4342362,250,J3490,,,,,,,BUPIVACAINE HCL SPINAL IN,14.47,5.79,0,12.3,12.3,SKIPPED,11,11,12.3,12.3,12.3,6.1,7.09,7.09,0,4.34,6.22,6.22,12.3
4342363,250,J2795,,,,,,,ROPIVACAINE HCL INJ [5MG/,90.08,36.03,0,76.57,76.57,SKIPPED,0.05,0.05,76.57,76.57,76.57,37.96,44.14,44.14,0,27.02,38.73,38.73,76.57
4342364,250,J3490,,,,,,,BUPIVACAINE HCL-MPF 0.5 I,20.11,8.04,0,17.09,17.09,SKIPPED,15.28,15.28,17.09,17.09,17.09,8.48,9.85,9.85,0,6.03,8.65,8.65,17.09
4342365,250,J3490,,,,,,,BUPIVACAINE HCL-MPF 0.25/,21.55,8.62,0,18.32,18.32,SKIPPED,16.38,16.38,18.32,18.32,18.32,9.08,10.56,10.56,0,6.46,9.27,9.27,18.32
4342366,250,J3490,,,,,,,BUPIVACAINE HCL .25 INJ,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342369,250,J3250,,,,,,,TRIMETHOBENZAMIDE INJ [2,70.99,28.4,0,60.34,60.34,SKIPPED,27.36,27.36,60.34,60.34,60.34,29.92,34.79,34.79,0,21.3,30.53,30.53,60.34
4342370,250,J3490,,,,,,,ALUMINUM HYDROXIDE MAG. S,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342371,250,J3490,,,,,,,VASOPRESSIN INJ [20U./1ML,630.61,252.24,0,536.02,536.02,SKIPPED,479.26,479.26,536.02,536.02,536.02,265.74,309,309,0,189.18,271.16,271.16,536.02
4342372,250,J2780,,,,,,,RANITIDINE HCL INJ [50MG/,41.15,16.46,0,34.98,34.98,SKIPPED,4.46,4.46,34.98,34.98,34.98,17.34,20.16,20.16,0,12.34,17.69,17.69,34.98
4342373,250,J3490,,,,,,,LIDOCAINE HCL-MPF INJ [10,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342374,250,J3490,,,,,,,LIDOCAINE-MPF INJ [20MG/M,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342375,250,J3010,,,,,,,FENTANYL AMP [50MCG/ML],14,5.6,0,11.9,11.9,SKIPPED,0.39,0.39,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342376,250,J3490,,,,,,,METHYLPHENIDATE TABLET 5,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342381,250,J3490,,,,,,,FENTANYL PATCH (25),56.57,22.63,0,48.08,48.08,SKIPPED,42.99,42.99,48.08,48.08,48.08,23.84,27.72,27.72,0,16.97,24.33,24.33,48.08
4342382,250,J3490,,,,,,,FENTANYL PATCH (100),142.07,56.83,0,120.76,120.76,SKIPPED,107.97,107.97,120.76,120.76,120.76,59.87,69.61,69.61,0,42.62,61.09,61.09,120.76
4342384,250,J3490,,,,,,,VALPROATE SODIUM INJ [500,101.24,40.5,0,86.05,86.05,SKIPPED,76.94,76.94,86.05,86.05,86.05,42.66,49.61,49.61,0,30.37,43.53,43.53,86.05
4342385,250,J3490,,,,,,,SODIUM CITRATE BULK BTL,13.57,5.43,0,11.53,11.53,SKIPPED,10.31,10.31,11.53,11.53,11.53,5.72,6.65,6.65,0,4.07,5.84,5.84,11.53
4342386,250,J3490,,,,,,,CHOLESTYRAMINE POWDER [4,8.96,3.58,0,7.62,7.62,SKIPPED,6.81,6.81,7.62,7.62,7.62,3.77,4.39,4.39,0,2.69,3.85,3.85,7.62
4342387,250,J3490,,,,,,,POLYETHYLENE GLYCOL POWDE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342390,250,J3490,,,,,,,POTASSIUM EFFERVESCENT TA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342392,250,J3490,,,,,,,METHYLCELLULOSE FIBER,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342393,252,J3490,,,,,,,CONJUGATED ESTROGEN VAG.,160.04,64.02,0,136.03,136.03,SKIPPED,121.63,121.63,136.03,136.03,136.03,67.44,78.42,78.42,0,48.01,68.82,68.82,136.03
4342397,250,J3490,,,,,,,HETASTARCH BAG,48.65,19.46,0,41.35,41.35,SKIPPED,36.97,36.97,41.35,41.35,41.35,20.5,23.84,23.84,0,14.6,20.92,20.92,41.35
4342398,250,J3490,,,,,,,ACETAMINOPHEN/CODIENE #3,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342400,250,J3490,,,,,,,OXAZEPAM CAPSULE [10MG],7.61,3.04,0,6.47,6.47,SKIPPED,5.78,5.78,6.47,6.47,6.47,3.2,3.73,3.73,0,2.28,3.27,3.27,6.47
4342401,250,J3490,,,,,,,OXAZEPAM CAPSULE,8.38,3.35,0,7.12,7.12,SKIPPED,6.37,6.37,7.12,7.12,7.12,3.53,4.11,4.11,0,2.51,3.6,3.6,7.12
4342403,250,J3490,,,,,,,DIAZEPAM TABLET [5MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342406,250,J3490,,,,,,,BUTALBITAL ASPIRIN/CAFFIN,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342407,250,J3490,,,,,,,CHLORDIAZEPOXIDE HYDROCHL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342410,250,J3490,,,,,,,LINDANE SHAMPOO,26.84,10.74,0,22.81,22.81,SKIPPED,20.4,20.4,22.81,22.81,22.81,11.31,13.15,13.15,0,8.05,11.54,11.54,22.81
4342411,250,J3490,,,,,,,LINDANE LOTION 1%,10.31,4.12,0,8.76,8.76,SKIPPED,7.84,7.84,8.76,8.76,8.76,4.34,5.05,5.05,0,3.09,4.43,4.43,8.76
4342412,250,J3490,,,,,,,FLUORESCEIN SODIUM OPTH S,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342415,250,J3490,,,,,,,TRIAMCINOLONE ACETONIDE D,150.12,60.05,0,127.6,127.6,SKIPPED,114.09,114.09,127.6,127.6,127.6,63.26,73.56,73.56,0,45.04,64.55,64.55,127.6
4342416,250,J3490,,,,,,,PHENYLEPHRINE HCL OPTH S,127.68,51.07,0,108.53,108.53,SKIPPED,97.04,97.04,108.53,108.53,108.53,53.8,62.56,62.56,0,38.3,54.9,54.9,108.53
4342417,250,J3490,,,,,,,FLUOROMETHOLONE OPTH SUSP,453.53,181.41,0,385.5,385.5,SKIPPED,344.68,344.68,385.5,385.5,385.5,191.12,222.23,222.23,0,136.06,195.02,195.02,385.5
4342419,250,J3490,,,,,,,TETRACAINE HCL OPTH SOL,37.19,14.88,0,31.61,31.61,SKIPPED,28.26,28.26,31.61,31.61,31.61,15.67,18.22,18.22,0,11.16,15.99,15.99,31.61
4342421,250,J3490,,,,,,,TETRAHYDROZOLINE HCL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342422,250,J3490,,,,,,,NEOMYCIN/POLYMYXIN B AND,360.8,144.32,0,306.68,306.68,SKIPPED,274.21,274.21,306.68,306.68,306.68,152.04,176.79,176.79,0,108.24,155.14,155.14,306.68
4342424,250,J3490,,,,,,,PILOCARPINE HCL OPTH SOL.,268.15,107.26,0,227.93,227.93,SKIPPED,203.79,203.79,227.93,227.93,227.93,112.99,131.39,131.39,0,80.44,115.3,115.3,227.93
4342427,250,J7641,,,,,,,FLUNISOLIDE NASAL INH,191.36,76.54,0,162.66,162.66,SKIPPED,145.43,145.43,162.66,162.66,162.66,80.63,93.77,93.77,0,57.41,82.28,82.28,162.66
4342430,250,J3490,,,,,,,NEOMYCIN/ POLYMYXIN B SUL,278.98,111.59,0,237.13,237.13,SKIPPED,212.02,212.02,237.13,237.13,237.13,117.56,136.7,136.7,0,83.69,119.96,119.96,237.13
4342432,250,J3490,,,,,,,OXYMETAZOLINE NASAL SPRA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342434,250,J3490,,,,,,,BENGAY CREAM 2 OZ TUBE,11.49,4.6,0,9.77,9.77,SKIPPED,8.73,8.73,9.77,9.77,9.77,4.84,5.63,5.63,0,3.45,4.94,4.94,9.77
4342444,250,J3490,,,,,,,ZINC OXIDE OINTMENT,8.25,3.3,0,7.01,7.01,SKIPPED,6.27,6.27,7.01,7.01,7.01,3.48,4.04,4.04,0,2.48,3.55,3.55,7.01
4342445,250,J3490,,,,,,,CARMEX,7.95,3.18,0,6.76,6.76,SKIPPED,6.04,6.04,6.76,6.76,6.76,3.35,3.9,3.9,0,2.38,3.42,3.42,6.76
4342446,250,J3490,,,,,,,ZINC OXIDE DIAPER RASH OI,11.94,4.78,0,10.15,10.15,SKIPPED,9.07,9.07,10.15,10.15,10.15,5.03,5.85,5.85,0,3.58,5.13,5.13,10.15
4342448,250,J3490,,,,,,,FLUOCINOLONE ACETONIDE CR,93.37,37.35,0,79.36,79.36,SKIPPED,70.96,70.96,79.36,79.36,79.36,39.35,45.75,45.75,0,28.01,40.15,40.15,79.36
4342449,250,J3490,,,,,,,FLUOCINONIDE OINTMENT,89.83,35.93,0,76.36,76.36,SKIPPED,68.27,68.27,76.36,76.36,76.36,37.86,44.02,44.02,0,26.95,38.63,38.63,76.36
4342451,250,J3490,,,,,,,CLOTRIMAZOLE CREAM (ANTIF,22.85,9.14,0,19.42,19.42,SKIPPED,17.37,17.37,19.42,19.42,19.42,9.63,11.2,11.2,0,6.86,9.83,9.83,19.42
4342452,250,J3490,,,,,,,DESONIDE CREAM 0.05% (60G,41.5,16.6,0,35.28,35.28,SKIPPED,31.54,31.54,35.28,35.28,35.28,17.49,20.34,20.34,0,12.45,17.85,17.85,35.28
4342453,250,J3490,,,,,,,PREPARATION H CREAM 1%,17.9,7.16,0,15.22,15.22,SKIPPED,13.6,13.6,15.22,15.22,15.22,7.55,8.77,8.77,0,5.37,7.7,7.7,15.22
4342454,252,J3490,,,,,,,XENADERM CREAM,157.07,62.83,0,133.51,133.51,SKIPPED,119.37,119.37,133.51,133.51,133.51,66.19,76.96,76.96,0,47.12,67.54,67.54,133.51
4342455,250,J3490,,,,,,,NEOMYCIN/POLYNTXINB AND B,9.39,3.76,0,7.98,7.98,SKIPPED,7.14,7.14,7.98,7.98,7.98,3.96,4.6,4.6,0,2.82,4.04,4.04,7.98
4342456,250,J3490,,,,,,,MAFENIDE ACETATE CREAM,193.17,77.27,0,164.19,164.19,SKIPPED,146.81,146.81,164.19,164.19,164.19,81.4,94.65,94.65,0,57.95,83.06,83.06,164.19
4342459,250,J3490,,,,,,,FLUCONAZOLE TABLET [100MG,63.84,25.54,0,54.26,54.26,SKIPPED,48.52,48.52,54.26,54.26,54.26,26.9,31.28,31.28,0,19.15,27.45,27.45,54.26
4342461,252,J3490,,,,,,,RIZATRIPTAN BENZOATE TABL,96.75,38.7,0,82.24,82.24,SKIPPED,73.53,73.53,82.24,82.24,82.24,40.77,47.41,47.41,0,29.02,41.6,41.6,82.24
4342462,250,J3490,,,,,,,LITHIUM CARBONATE TABLET[,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342463,250,J3490,,,,,,,INDAPAMIDE TABLET [2.5MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342464,252,J3490,,,,,,,LOSARTAN POTASSIUM TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342466,250,J3490,,,,,,,CLOTRIMAZOLE TABLET [10MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342467,250,J3490,,,,,,,MIRTAZAPINE TABLET [15MG],7.22,2.89,0,6.14,6.14,SKIPPED,5.49,5.49,6.14,6.14,6.14,3.04,3.54,3.54,0,2.17,3.1,3.1,6.14
4342468,250,J3490,,,,,,,PAROXETINE HCL TABLET [10,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342469,250,J3490,,,,,,,DIPYRIDAMOLE TABLET [25MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342473,252,J3490,,,,,,,QUETIAPINE FUMARATE TABLE,17.23,6.89,0,14.65,14.65,SKIPPED,13.09,13.09,14.65,14.65,14.65,7.26,8.44,8.44,0,5.17,7.41,7.41,14.65
4342477,250,J3490,,,,,,,SCOPOLAMINE TRANSDERMAL S,67.98,27.19,0,57.78,57.78,SKIPPED,51.66,51.66,57.78,57.78,57.78,28.65,33.31,33.31,0,20.39,29.23,29.23,57.78
4342479,250,J3490,,,,,,,ACETAMIN/COD SOL 120MG/12,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342481,250,J3490,,,,,,,HYDROCODONE/CHLORPHENIRAM,7.81,3.12,0,6.64,6.64,SKIPPED,5.94,5.94,6.64,6.64,6.64,3.29,3.83,3.83,0,2.34,3.36,3.36,6.64
4342482,250,J3490,,,,,,,SILVER NITRATE APPLICATOR,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342490,250,J3490,,,,,,,ERYTHROMYCIN SUSPENSION(B,319.2,127.68,0,271.32,271.32,SKIPPED,242.59,242.59,271.32,271.32,271.32,134.51,156.41,156.41,0,95.76,137.26,137.26,271.32
4342491,250,J3490,,,,,,,VALPROIC ACID SYRUP (BUL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342498,250,J3490,,,,,,,FUROSEMIDE SOLUTION (BUL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342500,250,J3490,,,,,,,ACETAMINOPHEN SUPP [325MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342501,250,J3490,,,,,,,ASPIRIN SUPP [600 MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342502,250,J3490,,,,,,,GLYCERIN ADULT SUPPOSITOR,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342504,250,J3490,,,,,,,PREPARATION-H HEMORRHOIDA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342505,250,90656,,,,,,,INFLUENZA VACCINE INJ [O,119.48,47.79,0,101.56,101.56,SKIPPED,12.3,12.3,101.56,101.56,101.56,50.35,58.55,58.55,0,35.84,51.38,51.38,101.56
4342508,250,J0630,,,,,,,CALCITONIN-SALMON INJ [20,4998.83,1999.53,0,4249.01,4249.01,SKIPPED,2252.44,2252.44,4249.01,4249.01,4249.01,2106.51,2449.43,2449.43,0,1499.65,2149.5,2149.5,4249.01
4342509,250,J2354,,,,,,,OCTREOTIDE ACETATE INJ [1,85.69,34.28,0,72.84,72.84,SKIPPED,0.31,0.31,72.84,72.84,72.84,36.11,41.99,41.99,0,25.71,36.85,36.85,72.84
4342513,250,90707,,,,,,,MEASLES/MUMP/RUBELLA LIVE,277.51,111,0,235.88,235.88,SKIPPED,42.08,42.08,235.88,235.88,235.88,116.94,135.98,135.98,0,83.25,119.33,119.33,235.88
4342514,252,90744,,,,,,,HEPATITIS B PEDI/ADOLESC,83.66,33.46,0,71.11,71.11,SKIPPED,19.51,19.51,71.11,71.11,71.11,35.25,40.99,40.99,0,25.1,35.97,35.97,71.11
4342515,252,J1571,,,,,,,HEPATITIS B IMMUNE (HUMAN,564.66,225.86,0,479.96,479.96,SKIPPED,69.94,69.94,479.96,479.96,479.96,237.94,276.68,276.68,0,169.4,242.8,242.8,479.96
4342517,250,J3490,,,,,,,CANDIDA ALBICANS SKIN TE,77.57,31.03,0,65.93,65.93,SKIPPED,58.95,58.95,65.93,65.93,65.93,32.69,38.01,38.01,0,23.27,33.36,33.36,65.93
4342518,250,J3490,,,,,,,TETANUS TOXID ADSORBED IN,256.82,102.73,0,218.3,218.3,SKIPPED,195.18,195.18,218.3,218.3,218.3,108.22,125.84,125.84,0,77.05,110.43,110.43,218.3
4342519,250,J3490,,,,,,,DIMENHYDRINATE TABLET [50,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342521,252,J3490,,,,,,,LOSARTAN POTASSIUM-HYDROC,8.51,3.4,0,7.23,7.23,SKIPPED,6.47,6.47,7.23,7.23,7.23,3.59,4.17,4.17,0,2.55,3.66,3.66,7.23
4342522,250,J3490,,,,,,,GLUCOSAMINE 500 MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342524,252,J3490,,,,,,,AMLODIPINE/BENAZEPRIL HCL,33.6,13.44,0,28.56,28.56,SKIPPED,25.54,25.54,28.56,28.56,28.56,14.16,16.46,16.46,0,10.08,14.45,14.45,28.56
4342525,250,J3490,,,,,,,ISONIAZID TABLET [300MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342526,250,J3490,,,,,,,HYOSCYAMINE SULFATE SUBLI,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342528,250,J3490,,,,,,,TORSEMIDE TAB [100MG],8.09,3.24,0,6.88,6.88,SKIPPED,6.15,6.15,6.88,6.88,6.88,3.41,3.96,3.96,0,2.43,3.48,3.48,6.88
4342530,250,J3490,,,,,,,MAGNESIUM OXIDE TAB [400M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342534,250,J3490,,,,,,,LUTEIN CAP [20MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342539,250,J3490,,,,,,,PYRIDOSTIGMINE BROMIDE TA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342540,250,J3490,,,,,,,MEDROXY-PROGESTERONE ACET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342541,250,J3490,,,,,,,PROPYLTHIOURACIL TAB [50M,8.94,3.58,0,7.6,7.6,SKIPPED,6.79,6.79,7.6,7.6,7.6,3.76,4.38,4.38,0,2.68,3.84,3.84,7.6
4342542,252,J3490,,,,,,,TOPIRAMAT TAB [100MG],16.49,6.6,0,14.02,14.02,SKIPPED,12.53,12.53,14.02,14.02,14.02,6.95,8.08,8.08,0,4.95,7.09,7.09,14.02
4342546,252,J3490,,,,,,,OXCARBAZEPINE TAB [600MG],12.83,5.13,0,10.91,10.91,SKIPPED,9.75,9.75,10.91,10.91,10.91,5.41,6.29,6.29,0,3.85,5.52,5.52,10.91
4342547,250,J3490,,,,,,,GLIMEPIRIDE TAB [2MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342551,252,J3490,,,,,,,IRBESARTON-HCTZ TABLETS,9.88,3.95,0,8.4,8.4,SKIPPED,7.51,7.51,8.4,8.4,8.4,4.16,4.84,4.84,0,2.96,4.25,4.25,8.4
4342552,252,J3490,,,,,,,ENTACAPONE TABLETS [200MG,24.61,9.84,0,20.92,20.92,SKIPPED,18.7,18.7,20.92,20.92,20.92,10.37,12.06,12.06,0,7.38,10.58,10.58,20.92
4342554,250,J3490,,,,,,,NIACIN ER TABLETS,24.54,9.82,0,20.86,20.86,SKIPPED,18.65,18.65,20.86,20.86,20.86,10.34,12.02,12.02,0,7.36,10.55,10.55,20.86
4342555,252,J3490,,,,,,,EZETIMIBE [10MG],36.71,14.68,0,31.2,31.2,SKIPPED,27.9,27.9,31.2,31.2,31.2,15.47,17.99,17.99,0,11.01,15.79,15.79,31.2
4342556,250,J3490,,,,,,,CYPROHEPTADINE TABLETS [4,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342558,250,J3490,,,,,,,SOTALOL HCL TABLET [80MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342559,252,J3490,,,,,,,CLARITHROMYCIN ER TABLET,25.7,10.28,0,21.84,21.84,SKIPPED,19.53,19.53,21.84,21.84,21.84,10.83,12.59,12.59,0,7.71,11.05,11.05,21.84
4342560,252,J3490,,,,,,,MESALAMINE DELAYED-RELEAS,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342563,252,J3490,,,,,,,RAMIPRIL CAPSULE [10MG],24.43,9.77,0,20.77,20.77,SKIPPED,18.57,18.57,20.77,20.77,20.77,10.29,11.97,11.97,0,7.33,10.5,10.5,20.77
4342568,252,J3490,,,,,,,CETIRIZINE HCL TABLET [10,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342569,252,S0119,,,,,,,ONDANSETRON HCL TABLET [4,65.91,26.36,0,56.02,56.02,SKIPPED,2.56,2.56,56.02,56.02,56.02,27.77,32.3,32.3,0,19.77,28.34,28.34,56.02
4342570,250,J3490,,,,,,,CHOLECALCIFEROL TABLET [4,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342572,250,J3490,,,,,,,BISOPROLO FUMARATE TAB [5,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342574,252,J3490,,,,,,,IRBESARTAN TABLET [150MG],9.08,3.63,0,7.72,7.72,SKIPPED,6.9,6.9,7.72,7.72,7.72,3.82,4.45,4.45,0,2.72,3.9,3.9,7.72
4342580,250,J1815,,,,,,,INSULIN DRIP [100 UNITS/M,47.47,18.99,0,40.35,40.35,SKIPPED,0.14,0.14,40.35,40.35,40.35,20,23.26,23.26,0,14.24,20.41,20.41,40.35
4342581,250,J3475,,,,,,,MAGNESIUM SULFATE [5GM/10,115,46,0,97.75,97.75,SKIPPED,0.07,0.07,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342582,250,J3490,,,,,,,METOPROLOL SUCCINATE TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342585,258,J7070,,,,,,,D5W BAG [250ML],20,8,0,17,17,SKIPPED,14.52,14.52,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342586,250,J3490,,,,,,,AMOXICILLIN TRIHYDRATE SU,14.13,5.65,0,12.01,12.01,SKIPPED,10.74,10.74,12.01,12.01,12.01,5.96,6.92,6.92,0,4.24,6.08,6.08,12.01
4342588,250,J3490,,,,,,,SODIUM CHLORIDE INHAL 3%,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342590,250,J3490,,,,,,,AMOX TR/POTASSIUM CLAVULA,16.23,6.49,0,13.8,13.8,SKIPPED,12.33,12.33,13.8,13.8,13.8,6.84,7.95,7.95,0,4.87,6.98,6.98,13.8
4342591,250,J3490,,,,,,,TIMOLOL MALEATE OPTH SOLU,39.9,15.96,0,33.92,33.92,SKIPPED,30.32,30.32,33.92,33.92,33.92,16.82,19.55,19.55,0,11.97,17.16,17.16,33.92
4342593,250,J3490,,,,,,,NEOMYCIN/POLYMYXIN B/ BAC,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342594,250,,,,,,,,METHYLPREDNISOLONE SODIUM,25.6,10.24,0,21.76,21.76,SKIPPED,19.46,19.46,21.76,21.76,21.76,10.79,12.54,12.54,0,7.68,11.01,11.01,21.76
4342596,250,J7620,,,,,,,ALBUTEROL/IPRATROPIUM INH,7,2.8,0,5.95,5.95,SKIPPED,0.63,0.63,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342597,250,J3490,,,,,,,GUAIFENSIN AC SYRUP 5ML [,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342598,258,J3490,,,,,,,LR BAG [500ML],16.83,6.73,0,14.31,14.31,SKIPPED,12.79,12.79,14.31,14.31,14.31,7.1,8.25,8.25,0,5.05,7.24,7.24,14.31
4342599,250,J3490,,,,,,,NEOMYCIN/POLYMYXIN B AND,267.81,107.12,0,227.64,227.64,SKIPPED,203.54,203.54,227.64,227.64,227.64,112.86,131.23,131.23,0,80.34,115.16,115.16,227.64
4342600,258,J7070,,,,,,,D5W BAG [500ML],14.76,5.9,0,14.52,12.55,SKIPPED,14.52,14.52,12.55,12.55,12.55,6.22,7.23,7.23,0,4.43,6.35,6.35,12.55
4342601,258,J7070,,,,,,,D5W BAG [1000ML],20,8,0,17,17,SKIPPED,14.52,14.52,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342602,250,J3490,,,,,,,CHLORDIAZEPOXIDE/CLIDINIU,105.73,42.29,0,89.87,89.87,SKIPPED,80.35,80.35,89.87,89.87,89.87,44.55,51.81,51.81,0,31.72,45.46,45.46,89.87
4342603,250,J3490,,,,,,,MIDAZOLAM HCL INJ,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342604,252,J3490,,,,,,,LEVETIRACETAM TAB [500MG],9.35,3.74,0,7.95,7.95,SKIPPED,7.11,7.11,7.95,7.95,7.95,3.94,4.58,4.58,0,2.8,4.02,4.02,7.95
4342605,250,J3490,,,,,,,CARDIZEM DRIP [50MG/10ML],14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342606,258,J3490,,,,,,,NS 0.9% FLUSH 10ML,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342610,250,J3490,,,,,,,GI COCKTAIL,8.3,3.32,0,7.06,7.06,SKIPPED,6.31,6.31,7.06,7.06,7.06,3.5,4.07,4.07,0,2.49,3.57,3.57,7.06
4342611,252,J3490,,,,,,,CLONIDINE TTS-2 PATCH,389.99,156,0,331.49,331.49,SKIPPED,296.39,296.39,331.49,331.49,331.49,164.35,191.1,191.1,0,117,167.7,167.7,331.49
4342613,252,J3490,,,,,,,CALCIUM TABLET [500MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342614,250,J2704,,,,,,,PROPOFOL 10MG/ML 20ML VL,19.15,7.66,0,16.28,16.28,SKIPPED,0.07,0.07,16.28,16.28,16.28,8.07,9.38,9.38,0,5.74,8.23,8.23,16.28
4342615,252,J3490,,,,,,,DIVALPROEX SODIUM ER TABL,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342616,252,S0138,,,,,,,FINASTERIDE [5 MG],8.33,3.33,0,7.08,7.08,SKIPPED,0.45,0.45,7.08,7.08,7.08,3.51,4.08,4.08,0,2.5,3.58,3.58,7.08
4342617,252,J3490,,,,,,,OSELTAMIVIR CAP [75MG],41.08,16.43,0,34.92,34.92,SKIPPED,31.22,31.22,34.92,34.92,34.92,17.31,20.13,20.13,0,12.32,17.66,17.66,34.92
4342618,252,,,,,,,,FLUZONE HIGH DOSE QUAD 65 AND OLDER,30,12,0,25.5,25.5,SKIPPED,22.8,22.8,25.5,25.5,25.5,12.64,14.7,14.7,0,9,12.9,12.9,25.5
4342619,252,J3490,,,,,,,EZETIMIBE/SIMVASTATIN 10/,13.14,5.26,0,11.17,11.17,SKIPPED,9.99,9.99,11.17,11.17,11.17,5.54,6.44,6.44,0,3.94,5.65,5.65,11.17
4342620,252,J3490,,,,,,,LOSARTAN POTASSIUM TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342625,252,J7510,,,,,,,PREDNISLOLONE SYRUP [5MG/,7,2.8,0,5.95,5.95,SKIPPED,0.1,0.1,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342628,252,J3490,,,,,,,SODIUM BICARBONATE TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342629,252,J3490,,,,,,,DIASTAT RECTAL GEL PEDI [,471.91,188.76,0,401.12,401.12,SKIPPED,358.65,358.65,401.12,401.12,401.12,198.86,231.24,231.24,0,141.57,202.92,202.92,401.12
4342631,252,J3490,,,,,,,VANCOMYCIN HCL 125MG CAPS,83.27,33.31,0,70.78,70.78,SKIPPED,63.29,63.29,70.78,70.78,70.78,35.09,40.8,40.8,0,24.98,35.81,35.81,70.78
4342632,252,J3490,,,,,,,AMOX TR/POTASSIUM CLAVULA,229.9,91.96,0,195.42,195.42,SKIPPED,174.72,174.72,195.42,195.42,195.42,96.88,112.65,112.65,0,68.97,98.86,98.86,195.42
4342633,252,J0702,,,,,,,BETAHETHASONE SODIUMAND B,33.46,13.38,0,28.44,28.44,SKIPPED,7.12,7.12,28.44,28.44,28.44,14.1,16.4,16.4,0,10.04,14.39,14.39,28.44
4342635,252,J3490,,,,,,,DULOXENTINE HCL CAPSULE [,20.48,8.19,0,17.41,17.41,SKIPPED,15.56,15.56,17.41,17.41,17.41,8.63,10.04,10.04,0,6.14,8.81,8.81,17.41
4342636,252,J3490,,,,,,,ROSUVASTATIN [10 MG],19,7.6,0,16.15,16.15,SKIPPED,14.44,14.44,16.15,16.15,16.15,8.01,9.31,9.31,0,5.7,8.17,8.17,16.15
4342637,252,J3490,,,,,,,CARVEDILOL TAB [25MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342638,252,J7608,,,,,,,ACETYLCYSTEINE SOLUTION 2,21.68,8.67,0,18.43,18.43,SKIPPED,4.2,4.2,18.43,18.43,18.43,9.13,10.62,10.62,0,6.5,9.32,9.32,18.43
4342639,252,J3490,,,,,,,EZETIMIBE/SIMVASTATIN 10/,13.14,5.26,0,11.17,11.17,SKIPPED,9.99,9.99,11.17,11.17,11.17,5.54,6.44,6.44,0,3.94,5.65,5.65,11.17
4342640,252,J3490,,,,,,,EZETIMIBE/SIMVASTATIN 10/,36.36,14.54,0,30.91,30.91,SKIPPED,27.63,27.63,30.91,30.91,30.91,15.32,17.82,17.82,0,10.91,15.63,15.63,30.91
4342641,252,J3490,,,,,,,URSODIOL CAP [300MG],7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342642,252,J3490,,,,,,,MELOXICAM TABLET [7.5 MG],8.24,3.3,0,7,7,SKIPPED,6.26,6.26,7,7,7,3.47,4.04,4.04,0,2.47,3.54,3.54,7
4342643,252,J3490,,,,,,,CIPROFLOXACIN HYDROCHLORI,125.84,50.34,0,106.96,106.96,SKIPPED,95.64,95.64,106.96,106.96,106.96,53.03,61.66,61.66,0,37.75,54.11,54.11,106.96
4342644,252,J3490,,,,,,,PREGABALIN CAPSULES [50 M,31.62,12.65,0,26.88,26.88,SKIPPED,24.03,24.03,26.88,26.88,26.88,13.33,15.49,15.49,0,9.49,13.6,13.6,26.88
4342645,252,J3490,,,,,,,PREGABALIN CAPSULES [75 M,31.62,12.65,0,26.88,26.88,SKIPPED,24.03,24.03,26.88,26.88,26.88,13.33,15.49,15.49,0,9.49,13.6,13.6,26.88
4342646,252,90700,,,,,,,TET-DIPTH-PERTUSSIS PEDI (DTAP< 7yrs),107.81,43.12,0,91.64,91.64,SKIPPED,26.21,26.21,91.64,91.64,91.64,45.43,52.83,52.83,0,32.34,46.36,46.36,91.64
4342647,252,90715,,,,,,,TET-DIPTH-PERTUSSIS ADULT(TDAP>7yrs),159.93,63.97,0,135.94,135.94,SKIPPED,38.82,38.82,135.94,135.94,135.94,67.39,78.37,78.37,0,47.98,68.77,68.77,135.94
4342648,250,J3490,,,,,,,NITROGLYCERIN CAPSULE [9M,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342650,252,J3490,,,,,,,DEFINITY INJ 2ML VL,485.33,194.13,0,412.53,412.53,SKIPPED,368.85,368.85,412.53,412.53,412.53,204.52,237.81,237.81,0,145.6,208.69,208.69,412.53
4342651,252,,,,,,,,ADENOSINE INJECTION 90MG/,34.75,13.9,0,29.54,29.54,SKIPPED,26.41,26.41,29.54,29.54,29.54,14.64,17.03,17.03,0,10.42,14.94,14.94,29.54
4342653,252,J3490,,,,,,,ROCALTROL 0.25 MCG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342654,252,J1756,,,,,,,IRON SUCROSE 100MG/5ML AM,184.34,73.74,0,156.69,156.69,SKIPPED,0.36,0.36,156.69,156.69,156.69,77.68,90.33,90.33,0,55.3,79.27,79.27,156.69
4342655,252,J7614,,,,,,,LEVALBUTEROL INH SOL.0.63,17.84,7.14,0,15.16,15.16,SKIPPED,1.48,1.48,15.16,15.16,15.16,7.52,8.74,8.74,0,5.35,7.67,7.67,15.16
4342656,252,J7614,,,,,,,LEVALBUTEROL INH SOL 1.25,7,2.8,0,5.95,5.95,SKIPPED,1.48,1.48,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342657,252,J1450,,,,,,,FLUCONAZOLE PB 200MG/100,115,46,0,97.75,97.75,SKIPPED,4.36,4.36,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342658,252,J3243,,,,,,,TIGECYCLINE 50 MG INJ,499.55,199.82,0,424.62,424.62,SKIPPED,2.16,2.16,424.62,424.62,424.62,210.51,244.78,244.78,0,149.86,214.81,214.81,424.62
4342659,252,J3490,,,,,,,TOBRAMYCIN OPTH SOL. 0.3%,18.09,7.24,0,15.38,15.38,SKIPPED,13.75,13.75,15.38,15.38,15.38,7.62,8.86,8.86,0,5.43,7.78,7.78,15.38
4342660,252,J3490,,,,,,,BANANA BAG,66.5,26.6,0,56.52,56.52,SKIPPED,50.54,50.54,56.52,56.52,56.52,28.03,32.58,32.58,0,19.95,28.6,28.6,56.52
4342662,252,J3490,,,,,,,BETAXOLOL HCL 20 MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342663,252,J3490,,,,,,,LINEZOLID 600 MG CAPSULE,488.57,195.43,0,415.28,415.28,SKIPPED,371.31,371.31,415.28,415.28,415.28,205.89,239.4,239.4,0,146.57,210.09,210.09,415.28
4342665,252,J3490,,,,,,,NEOMYCIN POLYMYXIN B & HC,452.86,181.14,0,384.93,384.93,SKIPPED,344.17,344.17,384.93,384.93,384.93,190.84,221.9,221.9,0,135.86,194.73,194.73,384.93
4342666,252,J0290,,,,,,,AMPICILLIN SODIUM 500 MG,14,5.6,0,11.9,11.9,SKIPPED,2.04,2.04,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342667,250,J3490,,,,,,,BRIMONIDINE TARTRATE OPTH,48.23,19.29,0,41,41,SKIPPED,36.65,36.65,41,41,41,20.33,23.63,23.63,0,14.47,20.74,20.74,41
4342669,252,J3490,,,,,,,CARBOXYMETHYLCELLULOSE SO,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342670,252,J3490,,,,,,,CHLORTHALIDONE 50MG TAB,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342671,252,J3490,,,,,,,VERAPAMIL 80MG TAB,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342673,252,J3490,,,,,,,PROCHLORPERAZINE MALEATE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342674,252,J3490,,,,,,,CLINDAMYCIN HYDROCHLORIDE,24.23,9.69,0,20.6,20.6,SKIPPED,18.41,18.41,20.6,20.6,20.6,10.21,11.87,11.87,0,7.27,10.42,10.42,20.6
4342676,252,J3490,,,,,,,ACTIVATED CHARCOAL WITH S,62.91,25.16,0,53.47,53.47,SKIPPED,47.81,47.81,53.47,53.47,53.47,26.51,30.83,30.83,0,18.87,27.05,27.05,53.47
4342677,252,J3490,,,,,,,CARBIDOPA/LEVODOPA TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342678,252,J3490,,,,,,,VERAPAMIL HCL ER 120MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342683,252,J1250,,,,,,,DOBUTAMINE 250MG/250ML PM,26.57,10.63,0,22.58,22.58,SKIPPED,2.85,2.85,22.58,22.58,22.58,11.2,13.02,13.02,0,7.97,11.43,11.43,22.58
4342684,252,J1956,,,,,,,LEVOFLOXACIN PM BAG 750 M,14,5.6,0,11.9,11.9,SKIPPED,1.72,1.72,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342685,252,J3490,,,,,,,NO MEDICATIONS,3,1.2,0,2.55,2.55,SKIPPED,2.28,2.28,2.55,2.55,2.55,1.26,1.47,1.47,0,0.9,1.29,1.29,2.55
4342686,252,J2785,,,,,,,LEXISCAN 0.4MG SYR (NUC M,798.8,319.52,0,678.98,678.98,SKIPPED,59.26,59.26,678.98,678.98,678.98,336.61,391.41,391.41,0,239.64,343.48,343.48,678.98
4342687,258,J1644,,,,,,,HEPARIN 20000/D5W 500MLWI,20,8,0,17,17,SKIPPED,0.19,0.19,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342688,252,J3490,,,,,,,SACCHAROMYCES BOULARDII L,3,1.2,0,2.55,2.55,SKIPPED,2.28,2.28,2.55,2.55,2.55,1.26,1.47,1.47,0,0.9,1.29,1.29,2.55
4342689,258,J1644,,,,,,,HEPARIN 20000/D5W500ML,39.85,15.94,0,33.87,33.87,SKIPPED,0.19,0.19,33.87,33.87,33.87,16.8,19.53,19.53,0,11.96,17.14,17.14,33.87
4342690,252,J1815,,,,,,,INSULIN LISPRO HUMALOG-MI,87.68,35.07,0,74.53,74.53,SKIPPED,0.14,0.14,74.53,74.53,74.53,36.95,42.96,42.96,0,26.3,37.7,37.7,74.53
4342691,252,J1815,,,,,,,INSULIN LISPRO HUMALOG MO,87.68,35.07,0,74.53,74.53,SKIPPED,0.14,0.14,74.53,74.53,74.53,36.95,42.96,42.96,0,26.3,37.7,37.7,74.53
4342692,252,J1815,,,,,,,INSULIN LISPRO HUMALOG AG,87.68,35.07,0,74.53,74.53,SKIPPED,0.14,0.14,74.53,74.53,74.53,36.95,42.96,42.96,0,26.3,37.7,37.7,74.53
4342693,252,J1815,,,,,,,INSULIN LISPRO HUMALOG OP,87.68,35.07,0,74.53,74.53,SKIPPED,0.14,0.14,74.53,74.53,74.53,36.95,42.96,42.96,0,26.3,37.7,37.7,74.53
4342694,252,J2265,,,,,,,MINOCYCLINE HCL 100 MG,9.04,3.62,0,7.68,7.68,SKIPPED,0.59,0.59,7.68,7.68,7.68,3.81,4.43,4.43,0,2.71,3.89,3.89,7.68
4342695,252,J2020,,,,,,,LINEZOLID 600MG/300ML BAG,153.48,61.39,0,130.46,130.46,SKIPPED,14.4,14.4,130.46,130.46,130.46,64.68,75.21,75.21,0,46.04,66,66,130.46
4342696,252,J0692,,,,,,,CEFEPIME HCL 2 GM,31.6,12.64,0,26.86,26.86,SKIPPED,2.45,2.45,26.86,26.86,26.86,13.32,15.48,15.48,0,9.48,13.59,13.59,26.86
4342699,252,J3490,,,,,,,BACTERIOSTATIC WATER 30 M,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342700,252,J1815,,,,,,,INSULIN NOVOLOG ASPART,7,2.8,0,5.95,5.95,SKIPPED,0.14,0.14,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342701,252,J3490,,,,,,,BACTERIOSTATIC 0.9% SODIU,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342702,252,J2280,,,,,,,MOXIFLOXACIN HCL 400 MG P,162.98,65.19,0,138.53,138.53,SKIPPED,7.95,7.95,138.53,138.53,138.53,68.68,79.86,79.86,0,48.89,70.08,70.08,138.53
4342703,252,J3490,,,,,,,MORPHINE SUL 15 MG IMMED,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342704,252,J3490,,,,,,,CILOSTAZOL 100 MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342705,252,J3490,,,,,,,CALCIUM ACETATE 667 MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342706,252,J3490,,,,,,,FISH OIL 1000 MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342707,252,J3490,,,,,,,GATORADE BOWEL PREP,47.5,19,0,40.38,40.38,SKIPPED,36.1,36.1,40.38,40.38,40.38,20.02,23.28,23.28,0,14.25,20.43,20.43,40.38
4342708,252,J3490,,,,,,,OLMESARTAN MEDOXOMIL 5 MG,10.01,4,0,8.51,8.51,SKIPPED,7.61,7.61,8.51,8.51,8.51,4.21,4.9,4.9,0,3,4.3,4.3,8.51
4342709,252,J2543,,,,,,,PIPERACILL NA/TAZOBACTAM,43.84,17.54,0,37.26,37.26,SKIPPED,2.56,2.56,37.26,37.26,37.26,18.47,21.48,21.48,0,13.15,18.85,18.85,37.26
4342710,252,J1120,,,,,,,ACETAZOLAMIDE 500 MG INJ,104.75,41.9,0,89.04,89.04,SKIPPED,28.17,28.17,89.04,89.04,89.04,44.14,51.33,51.33,0,31.42,45.04,45.04,89.04
4342711,252,J3490,,,,,,,ARIPIPRAZOLE 10 MG,85.41,34.16,0,72.6,72.6,SKIPPED,64.91,64.91,72.6,72.6,72.6,36,41.85,41.85,0,25.62,36.73,36.73,72.6
4342712,252,J3490,,,,,,,ISOVUE-M-300,274.09,109.64,0,232.98,232.98,SKIPPED,208.31,208.31,232.98,232.98,232.98,115.5,134.3,134.3,0,82.23,117.86,117.86,232.98
4342713,252,J3490,,,,,,,BUDESONIDE/FORMOTEROL FUM,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342714,252,J3535,,,,,,,BUDESONIDE/FORMOTEROL FUM,822.29,328.92,0,698.95,698.95,SKIPPED,624.94,624.94,698.95,698.95,698.95,346.51,402.92,402.92,0,246.69,353.58,353.58,698.95
4342715,252,J7607,,,,,,,LEVALBUTEROL HCL CONCENTR,8.91,3.56,0,7.57,7.57,SKIPPED,6.77,6.77,7.57,7.57,7.57,3.75,4.37,4.37,0,2.67,3.83,3.83,7.57
4342716,252,J3490,,,,,,,LIDOCAINE/EPI MPF 1.5 % 3,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342718,252,J7605,,,,,,,ARFORMOTEROL TARTRATE INH,59.88,23.95,0,50.9,50.9,SKIPPED,15.46,15.46,50.9,50.9,50.9,25.24,29.34,29.34,0,17.96,25.75,25.75,50.9
4342719,252,J1815,,,,,,,INSULIN REGULAR HUMAN,43.95,17.58,0,37.36,37.36,SKIPPED,0.14,0.14,37.36,37.36,37.36,18.52,21.54,21.54,0,13.18,18.9,18.9,37.36
4342721,250,J0132,,,,,,,ACETYLCYSTEINE (IV USE ON,20,8,0,17,17,SKIPPED,2.17,2.17,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342722,252,J0282,,,,,,,NEXTERONE 150MG/100ML PRE,115,46,0,97.75,97.75,SKIPPED,0.2,0.2,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342723,252,J0282,,,,,,,NEXTERONE 360MG/200ML PRE,147.28,58.91,0,125.19,125.19,SKIPPED,0.2,0.2,125.19,125.19,125.19,62.06,72.17,72.17,0,44.18,63.33,63.33,125.19
4342724,252,J3490,,,,,,,PIOGLITAZONE HCL 30MG TAB,28.51,11.4,0,24.23,24.23,SKIPPED,21.67,21.67,24.23,24.23,24.23,12.01,13.97,13.97,0,8.55,12.26,12.26,24.23
4342725,252,J3490,,,,,,,FENTANYL PATCH (12),7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342726,252,J3490,,,,,,,ALENDRONATE SODIUM(35 MG),54.5,21.8,0,46.32,46.32,SKIPPED,41.42,41.42,46.32,46.32,46.32,22.97,26.7,26.7,0,16.35,23.44,23.44,46.32
4342727,252,J3490,,,,,,,DULOXETINE HCL CAPSULE (2,21.72,8.69,0,18.46,18.46,SKIPPED,16.51,16.51,18.46,18.46,18.46,9.15,10.64,10.64,0,6.52,9.34,9.34,18.46
4342728,252,J3475,,,,,,,MAGNESIUM 2GM PM BAG,115,46,0,97.75,97.75,SKIPPED,0.07,0.07,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342730,252,J1940,,,,,,,FUROSEMIDE DRIP,115,46,0,97.75,97.75,SKIPPED,1.65,1.65,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342731,252,J1170,,,,,,,HYDROMORPHONE 1MG INJ,14,5.6,0,11.9,11.9,SKIPPED,0.4,0.4,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342732,252,J1815,,,,,,,INSULIN ASPART MILD SLIDI,92.36,36.94,0,78.51,78.51,SKIPPED,0.14,0.14,78.51,78.51,78.51,38.92,45.26,45.26,0,27.71,39.71,39.71,78.51
4342733,252,J1815,,,,,,,INSULIN ASPART MODERATE S,92.36,36.94,0,78.51,78.51,SKIPPED,0.14,0.14,78.51,78.51,78.51,38.92,45.26,45.26,0,27.71,39.71,39.71,78.51
4342735,252,J3490,,,,,,,DEMECLOCYCLINE 150 MG,28.13,11.25,0,23.91,23.91,SKIPPED,21.38,21.38,23.91,23.91,23.91,11.86,13.78,13.78,0,8.44,12.1,12.1,23.91
4342736,252,J3490,,,,,,,ROPINIROLE HYDROCHLORIDE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342737,252,J3490,,,,,,,ROPINIROLE HYDROCHLORIDE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342738,252,J1815,,,,,,,INSULIN NOVOLOG MIX 70/30,7,2.8,0,5.95,5.95,SKIPPED,0.14,0.14,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342739,250,J3490,,,,,,,LEVOTHYROXINE SOD INJ (10,337.02,134.81,0,286.47,286.47,SKIPPED,256.14,256.14,286.47,286.47,286.47,142.02,165.14,165.14,0,101.11,144.92,144.92,286.47
4342740,252,J3490,,,,,,,LIDOCAINE 1.5 % MPF 20 ML,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342741,252,J3490,,,,,,,PRAMIPEXOLE DIHYDROCHLORI,23.53,9.41,0,20,20,SKIPPED,17.88,17.88,20,20,20,9.92,11.53,11.53,0,7.06,10.12,10.12,20
4342742,252,J3490,,,,,,,HYDROCODONE/APAP 5/325 TA,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342745,252,J3490,,,,,,,SOLIFENACIN SUSSINATE 10,22.83,9.13,0,19.41,19.41,SKIPPED,17.35,17.35,19.41,19.41,19.41,9.62,11.19,11.19,0,6.85,9.82,9.82,19.41
4342746,252,J3490,,,,,,,SITAGLIPTIN 100 MG,55.48,22.19,0,47.16,47.16,SKIPPED,42.16,42.16,47.16,47.16,47.16,23.38,27.19,27.19,0,16.64,23.86,23.86,47.16
4342747,250,J3490,,,,,,,RESTORIL 7.5MG CAP,15.37,6.15,0,13.06,13.06,SKIPPED,11.68,11.68,13.06,13.06,13.06,6.48,7.53,7.53,0,4.61,6.61,6.61,13.06
4342748,250,J3490,,,,,,,NEUT 4% 5ML VIAL,65.88,26.35,0,56,56,SKIPPED,50.07,50.07,56,56,56,27.76,32.28,32.28,0,19.76,28.33,28.33,56
4342749,250,J3490,,,,,,,ULTIVA 1MG,195.64,78.26,0,166.29,166.29,SKIPPED,148.69,148.69,166.29,166.29,166.29,82.45,95.86,95.86,0,58.69,84.13,84.13,166.29
4342750,250,J3490,,,,,,,Tizanidine 6mg cap,13.71,5.48,0,11.65,11.65,SKIPPED,10.42,10.42,11.65,11.65,11.65,5.78,6.72,6.72,0,4.11,5.9,5.9,11.65
4342751,250,J3490,,,,,,,OXYCODONE/ACETAMINOPHEN TAB,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342752,250,90633,,,,,,,HAVRIX PEDI(CLINIC ONLY),228.2,91.28,0,193.97,193.97,SKIPPED,31.12,31.12,193.97,193.97,193.97,96.17,111.82,111.82,0,68.46,98.13,98.13,193.97
4342753,250,J3490,,,,,,,VAQTA CLINIC,226.55,90.62,0,192.57,192.57,SKIPPED,172.18,172.18,192.57,192.57,192.57,95.47,111.01,111.01,0,67.96,97.42,97.42,192.57
4342754,250,90648,,,,,,,ACTHIB VACCINE(CLINIC ONLY),57.82,23.13,0,49.15,49.15,SKIPPED,12,12,49.15,49.15,49.15,24.36,28.33,28.33,0,17.35,24.86,24.86,49.15
4342755,250,90649,,,,,,,GARDASIL VACCINE(CLINIC USE ONLY),809.1,323.64,0,687.74,687.74,SKIPPED,146.29,146.29,687.74,687.74,687.74,340.95,396.46,396.46,0,242.73,347.91,347.91,687.74
4342756,250,90713,,,,,,,IPOL VACCINE(CLINIC USE ONLY),246.54,98.62,0,209.56,209.56,SKIPPED,29.93,29.93,209.56,209.56,209.56,103.89,120.8,120.8,0,73.96,106.01,106.01,209.56
4342757,250,90734,,,,,,,MENACTRA VAC (CLINIC USE ONLY),903.81,361.52,0,768.24,768.24,SKIPPED,85.08,85.08,768.24,768.24,768.24,380.87,442.87,442.87,0,271.14,388.64,388.64,768.24
4342758,250,90698,,,,,,,PENTACEL VACCINE,336.92,134.77,0,286.38,286.38,SKIPPED,105.3,105.3,286.38,286.38,286.38,141.98,165.09,165.09,0,101.08,144.88,144.88,286.38
4342759,250,90670,,,,,,,PREVNAR 13 VACCINE(CLINIC USE ONLY),1444.74,577.9,0,1228.03,1228.03,SKIPPED,173.56,173.56,1228.03,1228.03,1228.03,608.82,707.92,707.92,0,433.42,621.24,621.24,1228.03
4342760,250,90716,,,,,,,VARICELLA VAC (CLINIC USE ONLY),481.52,192.61,0,409.29,409.29,SKIPPED,142.76,142.76,409.29,409.29,409.29,202.91,235.94,235.94,0,144.46,207.05,207.05,409.29
4342761,250,90736,,,,,,,ZOSTAVAX VAC(CLINIC USE ONLY),678.83,271.53,0,577.01,577.01,SKIPPED,248.82,248.82,577.01,577.01,577.01,286.06,332.63,332.63,0,203.65,291.9,291.9,577.01
4342762,250,J1815,,,,,,,INSULIN LEVEMIR,7,2.8,0,5.95,5.95,SKIPPED,0.14,0.14,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342763,250,J3490,,,,,,,MYDRIACYL OPTH 1%15ML,28.33,11.33,0,24.08,24.08,SKIPPED,21.53,21.53,24.08,24.08,24.08,11.94,13.88,13.88,0,8.5,12.18,12.18,24.08
4342764,250,J3490,,,,,,,ISOVUE 300(CT ONLY),281.16,112.46,0,238.99,238.99,SKIPPED,213.68,213.68,238.99,238.99,238.99,118.48,137.77,137.77,0,84.35,120.9,120.9,238.99
4342765,250,J3490,,,,,,,PROHANCE 20ML,335.5,134.2,0,285.18,285.18,SKIPPED,254.98,254.98,285.18,285.18,285.18,141.38,164.4,164.4,0,100.65,144.27,144.27,285.18
4342766,250,J3490,,,,,,,PROHANCE 17ML SYR(MRI USE ONLY),294.05,117.62,0,249.94,249.94,SKIPPED,223.48,223.48,249.94,249.94,249.94,123.91,144.08,144.08,0,88.22,126.44,126.44,249.94
4342767,250,J3490,,,,,,,PHENYLEPHRINE 2.5% OPTH,21.62,8.65,0,18.38,18.38,SKIPPED,16.43,16.43,18.38,18.38,18.38,9.11,10.59,10.59,0,6.49,9.3,9.3,18.38
4342768,250,90710,,,,,,,PRO-QUAD/MMRV (CLINIC ONLY),796.45,318.58,0,676.98,676.98,SKIPPED,202.4,202.4,676.98,676.98,676.98,335.62,390.26,390.26,0,238.94,342.47,342.47,676.98
4342769,250,90723,,,,,,,PEDIARIX (CLINIC ONLY),285.43,114.17,0,242.62,242.62,SKIPPED,85.1,85.1,242.62,242.62,242.62,120.28,139.86,139.86,0,85.63,122.73,122.73,242.62
4342770,250,J3490,,,,,,,TOBRADEX OPTH OINT,728.44,291.38,0,619.17,619.17,SKIPPED,553.61,553.61,619.17,619.17,619.17,306.97,356.94,356.94,0,218.53,313.23,313.23,619.17
4342771,250,J3490,,,,,,,ALPHAGAN (ALPHAGAN 0.1%),564.83,225.93,0,480.11,480.11,SKIPPED,429.27,429.27,480.11,480.11,480.11,238.02,276.77,276.77,0,169.45,242.88,242.88,480.11
4342772,250,J2360,,,,,,,ORPHENADRINE 30MG/ML VL,29.53,11.81,0,25.1,25.1,SKIPPED,9.66,9.66,25.1,25.1,25.1,12.45,14.47,14.47,0,8.86,12.7,12.7,25.1
4342773,250,J2010,,,,,,,LINCOCIN 300MG/ML INJ,537.08,214.83,0,456.52,456.52,SKIPPED,7.63,7.63,456.52,456.52,456.52,226.32,263.17,263.17,0,161.12,230.94,230.94,456.52
4342774,258,J7120,,,,,,,LACTATED RINGERS 500ML,20,8,0,17,17,SKIPPED,5.3,5.3,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342775,250,J3490,,,,,,,APRESOLINE 50MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342776,250,90632,,,,,,,HAVRIX A ADULT(CLINIC ONLY),237.34,94.94,0,201.74,201.74,SKIPPED,65.11,65.11,201.74,201.74,201.74,100.02,116.3,116.3,0,71.2,102.06,102.06,201.74
4342777,250,J3490,,,,,,,FLORASTOR 250MG CAP,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342778,250,J3490,,,,,,,SANTYL OINT 30GM,875.41,350.16,0,744.1,744.1,SKIPPED,665.31,665.31,744.1,744.1,744.1,368.9,428.95,428.95,0,262.62,376.43,376.43,744.1
4342779,250,J1670,,,,,,,HYPER-TET 250UNITS,1953.18,781.27,0,1660.2,1660.2,SKIPPED,498.03,498.03,1660.2,1660.2,1660.2,823.07,957.06,957.06,0,585.95,839.87,839.87,1660.2
4342780,250,J0692,,,,,,,CEFEPIME 1GM,16.47,6.59,0,14,14,SKIPPED,2.45,2.45,14,14,14,6.94,8.07,8.07,0,4.94,7.08,7.08,14
4342781,250,J3490,,,,,,,LIDODERM 5% PATCH,76.98,30.79,0,65.43,65.43,SKIPPED,58.5,58.5,65.43,65.43,65.43,32.44,37.72,37.72,0,23.09,33.1,33.1,65.43
4342782,250,90680,,,,,,,ROTAVIRUS ORAL,288.47,115.39,0,245.2,245.2,SKIPPED,96.98,96.98,245.2,245.2,245.2,121.56,141.35,141.35,0,86.54,124.04,124.04,245.2
4342783,250,P9047,,,,,,,ALBUMIN 25% 50ML,287.28,114.91,0,244.19,244.19,SKIPPED,62.21,62.21,244.19,244.19,244.19,121.06,140.77,140.77,0,86.18,123.53,123.53,244.19
4342784,250,J1100,,,,,,,DECADRON 10MG/ML VL,21.87,8.75,0,18.59,18.59,SKIPPED,0.03,0.03,18.59,18.59,18.59,9.21,10.72,10.72,0,6.56,9.4,9.4,18.59
4342785,250,J3490,,,,,,,TRICOR 145MG TABLET,13.7,5.48,0,11.64,11.64,SKIPPED,10.41,10.41,11.64,11.64,11.64,5.77,6.71,6.71,0,4.11,5.89,5.89,11.64
4342786,250,J3490,,,,,,,TRICOR 48MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342788,250,J3490,,,,,,,PATANOL OPTH SOL 5ML,83.12,33.25,0,70.65,70.65,SKIPPED,63.17,63.17,70.65,70.65,70.65,35.03,40.73,40.73,0,24.94,35.74,35.74,70.65
4342789,250,J3490,,,,,,,CEFOTAN 1GM VIAL,67.22,26.89,0,57.14,57.14,SKIPPED,51.09,51.09,57.14,57.14,57.14,28.32,32.94,32.94,0,20.17,28.9,28.9,57.14
4342790,250,J3490,,,,,,,UROXATRAL ER 10MG TABLET,39.33,15.73,0,33.43,33.43,SKIPPED,29.89,29.89,33.43,33.43,33.43,16.57,19.27,19.27,0,11.8,16.91,16.91,33.43
4342791,250,J3490,,,,,,,INS REG PHILLIPS PROTOCOL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342792,250,J3301,,,,,,,KENALOG 10MG(CLINIC ONLY),38.6,15.44,0,32.81,32.81,SKIPPED,1.71,1.71,32.81,32.81,32.81,16.27,18.91,18.91,0,11.58,16.6,16.6,32.81
4342793,250,J3490,,,,,,,MISC PHARMACY,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,8.5,4.21,4.9,4.9,0,3,4.3,4.3,8.5
4342794,250,J2405,,,,,,,ZOFRAN 4MG SUBL TABLET,61.48,24.59,0,52.26,52.26,SKIPPED,0.59,0.59,52.26,52.26,52.26,25.91,30.13,30.13,0,18.44,26.44,26.44,52.26
4342795,250,J3490,,,,,,,ELIQUIS 2.5MG TABLET,28.14,11.26,0,23.92,23.92,SKIPPED,21.39,21.39,23.92,23.92,23.92,11.86,13.79,13.79,0,8.44,12.1,12.1,23.92
4342796,250,J3490,,,,,,,RANEXA ER 500MG TABLET,21.87,8.75,0,18.59,18.59,SKIPPED,16.62,16.62,18.59,18.59,18.59,9.21,10.72,10.72,0,6.56,9.4,9.4,18.59
4342797,250,J3490,,,,,,,CIPRODEX OTIC SUSP,795.1,318.04,0,675.84,675.84,SKIPPED,604.28,604.28,675.84,675.84,675.84,335.05,389.6,389.6,0,238.53,341.89,341.89,675.84
4342798,250,J3490,,,,,,,DITROPAN E.R. 10MG TABLET,8.74,3.5,0,7.43,7.43,SKIPPED,6.64,6.64,7.43,7.43,7.43,3.68,4.28,4.28,0,2.62,3.76,3.76,7.43
4342799,250,J3490,,,,,,,ZANAFLEX 4MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342800,250,J3490,,,,,,,GEODON 20MG TABLET,23.84,9.54,0,20.26,20.26,SKIPPED,18.12,18.12,20.26,20.26,20.26,10.04,11.68,11.68,0,7.15,10.25,10.25,20.26
4342801,250,J3490,,,,,,,ABILIFY 2MG TABLET,62.12,24.85,0,52.8,52.8,SKIPPED,47.21,47.21,52.8,52.8,52.8,26.18,30.44,30.44,0,18.64,26.71,26.71,52.8
4342802,250,J3490,,,,,,,BYSTOLIC 5MG TABLET,17.64,7.06,0,14.99,14.99,SKIPPED,13.41,13.41,14.99,14.99,14.99,7.44,8.64,8.64,0,5.29,7.59,7.59,14.99
4342803,250,J3490,,,,,,,MAGIC MOUTHWASH SOLUTION,8.5,3.4,0,7.22,7.22,SKIPPED,6.46,6.46,7.22,7.22,7.22,3.59,4.16,4.16,0,2.55,3.66,3.66,7.22
4342804,250,J3490,,,,,,,PRISTIQ E.R. 50MG TABLET,46.6,18.64,0,39.61,39.61,SKIPPED,35.42,35.42,39.61,39.61,39.61,19.64,22.83,22.83,0,13.98,20.04,20.04,39.61
4342806,250,J1953,,,,,,,KEPPRA 500MG/ML 5ML VIAL,14,5.6,0,11.9,11.9,SKIPPED,0.24,0.24,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342807,250,90696,,,,,,,TV KINRIX (STATE ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4342808,250,J3490,,,,,,,TV VAQTA (STATE ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4342809,250,90715,,,,,,,TV BOOSTRIX(STATE ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4342810,250,J3490,,,,,,,TV ROTATEQ(STATE ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4342811,250,J7325,,,,,,,SYNVISC 16UNITS/2ML,1457.27,582.91,0,1238.68,1238.68,SKIPPED,12.74,12.74,1238.68,1238.68,1238.68,614.1,714.06,714.06,0,437.18,626.63,626.63,1238.68
4342812,250,J7325,,,,,,,SYNVISC ONE 6ML SYR,4371.82,1748.73,0,3716.05,3716.05,SKIPPED,12.74,12.74,3716.05,3716.05,3716.05,1842.28,2142.19,2142.19,0,1311.55,1879.88,1879.88,3716.05
4342813,636,J7298,,,,,,,MIRENA 52 mg IUD,2901.42,1160.57,0,2466.21,2466.21,SKIPPED,858.33,858.33,2466.21,2466.21,2466.21,1222.66,1421.7,1421.7,0,870.43,1247.61,1247.61,2466.21
4342814,250,J3490,,,,,,,CARDENE 20MG/200ML PM,324.47,129.79,0,275.8,275.8,SKIPPED,246.6,246.6,275.8,275.8,275.8,136.73,158.99,158.99,0,97.34,139.52,139.52,275.8
4342815,250,J2997,,,,,,,ACTIVASE 100MG VL(TPA),28090.74,11236.3,0,23877.13,23877.13,SKIPPED,36.2,36.2,23877.13,23877.13,23877.13,11837.44,13764.46,13764.46,0,8427.22,12079.02,12079.02,23877.13
4342816,250,J7323,,,,,,,EUFLEXXA 20MG PFS,1117.59,447.04,0,949.95,949.95,SKIPPED,183.05,183.05,949.95,949.95,949.95,470.95,547.62,547.62,0,335.28,480.56,480.56,949.95
4342817,250,J3490,,,,,,,TAPAZOLE 10MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342820,250,90686,,,,,,,AFLURIA 6 MON. +,56.96,22.78,0,48.42,48.42,SKIPPED,16.05,16.05,48.42,48.42,48.42,24,27.91,27.91,0,17.09,24.49,24.49,48.42
4342821,250,90672,,,,,,,FLUMIST TVC,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4342822,250,90685,,,,,,,AFLURIA VACCINE 6 - 35 MONTHS,59.36,23.74,0,50.46,50.46,SKIPPED,21.7,21.7,50.46,50.46,50.46,25.01,29.09,29.09,0,17.81,25.52,25.52,50.46
4342823,250,90685,,,,,,,TVC FLUZONE VACCINE 6 - 35 MONTHS,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4342824,250,90686,,,,,,,TV FLUZONE VACCINE 3 YRS >,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4342826,250,J3490,,,,,,,ABILIFY 20MG TABLET,120.65,48.26,0,102.55,102.55,SKIPPED,91.69,91.69,102.55,102.55,102.55,50.84,59.12,59.12,0,36.2,51.88,51.88,102.55
4342827,250,90746,,,,,,,HEPATITIS B ADULT VACCINE,200.81,80.32,0,170.69,170.69,SKIPPED,45.97,45.97,170.69,170.69,170.69,84.62,98.4,98.4,0,60.24,86.35,86.35,170.69
4342828,250,J0885,,,,,,,"PROCRIT 10,000UNITS/ML VIAL",853.06,341.22,0,725.1,725.1,SKIPPED,16.11,16.11,725.1,725.1,725.1,359.48,418,418,0,255.92,366.82,366.82,725.1
4342829,250,J0834,,,,,,,CORTROSYN 0.25MG VL,340.2,136.08,0,289.17,289.17,SKIPPED,55.43,55.43,289.17,289.17,289.17,143.36,166.7,166.7,0,102.06,146.29,146.29,289.17
4342830,250,J3490,,,,,,,"PROCRIT 2,000UNITS/1ML",170.64,68.26,0,145.04,145.04,SKIPPED,129.69,129.69,145.04,145.04,145.04,71.91,83.61,83.61,0,51.19,73.38,73.38,145.04
4342831,250,J3490,,,,,,,ED ZITHROMAX SUSP(15ML),92.78,37.11,0,78.86,78.86,SKIPPED,70.51,70.51,78.86,78.86,78.86,39.1,45.46,45.46,0,27.83,39.9,39.9,78.86
4342832,250,J3490,,,,,,,SURG-BACTROBAN NASAL,54.49,21.8,0,46.32,46.32,SKIPPED,41.41,41.41,46.32,46.32,46.32,22.96,26.7,26.7,0,16.35,23.43,23.43,46.32
4342833,250,J2795,,,,,,,NAROPIN 2MG/ML 200ML BT,259.57,103.83,0,220.63,220.63,SKIPPED,0.05,0.05,220.63,220.63,220.63,109.39,127.19,127.19,0,77.87,111.62,111.62,220.63
4342834,250,J3490,,,,,,,RENVELA 800MG TABLET,18.99,7.6,0,16.14,16.14,SKIPPED,14.43,14.43,16.14,16.14,16.14,8.01,9.31,9.31,0,5.7,8.17,8.17,16.14
4342835,250,J2250,,,,,,,VERSED 2MG/2ML VL(ANES ONLY),14,5.6,0,11.9,11.9,SKIPPED,0.11,0.11,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342836,250,J1410,,,,,,,PREMARIN 25MG INJ VL,1086.26,434.5,0,923.32,923.32,SKIPPED,288.16,288.16,923.32,923.32,923.32,457.75,532.27,532.27,0,325.88,467.09,467.09,923.32
4342837,250,S0028,,,,,,,PEPCID 20MG VIAL,14,5.6,0,11.9,11.9,SKIPPED,0.58,0.58,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342838,250,J2704,,,,,,,PROPOFOL 10MG/ML 100ML VL(ANES ONLY),93.24,37.3,0,79.25,79.25,SKIPPED,0.07,0.07,79.25,79.25,79.25,39.29,45.69,45.69,0,27.97,40.09,40.09,79.25
4342839,250,J3490,,,,,,,TYPHOID VAC 25MG(CLINIC ONLY),371.44,148.58,0,315.72,315.72,SKIPPED,282.29,282.29,315.72,315.72,315.72,156.53,182.01,182.01,0,111.43,159.72,159.72,315.72
4342840,250,Q9967,,,,,,,OMNIPAQUE 300MG/ML 10ML VL,149.55,59.82,0,127.12,127.12,SKIPPED,0.39,0.39,127.12,127.12,127.12,63.02,73.28,73.28,0,44.86,64.31,64.31,127.12
4342841,250,J3490,,,,,,,"VITAMIN D 50,000UNITS CAPSULE",7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342842,250,J3490,,,,,,,MIDODRINE 2.5MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342843,250,J1652,,,,,,,ARIXTRA 2.5MG INJ,145.37,58.15,0,123.56,123.56,SKIPPED,2.07,2.07,123.56,123.56,123.56,61.26,71.23,71.23,0,43.61,62.51,62.51,123.56
4342844,250,J3490,,,,,,,FERAHEME 510MG INJ,3810.02,1524.01,0,3238.52,3238.52,SKIPPED,2895.62,2895.62,3238.52,3238.52,3238.52,1605.54,1866.91,1866.91,0,1143.01,1638.31,1638.31,3238.52
4342847,250,J3490,,,,,,,CLN HM CYANOCOBALAMIN 1000MCG INJ,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4342849,250,J3490,,,,,,,CLN HM DEPO-ESTRADIOL 5MG INJ,0.03,0.01,0,0.03,0.03,SKIPPED,0.02,0.02,0.03,0.03,0.03,0.01,0.01,0.01,0,0.01,0.01,0.01,0.03
4342850,250,J0897,,,,,,,PROLIA 60MG INJ,4715.09,1886.04,0,4007.83,4007.83,SKIPPED,17.75,17.75,4007.83,4007.83,4007.83,1986.94,2310.39,2310.39,0,1414.53,2027.49,2027.49,4007.83
4342852,250,90715,,,,,,,BOOSTRIX TDAP INJ(CLINIC ONLY),141.8,56.72,0,120.53,120.53,SKIPPED,38.82,38.82,120.53,120.53,120.53,59.75,69.48,69.48,0,42.54,60.97,60.97,120.53
4342853,250,J3490,,,,,,,DANTRIUM 20MG INJ VL,282.94,113.18,0,240.5,240.5,SKIPPED,215.03,215.03,240.5,240.5,240.5,119.23,138.64,138.64,0,84.88,121.66,121.66,240.5
4342854,250,J2001,,,,,,,LIDOCAINE VISC U/D ORAL 15ML,7,2.8,0,5.95,5.95,SKIPPED,0.02,0.02,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342855,250,J3490,,,,,,,NARCAN 0.4MG PF SYRING,49.28,19.71,0,41.89,41.89,SKIPPED,37.45,37.45,41.89,41.89,41.89,20.77,24.15,24.15,0,14.78,21.19,21.19,41.89
4342856,250,J3490,,,,,,,SYMMETREL 100MG CAPSULE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342857,250,J3490,,,,,,,MYSOLINE 250MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342858,250,J3490,,,,,,,AVODART 0.5MG CAPSULE,25.25,10.1,0,21.46,21.46,SKIPPED,19.19,19.19,21.46,21.46,21.46,10.64,12.37,12.37,0,7.58,10.86,10.86,21.46
4342859,250,J3490,,,,,,,LAMISIL 250MG TABLET,34.78,13.91,0,29.56,29.56,SKIPPED,26.43,26.43,29.56,29.56,29.56,14.66,17.04,17.04,0,10.43,14.96,14.96,29.56
4342860,250,J3490,,,,,,,XARELTO 10MG TABLET,54.97,21.99,0,46.72,46.72,SKIPPED,41.78,41.78,46.72,46.72,46.72,23.17,26.94,26.94,0,16.49,23.64,23.64,46.72
4342861,250,J3490,,,,,,,MELATONIN 1MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342862,250,J3490,,,,,,,VITAMIN D3 1000 IU TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342863,250,J0171,,,,,,,ADRENALIN 1MG/ML VIAL,47.75,19.1,0,40.59,40.59,SKIPPED,0.14,0.14,40.59,40.59,40.59,20.12,23.4,23.4,0,14.32,20.53,20.53,40.59
4342864,250,J3490,,,,,,,TORADOL 15MG INJ VIAL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342865,250,J3490,,,,,,,TRAVATAN Z OPTH SOLUTION,619.19,247.68,0,526.31,526.31,SKIPPED,470.58,470.58,526.31,526.31,526.31,260.92,303.4,303.4,0,185.76,266.25,266.25,526.31
4342866,250,J3490,,,,,,,CLOTRIMAZOLE VAGINAL 1% CR,15.64,6.26,0,13.29,13.29,SKIPPED,11.89,11.89,13.29,13.29,13.29,6.6,7.66,7.66,0,4.69,6.73,6.73,13.29
4342867,250,J3490,,,,,,,RESTASIS 0.05% OPTH SOL,34.35,13.74,0,29.2,29.2,SKIPPED,26.11,26.11,29.2,29.2,29.2,14.47,16.83,16.83,0,10.3,14.77,14.77,29.2
4342868,250,J3490,,,,,,,SOD PHOSPHATE 15ML VIAL,105.37,42.15,0,89.56,89.56,SKIPPED,80.08,80.08,89.56,89.56,89.56,44.4,51.63,51.63,0,31.61,45.31,45.31,89.56
4342869,250,J3490,,,,,,,VECURONIUM 20MG VIAL,31.92,12.77,0,27.13,27.13,SKIPPED,24.26,24.26,27.13,27.13,27.13,13.46,15.64,15.64,0,9.58,13.73,13.73,27.13
4342870,250,J3490,,,,,,,TOFRANIL 10MG TABLETE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342871,250,J3490,,,,,,,HYDROCORTISONE 5MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342872,250,J3490,,,,,,,BREVITAL 500MG VIAL,261.21,104.48,0,222.03,222.03,SKIPPED,198.52,198.52,222.03,222.03,222.03,110.07,127.99,127.99,0,78.36,112.32,112.32,222.03
4342873,250,J3490,,,,,,,VITAMIN B6 100MG/ML 1ML VL,52.89,21.16,0,44.96,44.96,SKIPPED,40.2,40.2,44.96,44.96,44.96,22.29,25.92,25.92,0,15.87,22.74,22.74,44.96
4342874,250,J1170,,,,,,,DILAUDID PCA 55MG/55ML PFS,20.01,8,0,17.01,17.01,SKIPPED,0.4,0.4,17.01,17.01,17.01,8.43,9.8,9.8,0,6,8.6,8.6,17.01
4342875,250,J2001,,,,,,,XYLOCAINE MPF 10MG/ML 2ML VL,14,5.6,0,11.9,11.9,SKIPPED,0.02,0.02,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342876,250,J2001,,,,,,,XYLOCAINE 20MG/ML 10ML VL,14,5.6,0,11.9,11.9,SKIPPED,0.02,0.02,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342877,250,J3490,,,,,,,MORPHINE 8MG/ML 1ML SYRINGE,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342878,250,J3490,,,,,,,STEMI KIT,304.48,121.79,0,258.81,258.81,SKIPPED,231.4,231.4,258.81,258.81,258.81,128.31,149.2,149.2,0,91.34,130.93,130.93,258.81
4342880,250,J3490,,,,,,,LIDOCAINE/EPI 1% 10ML VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342881,250,J3490,,,,,,,LIDOCAINE 2%PL 50ML,19.79,7.92,0,16.82,16.82,SKIPPED,15.04,15.04,16.82,16.82,16.82,8.34,9.7,9.7,0,5.94,8.51,8.51,16.82
4342882,250,J2001,,,,,,,XYLOCAINE MPF/EPI 1.5% 10ML,26.59,10.64,0,22.6,22.6,SKIPPED,0.02,0.02,22.6,22.6,22.6,11.2,13.03,13.03,0,7.98,11.43,11.43,22.6
4342883,250,J3490,,,,,,,BUPIVACAINE 0.5% 10ML,14.56,5.82,0,12.38,12.38,SKIPPED,11.07,11.07,12.38,12.38,12.38,6.13,7.13,7.13,0,4.37,6.26,6.26,12.38
4342884,250,J3490,,,,,,,BUPIVACAINE 0.25% 10ML,18.19,7.28,0,15.46,15.46,SKIPPED,13.82,13.82,15.46,15.46,15.46,7.66,8.91,8.91,0,5.46,7.82,7.82,15.46
4342885,250,J3490,,,,,,,MORPHINE 10MG/ML CARPJ,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342886,250,J3490,,,,,,,BUPIVACAINE/EPI 0.5% 10ML VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342887,250,J3490,,,,,,,EUCERIN CREAM,16.28,6.51,0,13.84,13.84,SKIPPED,12.37,12.37,13.84,13.84,13.84,6.86,7.98,7.98,0,4.88,7,7,13.84
4342888,250,J3490,,,,,,,KCENTRA 1000 UNIT VL,8671.6,3468.64,0,7370.86,7370.86,SKIPPED,6590.42,6590.42,7370.86,7370.86,7370.86,3654.21,4249.08,4249.08,0,2601.48,3728.79,3728.79,7370.86
4342889,250,J3490,,,,,,,CIPRO 200MG PM BAG,38.9,15.56,0,33.06,33.06,SKIPPED,29.56,29.56,33.06,33.06,33.06,16.4,19.06,19.06,0,11.67,16.73,16.73,33.06
4342890,250,J3490,,,,,,,VERSED 5MG/ML 1ML VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342891,250,J3490,,,,,,,BUMEX 0.25MG/ML 4ML VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342892,250,J3475,,,,,,,MAGNESIUM 1GM/2ML VIAL,14,5.6,0,11.9,11.9,SKIPPED,0.07,0.07,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342893,250,J3490,,,,,,,SYSTANE OPTH DROP,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342894,250,J3490,,,,,,,ZYRTEC CHILD O/S 2.5MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342895,250,J3490,,,,,,,SENSORCAINE MPF 0.25% 10ML VIAL,18.19,7.28,0,15.46,15.46,SKIPPED,13.82,13.82,15.46,15.46,15.46,7.66,8.91,8.91,0,5.46,7.82,7.82,15.46
4342896,250,J3490,,,,,,,TRANEXAMIC ACID 10ML VIAL,99.75,39.9,0,84.79,84.79,SKIPPED,75.81,75.81,84.79,84.79,84.79,42.03,48.88,48.88,0,29.92,42.89,42.89,84.79
4342897,250,J3489,,,,,,,ZOMETA 4MG/5ML VIAL,574.56,229.82,0,488.38,488.38,SKIPPED,8.1,8.1,488.38,488.38,488.38,242.12,281.53,281.53,0,172.37,247.06,247.06,488.38
4342898,250,J1335,,,,,,,INVANZ 1GM VIAL,410.68,164.27,0,349.08,349.08,SKIPPED,58.54,58.54,349.08,349.08,349.08,173.06,201.23,201.23,0,123.2,176.59,176.59,349.08
4342899,250,J3490,,,,,,,THROMBIN 5000IU TOPICAL,230.25,92.1,0,195.71,195.71,SKIPPED,174.99,174.99,195.71,195.71,195.71,97.03,112.82,112.82,0,69.08,99.01,99.01,195.71
4342900,250,J3490,,,,,,,VISION BLUE 2.5ML OPTH SOL,236.53,94.61,0,201.05,201.05,SKIPPED,179.76,179.76,201.05,201.05,201.05,99.68,115.9,115.9,0,70.96,101.71,101.71,201.05
4342901,250,90696,,,,,,,KINRIX VACCINE,181.04,72.42,0,153.88,153.88,SKIPPED,57.74,57.74,153.88,153.88,153.88,76.29,88.71,88.71,0,54.31,77.85,77.85,153.88
4342902,250,J3490,,,,,,,LIDOCAINE MPF1%30ML VIAL,32.72,13.09,0,27.81,27.81,SKIPPED,24.87,24.87,27.81,27.81,27.81,13.79,16.03,16.03,0,9.82,14.07,14.07,27.81
4342903,250,J3490,,,,,,,LIDOCAINE MPF 0.5%50ML VIAL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342904,250,J3490,,,,,,,Allegra-D 120mg 12 Hour Tablet,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342905,250,J2185,,,,,,,MEROPENEM 1GM VIAL,63.84,25.54,0,54.26,54.26,SKIPPED,2.76,2.76,54.26,54.26,54.26,26.9,31.28,31.28,0,19.15,27.45,27.45,54.26
4342906,250,J7321,,,,,,,SUPARTZ 25MG/2.5ML PF SYRINGE,757.17,302.87,0,643.59,643.59,SKIPPED,90.95,90.95,643.59,643.59,643.59,319.07,371.01,371.01,0,227.15,325.58,325.58,643.59
4342907,250,J0702,,,,,,,BETAMETHASONE NA PHOS 12MG/ML VIAL,63.84,25.54,0,54.26,54.26,SKIPPED,7.12,7.12,54.26,54.26,54.26,26.9,31.28,31.28,0,19.15,27.45,27.45,54.26
4342908,250,J3490,,,,,,,BRIDION 200MG2ML INJ,368.42,147.37,0,313.16,313.16,SKIPPED,280,280,313.16,313.16,313.16,155.25,180.53,180.53,0,110.53,158.42,158.42,313.16
4342909,250,J3490,,,,,,,PRADAXA 150MG CAPSULE,26.39,10.56,0,22.43,22.43,SKIPPED,20.06,20.06,22.43,22.43,22.43,11.12,12.93,12.93,0,7.92,11.35,11.35,22.43
4342910,250,J3490,,,,,,,PRAXBIND 2.5GM/50ML VL,7102.89,2841.16,0,6037.46,6037.46,SKIPPED,5398.2,5398.2,6037.46,6037.46,6037.46,2993.16,3480.42,3480.42,0,2130.87,3054.24,3054.24,6037.46
4342911,250,J0702,,,,,,,BETAMETHASONE PF 12MG/2ML VL,59.69,23.88,0,50.74,50.74,SKIPPED,7.12,7.12,50.74,50.74,50.74,25.16,29.25,29.25,0,17.91,25.67,25.67,50.74
4342912,250,J7515,,,,,,,CYCLOSPORINE 25MG CAPSULE,7,2.8,0,5.95,5.95,SKIPPED,0.59,0.59,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342913,250,J3490,,,,,,,MINOXIDIL 2.5MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342914,250,J3490,,,,,,,BUPIVACAINE EPI 0.25% INJ,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342915,250,J3370,,,,,,,VANCOMYCIN 500MG VL(SURGERY ONLY),22.34,8.94,0,18.99,18.99,SKIPPED,4.47,4.47,18.99,18.99,18.99,9.42,10.95,10.95,0,6.7,9.61,9.61,18.99
4342916,250,J3490,,,,,,,CATARACT KIT,1093.75,437.5,0,929.69,929.69,SKIPPED,831.25,831.25,929.69,929.69,929.69,460.9,535.94,535.94,0,328.12,470.31,470.31,929.69
4342917,250,J3490,,,,,,,YAG KIT,822.61,329.04,0,699.22,699.22,SKIPPED,625.18,625.18,699.22,699.22,699.22,346.65,403.08,403.08,0,246.78,353.72,353.72,699.22
4342918,250,J3490,,,,,,,LET 3ML SYRINGE,44.05,17.62,0,37.44,37.44,SKIPPED,33.48,33.48,37.44,37.44,37.44,18.56,21.58,21.58,0,13.22,18.94,18.94,37.44
4342919,250,J3490,,,,,,,CALCITRATE 950 MG,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342920,250,J3490,,,,,,,PERCOCET 10/325 TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342921,250,J0696,,,,,,,ROCEPHIN 250MG INJ,14,5.6,0,11.9,11.9,SKIPPED,2.53,2.53,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342922,250,J0696,,,,,,,ROCEPHIN 500MG INJ VL,14,5.6,0,11.9,11.9,SKIPPED,2.53,2.53,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342923,250,J3490,,,,,,,ETHYL CHLORIDE SPRAY,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342924,250,J3490,,,,,,,PHENOL EZ SWAB,14.52,5.81,0,12.34,12.34,SKIPPED,11.04,11.04,12.34,12.34,12.34,6.12,7.11,7.11,0,4.36,6.24,6.24,12.34
4342925,250,J3490,,,,,,,MONSELS SOLUTION,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342926,250,S0119,,,,,,,ZOFRAN 4MG SL TABLET,61.48,24.59,0,52.26,52.26,SKIPPED,2.56,2.56,52.26,52.26,52.26,25.91,30.13,30.13,0,18.44,26.44,26.44,52.26
4342927,250,J3490,,,,,,,PROVOCHOL 100MG/20ML INH VL,248.98,99.59,0,211.63,211.63,SKIPPED,189.22,189.22,211.63,211.63,211.63,104.92,122,122,0,74.69,107.06,107.06,211.63
4342928,250,J3490,,,,,,,IODINE 10% OINTMENT 1OZ,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342929,250,J0131,,,,,,,ACETAMINOPHEN IV INJECTABLE,151.2,60.48,0,128.52,128.52,SKIPPED,0.26,0.26,128.52,128.52,128.52,63.72,74.09,74.09,0,45.36,65.02,65.02,128.52
4342930,250,J3490,,,,,,,LidocaineEpi 1% 30ml vl,16.46,6.58,0,13.99,13.99,SKIPPED,12.51,12.51,13.99,13.99,13.99,6.94,8.07,8.07,0,4.94,7.08,7.08,13.99
4342931,250,J3490,,,,,,,FLAGYL TOPICAL GEL 45GM,232.28,92.91,0,197.44,197.44,SKIPPED,176.53,176.53,197.44,197.44,197.44,97.88,113.82,113.82,0,69.68,99.88,99.88,197.44
4342932,250,,,,,,,,DEHYDRATED ALCOHOL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342933,250,J3490,,,,,,,DEHYDRATED ALCOHOL,1485.47,594.19,0,1262.65,1262.65,SKIPPED,1128.96,1128.96,1262.65,1262.65,1262.65,625.98,727.88,727.88,0,445.64,638.75,638.75,1262.65
4342934,250,J3490,,,,,,,LUMICAIN TOPICAL SOLUTION,18.14,7.26,0,15.42,15.42,SKIPPED,13.79,13.79,15.42,15.42,15.42,7.64,8.89,8.89,0,5.44,7.8,7.8,15.42
4342935,250,90696,,,,,,,CLN KINRIX VACCINE,181.04,72.42,0,153.88,153.88,SKIPPED,57.74,57.74,153.88,153.88,153.88,76.29,88.71,88.71,0,54.31,77.85,77.85,153.88
4342936,250,J3490,,,,,,,GENTAMICIN TOPICAL OINTMENT,131.35,52.54,0,111.65,111.65,SKIPPED,99.83,99.83,111.65,111.65,111.65,55.35,64.36,64.36,0,39.4,56.48,56.48,111.65
4342937,250,J2360,,,,,,,CLN NORFLEX 60MG/2ML VIAL,38.3,15.32,0,32.56,32.56,SKIPPED,9.66,9.66,32.56,32.56,32.56,16.14,18.77,18.77,0,11.49,16.47,16.47,32.56
4342938,250,,,,,,,,ACTIVASE 2MG INJ VIAL,512.98,205.19,0,436.03,436.03,SKIPPED,389.86,389.86,436.03,436.03,436.03,216.17,251.36,251.36,0,153.89,220.58,220.58,436.03
4342940,250,J3490,,,,,,,TV INFANRIX(STATE ONLY),0.05,0.02,0,0.04,0.04,SKIPPED,0.04,0.04,0.04,0.04,0.04,0.02,0.02,0.02,0,0.02,0.02,0.02,0.04
4342941,250,,,,,,,,ANCEF 1GM/DEX 50ML IVPB,115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342942,250,J0885,,,,,,,"PROCRIT 10,000 UNITS/ML INJ",853.06,341.22,0,725.1,725.1,SKIPPED,16.11,16.11,725.1,725.1,725.1,359.48,418,418,0,255.92,366.82,366.82,725.1
4342943,250,,,,,,,,GLYCERIN PF 2ML INJ VIAL,31.9,12.76,0,27.12,27.12,SKIPPED,24.24,24.24,27.12,27.12,27.12,13.45,15.63,15.63,0,9.57,13.72,13.72,27.12
4342944,250,,,,,,,,SODIUM TETRADECYL 2ML INJ VIAL,53.2,21.28,0,45.22,45.22,SKIPPED,40.43,40.43,45.22,45.22,45.22,22.42,26.07,26.07,0,15.96,22.88,22.88,45.22
4342945,250,J2001,,,,,,,LIDOCAINE EPI 1% 50ML VIAL,30.16,12.06,0,25.64,25.64,SKIPPED,0.02,0.02,25.64,25.64,25.64,12.71,14.78,14.78,0,9.05,12.97,12.97,25.64
4342946,250,J3490,,,,,,,CHLORHEX GLUCONATE RINSE,27.93,11.17,0,23.74,23.74,SKIPPED,21.23,21.23,23.74,23.74,23.74,11.77,13.69,13.69,0,8.38,12.01,12.01,23.74
4342947,250,J3490,,,,,,,TRACRIUM 100MG/10ML VIAL,50.54,20.22,0,42.96,42.96,SKIPPED,38.41,38.41,42.96,42.96,42.96,21.3,24.76,24.76,0,15.16,21.73,21.73,42.96
4342948,250,J3490,,,,,,,PRECEDEX 100MCG/ML 2ML VL,17.3,6.92,0,14.7,14.7,SKIPPED,13.15,13.15,14.7,14.7,14.7,7.29,8.48,8.48,0,5.19,7.44,7.44,14.7
4342949,250,J0878,,,,,,,CUBICIN 500MG INJ VIAL,1422.01,568.8,0,1208.71,1208.71,SKIPPED,0.62,0.62,1208.71,1208.71,1208.71,599.23,696.78,696.78,0,426.6,611.46,611.46,1208.71
4342950,250,J3490,,,,,,,RIFADIN 600MG INJ VL,569.96,227.98,0,484.47,484.47,SKIPPED,433.17,433.17,484.47,484.47,484.47,240.18,279.28,279.28,0,170.99,245.08,245.08,484.47
4342951,250,J3475,,,,,,,MAGNESIUM 50% 500MG/ML 20ML VIAL,14,5.6,0,11.9,11.9,SKIPPED,0.07,0.07,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342952,250,J3490,,,,,,,MINERAL OIL STERILE TOPICAL,14.5,5.8,0,12.32,12.32,SKIPPED,11.02,11.02,12.32,12.32,12.32,6.12,7.1,7.1,0,4.35,6.24,6.24,12.32
4342953,250,J3490,,,,,,,CLN DONNATAL ELIX 10ML,119.7,47.88,0,101.74,101.74,SKIPPED,90.97,90.97,101.74,101.74,101.74,50.44,58.65,58.65,0,35.91,51.47,51.47,101.74
4342954,252,J3490,,,,,,,SEVOFLURANE/DESFLURANE GLOBAL CHARGE,165,66,0,140.25,140.25,SKIPPED,125.4,125.4,140.25,140.25,140.25,69.53,80.85,80.85,0,49.5,70.95,70.95,140.25
4342955,250,J3490,,,,,,,MELATONIN 5MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342956,250,,,,,,,,OPTIMARK 330.9MG/ML 20ML VIAL,358.65,143.46,0,304.85,304.85,SKIPPED,272.57,272.57,304.85,304.85,304.85,151.14,175.74,175.74,0,107.6,154.22,154.22,304.85
4342957,250,,,,,,,,OPTIMARK 0.5MMOL/ML 15ML PFS,268.35,107.34,0,228.1,228.1,SKIPPED,203.95,203.95,228.1,228.1,228.1,113.08,131.49,131.49,0,80.5,115.39,115.39,228.1
4342958,250,90686,,,,,,,FLUZONE VACCINE 6MON +,30,12,0,25.5,25.5,SKIPPED,16.05,16.05,25.5,25.5,25.5,12.64,14.7,14.7,0,9,12.9,12.9,25.5
4342959,250,90756,,,,,,,CLN FLUCELVAX VACCINE 4 YRS>,78.77,31.51,0,66.95,66.95,SKIPPED,25.37,25.37,66.95,66.95,66.95,33.19,38.6,38.6,0,23.63,33.87,33.87,66.95
4342960,250,,,,,,,,SOD CHL 0.9% 150ML BAG,115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4342961,250,,,,,,,,NAROPIN 2MG/ML 100ML BT,191.52,76.61,0,162.79,162.79,SKIPPED,145.56,145.56,162.79,162.79,162.79,80.7,93.84,93.84,0,57.46,82.35,82.35,162.79
4342962,250,J1094,,,,,,,CLN DECADRON 0.5/5ml Elixir,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342963,250,J3490,,,,,,,UREA POWDER 15GM PKT,11.17,4.47,0,9.49,9.49,SKIPPED,8.49,8.49,9.49,9.49,9.49,4.7,5.47,5.47,0,3.35,4.8,4.8,9.49
4342964,250,J3490,,,,,,,TRANEXAMIC ACID 1000MG/10ML VL,99.75,39.9,0,84.79,84.79,SKIPPED,75.81,75.81,84.79,84.79,84.79,42.03,48.88,48.88,0,29.92,42.89,42.89,84.79
4342965,250,J2001,,,,,,,XYLOCAINE 1% SDV 5ML,14,5.6,0,11.9,11.9,SKIPPED,0.02,0.02,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342966,250,,,,,,,,GLUCAGON 1MG VIAL(Omnicell only),544.24,217.7,0,462.6,462.6,SKIPPED,413.62,413.62,462.6,462.6,462.6,229.34,266.68,266.68,0,163.27,234.02,234.02,462.6
4342967,250,,,,,,,,DILAUDID 2MG/ML 1ML VIAL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342968,250,J3490,,,,,,,ATROPINE PEDI 0.25MG SYRINGE,53.75,21.5,0,45.69,45.69,SKIPPED,40.85,40.85,45.69,45.69,45.69,22.65,26.34,26.34,0,16.12,23.11,23.11,45.69
4342969,250,J3490,,,,,,,SENSORCAINE EPI 0.5%30ML VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342970,250,,,,,,,,MORPHINE 4MG/ML 1ML VIAL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342971,250,J3490,,,,,,,VERSED 2MG/ML 5ML SYRUP,19.5,7.8,0,16.58,16.58,SKIPPED,14.82,14.82,16.58,16.58,16.58,8.22,9.56,9.56,0,5.85,8.39,8.39,16.58
4342972,250,J3490,,,,,,,MORPHINE ORAL SOLUTION 10MG/5ML,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342973,250,J3490,,,,,,,XYLOCAINE EPI 1.5% 5ML AMP,15.74,6.3,0,13.38,13.38,SKIPPED,11.96,11.96,13.38,13.38,13.38,6.63,7.71,7.71,0,4.72,6.77,6.77,13.38
4342974,250,J1170,,,,,,,DILAUDID 1MG/ML 1ML CPJ,14,5.6,0,11.9,11.9,SKIPPED,0.4,0.4,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342975,250,J3490,,,,,,,LIPITOR 20MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342977,250,J3490,,,,,,,KETAMINE 10MG/ML 20ML VL,64.18,25.67,0,54.55,54.55,SKIPPED,48.78,48.78,54.55,54.55,54.55,27.05,31.45,31.45,0,19.25,27.6,27.6,54.55
4342978,250,J3490,,,,,,,EXPAREL 133MG/10ML VL,604.46,241.78,0,513.79,513.79,SKIPPED,459.39,459.39,513.79,513.79,513.79,254.72,296.19,296.19,0,181.34,259.92,259.92,513.79
4342979,636,J7326,,,,,,,CLN GEL-ONE 30MG/3ML PF SYRINGE,3670.8,1468.32,0,3120.18,3120.18,SKIPPED,529.83,529.83,3120.18,3120.18,3120.18,1546.87,1798.69,1798.69,0,1101.24,1578.44,1578.44,3120.18
4342980,250,J3490,,,,,,,XYLOCAINE 1% MDV 50ML VL,15.86,6.34,0,13.48,13.48,SKIPPED,12.05,12.05,13.48,13.48,13.48,6.68,7.77,7.77,0,4.76,6.82,6.82,13.48
4342981,250,J3490,,,,,,,SENSORCAINE EPI 0.25% 30ML,29.33,11.73,0,24.93,24.93,SKIPPED,22.29,22.29,24.93,24.93,24.93,12.36,14.37,14.37,0,8.8,12.61,12.61,24.93
4342982,250,,,,,,,,ON Q NAROPIN 2MG/ML 545ML,1373.83,549.53,0,1167.76,1167.76,SKIPPED,1044.11,1044.11,1167.76,1167.76,1167.76,578.94,673.18,673.18,0,412.15,590.75,590.75,1167.76
4342983,250,,,,,,,,ATIVAN 20MG/10ML VL,33.99,13.6,0,28.89,28.89,SKIPPED,25.83,25.83,28.89,28.89,28.89,14.33,16.66,16.66,0,10.2,14.62,14.62,28.89
4342984,250,J3490,,,,,,,AUGMENTIN 400MG/5ML SUSP 50ML,100.42,40.17,0,85.36,85.36,SKIPPED,76.32,76.32,85.36,85.36,85.36,42.32,49.21,49.21,0,30.13,43.18,43.18,85.36
4342985,250,J3490,,,,,,,BUPIVACAINE EPI 0.5% 10ML VL,19.02,7.61,0,16.17,16.17,SKIPPED,14.46,14.46,16.17,16.17,16.17,8.02,9.32,9.32,0,5.71,8.18,8.18,16.17
4342986,250,90686,,,,,,,TV FluLaVel 0.5ml > 6 mon.,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4342987,250,90746,,,,,,,CLN ENGERIX B ADULT VAC 20MCG/ML,204.86,81.94,0,174.13,174.13,SKIPPED,45.97,45.97,174.13,174.13,174.13,86.33,100.38,100.38,0,61.46,88.09,88.09,174.13
4342988,250,,,,,,,,TRANDATE 20MG/4ML CPJ SYRINGE,23.96,9.58,0,20.37,20.37,SKIPPED,18.21,18.21,20.37,20.37,20.37,10.09,11.74,11.74,0,7.19,10.3,10.3,20.37
4342989,250,J3490,,,,,,,SENSORCAINE MPF 0.25% 30ML VL,20.88,8.35,0,17.75,17.75,SKIPPED,15.87,15.87,17.75,17.75,17.75,8.8,10.23,10.23,0,6.26,8.98,8.98,17.75
4342990,250,J3490,,,,,,,OrderSet MS 2mg/1ml inj,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342991,250,,,,,,,,CLN ORTHOVISC 30MG/2ML SYRINGE,1525.78,610.31,0,1296.91,1296.91,SKIPPED,1159.59,1159.59,1296.91,1296.91,1296.91,642.97,747.63,747.63,0,457.73,656.09,656.09,1296.91
4342992,250,,,,,,,,INF VANCOMYCIN 1GM VIAL,19.95,7.98,0,16.96,16.96,SKIPPED,15.16,15.16,16.96,16.96,16.96,8.41,9.78,9.78,0,5.98,8.58,8.58,16.96
4342993,250,,,,,,,,INF ROCEPHIN 1GM VIAL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342994,636,Q0138,,,,,,,INF FERAHEME 510MG VIAL,3810.02,1524.01,0,3238.52,3238.52,SKIPPED,1.48,1.48,3238.52,3238.52,3238.52,1605.54,1866.91,1866.91,0,1143.01,1638.31,1638.31,3238.52
4342995,250,J1940,,,,,,,INF LASIX 20MG INJ VIAL,14,5.6,0,11.9,11.9,SKIPPED,1.65,1.65,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4342996,250,J3490,,,,,,,INF BENADRYL 25MG CAPSULE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342997,250,J3490,,,,,,,INF TYLENOL 325MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4342998,250,J3490,,,,,,,INF SOD CHL 0.9% 1000ML BAG,20,8,0,17,17,SKIPPED,15.2,15.2,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4342999,250,90662,,,,,,,CLN FLU HIGH DOSE ADULT 0.5ML SYRINGE,182.73,73.09,0,155.32,155.32,SKIPPED,31.98,31.98,155.32,155.32,155.32,77,89.54,89.54,0,54.82,78.57,78.57,155.32
4343000,250,J7327,,,,,,,CLN MONOVISC 88MG/4ML,4788,1915.2,0,4069.8,4069.8,SKIPPED,889.12,889.12,4069.8,4069.8,4069.8,2017.66,2346.12,2346.12,0,1436.4,2058.84,2058.84,4069.8
4343001,250,J3490,,,,,,,INF SOD CHL 0.9% 500ML,20,8,0,17,17,SKIPPED,15.2,15.2,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4343002,250,J3490,,,,,,,INF SOD CHL0.9% FLUSH SYR,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343003,250,,,,,,,,INF DHE 1MG/ML AMP,419.27,167.71,0,356.38,356.38,SKIPPED,318.65,318.65,356.38,356.38,356.38,176.68,205.44,205.44,0,125.78,180.29,180.29,356.38
4343004,250,J1815,,,,,,,INS REGULAR 3ML VL(MedSurg Only),47.46,18.98,0,40.34,40.34,SKIPPED,0.14,0.14,40.34,40.34,40.34,20,23.26,23.26,0,14.24,20.41,20.41,40.34
4343005,250,J1815,,,,,,,INS NPH 3ML vial,47.46,18.98,0,40.34,40.34,SKIPPED,0.14,0.14,40.34,40.34,40.34,20,23.26,23.26,0,14.24,20.41,20.41,40.34
4343006,250,J3490,,,,,,,INS HUMALOG LISPRO 3ML(MedSurg Only),87.68,35.07,0,74.53,74.53,SKIPPED,66.64,66.64,74.53,74.53,74.53,36.95,42.96,42.96,0,26.3,37.7,37.7,74.53
4343007,250,J3490,,,,,,,INF BENADRYL 50MG/ML VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343008,250,J3490,,,,,,,INF COMPAZINE 10MG/2ML INJ,28.73,11.49,0,24.42,24.42,SKIPPED,21.83,21.83,24.42,24.42,24.42,12.1,14.08,14.08,0,8.62,12.35,12.35,24.42
4343009,250,J3490,,,,,,,INF DEPACON 500MG/5ML VL,21.39,8.56,0,18.18,18.18,SKIPPED,16.26,16.26,18.18,18.18,18.18,9.02,10.48,10.48,0,6.42,9.2,9.2,18.18
4343010,250,J3490,,,,,,,SOTRADECOL1% 10MG/ML 2ML VL,249.38,99.75,0,211.97,211.97,SKIPPED,189.53,189.53,211.97,211.97,211.97,105.09,122.2,122.2,0,74.81,107.23,107.23,211.97
4343011,250,J3490,,,,,,,INF SOD CHL 50ML PLAIN BAG,115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4343012,250,J3490,,,,,,,INF SOD CHL MINI 50ML BAG,115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4343013,250,J3490,,,,,,,INF SOD CHL MINI 100ML MINI BAG,115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4343014,250,J3490,,,,,,,INF SOD CHL 100ML PLAIN BAG,115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4343015,250,J3490,,,,,,,INF TORADOL 60MG/2ML VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343016,250,J3490,,,,,,,XYLOCAINE EPI MPF 1% 30ML VL,32.85,13.14,0,27.92,27.92,SKIPPED,24.97,24.97,27.92,27.92,27.92,13.85,16.1,16.1,0,9.86,14.13,14.13,27.92
4343017,250,,,,,,,,"RETACRIT 10,000UNITS/ML 1ML VL",352.08,140.83,0,299.27,299.27,SKIPPED,267.58,267.58,299.27,299.27,299.27,148.36,172.52,172.52,0,105.62,151.39,151.39,299.27
4343018,250,J3490,,,,,,,INF ST WATER DILUENT 10ML VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343019,250,,,,,,,,INF SOD CHL0.9% 250ML BAG,20,8,0,17,17,SKIPPED,15.2,15.2,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4343020,250,,,,,,,,INF ACTIVASE 2MG FLUSH CATHFLO VL,512.98,205.19,0,436.03,436.03,SKIPPED,389.86,389.86,436.03,436.03,436.03,216.17,251.36,251.36,0,153.89,220.58,220.58,436.03
4343021,250,J3490,,,,,,,REQUIP 5MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4343022,250,J3490,,,,,,,NUTRILIPID 20%,67.93,27.17,0,57.74,57.74,SKIPPED,51.63,51.63,57.74,57.74,57.74,28.63,33.29,33.29,0,20.38,29.21,29.21,57.74
4343023,250,J3490,,,,,,,INF INJECTAFER 750MG INJ VIAL,4140.8,1656.32,0,3519.68,3519.68,SKIPPED,3147.01,3147.01,3519.68,3519.68,3519.68,1744.93,2028.99,2028.99,0,1242.24,1780.54,1780.54,3519.68
4343024,250,J3490,,,,,,,TV RECOMBIVAX HB PEDI SYR(STATE ONLY),0.03,0.01,0,0.03,0.03,SKIPPED,0.02,0.02,0.03,0.03,0.03,0.01,0.01,0.01,0,0.01,0.01,0.01,0.03
4343025,250,J3490,,,,,,,BUPIVACINE EPI MPF 0.5% 30ML,31.6,12.64,0,26.86,26.86,SKIPPED,24.02,24.02,26.86,26.86,26.86,13.32,15.48,15.48,0,9.48,13.59,13.59,26.86
4343027,250,J3490,,,,,,,INF RECLAST 5MG INJ VIAL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343028,250,J3490,,,,,,,INF GENTAMICIN 80MG/2ML INJ,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343029,250,J3490,,,,,,,DURAMORPH 10MG/10ML AMP,92.44,36.98,0,78.57,78.57,SKIPPED,70.25,70.25,78.57,78.57,78.57,38.96,45.3,45.3,0,27.73,39.75,39.75,78.57
4343030,250,J3490,,,,,,,INF MAGNESIUM 1000MG/2ML VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343031,250,J3490,,,,,,,INF SOLU-MEDROL 125MG INJ VL,31.08,12.43,0,26.42,26.42,SKIPPED,23.62,23.62,26.42,26.42,26.42,13.09,15.23,15.23,0,9.32,13.36,13.36,26.42
4343032,250,J1885,,,,,,,INF TORADOL 30MG/1ML INJ VL,15.96,6.38,0,13.57,13.57,SKIPPED,0.22,0.22,13.57,13.57,13.57,6.72,7.82,7.82,0,4.79,6.86,6.86,13.57
4343033,250,J3490,,,,,,,INF PHENERGAN 25MG/ML 1ML INJ VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343034,250,J3490,,,,,,,NICORETTE 2MG GUM,23.91,9.56,0,20.32,20.32,SKIPPED,18.17,18.17,20.32,20.32,20.32,10.07,11.72,11.72,0,7.17,10.28,10.28,20.32
4343035,250,J3490,,,,,,,CLN BENADRYL 25MG CAPSULE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4343036,250,,,,,,,,PATIENT SPECIFIC GLYCERIN,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4343037,250,,,,,,,,PATIENT SPECIFIC BETAMETH 12MG VL,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4343038,250,J3490,,,,,,,HEPLISAV-B 20MCG/0.5ML SYRINGE,425.81,170.32,0,361.94,361.94,SKIPPED,323.62,323.62,361.94,361.94,361.94,179.44,208.65,208.65,0,127.74,183.1,183.1,361.94
4343040,250,J3490,,,,,,,INSULIN 70/30 3ML VL,47.46,18.98,0,40.34,40.34,SKIPPED,36.07,36.07,40.34,40.34,40.34,20,23.26,23.26,0,14.24,20.41,20.41,40.34
4343041,250,J3490,,,,,,,REMIFENTAL 1MG/3ML INJ VIAL,205.28,82.11,0,174.49,174.49,SKIPPED,156.01,156.01,174.49,174.49,174.49,86.5,100.59,100.59,0,61.58,88.27,88.27,174.49
4343042,250,,,,,,,,TV FLUZONE ADULT VACCINE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4343043,250,J3490,,,,,,,CLN DULCOLAX 5MG TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4343044,250,J3490,,,,,,,CLN MIRALAX 238GM BOTTLE,37.32,14.93,0,31.72,31.72,SKIPPED,28.36,28.36,31.72,31.72,31.72,15.73,18.29,18.29,0,11.2,16.05,16.05,31.72
4343045,250,,,,,,,,CLN FLUCELVAX FLU(4YR+),78.77,31.51,0,66.95,66.95,SKIPPED,59.87,59.87,66.95,66.95,66.95,33.19,38.6,38.6,0,23.63,33.87,33.87,66.95
4343047,250,J3490,,,,,,,CLN GOLYTELY PREP,75.76,30.3,0,64.4,64.4,SKIPPED,57.58,57.58,64.4,64.4,64.4,31.93,37.12,37.12,0,22.73,32.58,32.58,64.4
4343048,250,J3490,,,,,,,NEO-SYNEPHRINE 1MG/10MLSYR(ANES ONLY),21.39,8.56,0,18.18,18.18,SKIPPED,16.26,16.26,18.18,18.18,18.18,9.02,10.48,10.48,0,6.42,9.2,9.2,18.18
4343049,250,J3490,,,,,,,EPHEDRINE 50MG/10MLSYR(ANES ONLY),94.48,37.79,0,80.31,80.31,SKIPPED,71.8,71.8,80.31,80.31,80.31,39.82,46.3,46.3,0,28.34,40.63,40.63,80.31
4343050,250,J3490,,,,,,,ZOSYN 4.5GM VL,25.27,10.11,0,21.48,21.48,SKIPPED,19.21,19.21,21.48,21.48,21.48,10.65,12.38,12.38,0,7.58,10.87,10.87,21.48
4343051,250,J3490,,,,,,,INF REGLAN 10MG INJ VL,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343052,250,J3490,,,,,,,CLN RACEPINEPHRINE INH SOL 5ML,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4343053,250,J3490,,,,,,,INF INVANZ 1GM INJ VIAL,373.69,149.48,0,317.64,317.64,SKIPPED,284,284,317.64,317.64,317.64,157.48,183.11,183.11,0,112.11,160.69,160.69,317.64
4343054,250,J3490,,,,,,,LORATADINE-D E.R.TABLET,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4343055,250,J3490,,,,,,,NASONEX 0.1%OINT 15GM,64.64,25.86,0,54.94,54.94,SKIPPED,49.13,49.13,54.94,54.94,54.94,27.24,31.67,31.67,0,19.39,27.8,27.8,54.94
4343056,250,J3490,,,,,,,CELESTONE TOPICAL 0.1%OINT 15GM,54.1,21.64,0,45.98,45.98,SKIPPED,41.12,41.12,45.98,45.98,45.98,22.79,26.51,26.51,0,16.23,23.26,23.26,45.98
4343057,250,J3490,,,,,,,ZADITOR OPTH SOL 5ML,31.12,12.45,0,26.45,26.45,SKIPPED,23.65,23.65,26.45,26.45,26.45,13.11,15.25,15.25,0,9.34,13.38,13.38,26.45
4343058,250,90674,,,,,,,TV FLUCELVAX VACCINE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4343059,250,P9047,,,,,,,INF ALBUMIN 25% 50ML VL,287.28,114.91,0,244.19,244.19,SKIPPED,62.21,62.21,244.19,244.19,244.19,121.06,140.77,140.77,0,86.18,123.53,123.53,244.19
4343060,250,J3490,,,,,,,CALDOLOR 800MG/200ML PM BAG,74.94,29.98,0,63.7,63.7,SKIPPED,56.95,56.95,63.7,63.7,63.7,31.58,36.72,36.72,0,22.48,32.22,32.22,63.7
4343061,250,J3490,,,,,,,NIMBEX 200MG/20ML INJ VL,863.44,345.38,0,733.92,733.92,SKIPPED,656.21,656.21,733.92,733.92,733.92,363.85,423.09,423.09,0,259.03,371.28,371.28,733.92
4343063,250,J3490,,,,,,,CLN SILVER NITRATE STICK,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4343064,250,J3490,,,,,,,CLN ASPIRIN 81MG CHEWABLE TAB,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4343065,250,J3490,,,,,,,CLN FLUORESCEIN OPTH STRIPS,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4343066,250,J3490,,,,,,,CLN DRY-SOL SOLUTION,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4343067,250,J3490,,,,,,,INAPSINE 2.5MG/ML 2ML VL,27.48,10.99,0,23.36,23.36,SKIPPED,20.88,20.88,23.36,23.36,23.36,11.58,13.47,13.47,0,8.24,11.82,11.82,23.36
4343068,250,J3490,,,,,,,INF ORBACTIV 400MG INJ,3493.11,1397.24,0,2969.14,2969.14,SKIPPED,2654.76,2654.76,2969.14,2969.14,2969.14,1472,1711.62,1711.62,0,1047.93,1502.04,1502.04,2969.14
4343069,250,J3490,,,,,,,ANGIOMAX 250MG INJ VL,462.84,185.14,0,393.41,393.41,SKIPPED,351.76,351.76,393.41,393.41,393.41,195.04,226.79,226.79,0,138.85,199.02,199.02,393.41
4343070,250,J3490,,,,,,,HYLENEX 150units/ml 1ML VL,178.11,71.24,0,151.39,151.39,SKIPPED,135.36,135.36,151.39,151.39,151.39,75.06,87.27,87.27,0,53.43,76.59,76.59,151.39
4343071,250,J3490,,,,,,,SENSOCARINE 0.75% 30ML VL,16.81,6.72,0,14.29,14.29,SKIPPED,12.78,12.78,14.29,14.29,14.29,7.09,8.24,8.24,0,5.04,7.23,7.23,14.29
4343072,250,J3490,,,,,,,EPINEPHRINE 1MG/ML AMP(EYE OR),46.55,18.62,0,39.57,39.57,SKIPPED,35.38,35.38,39.57,39.57,39.57,19.62,22.81,22.81,0,13.96,20.02,20.02,39.57
4343073,250,,,,,,,,CLINIMIX E 2000ML IV SOL BAG,259.14,103.66,0,220.27,220.27,SKIPPED,196.95,196.95,220.27,220.27,220.27,109.2,126.98,126.98,0,77.74,111.43,111.43,220.27
4343074,250,J3490,,,,,,,CLINIMIX E 4.5/10 IV SOL 1000ML BAG,35.72,14.29,0,30.36,30.36,SKIPPED,27.15,27.15,30.36,30.36,30.36,15.05,17.5,17.5,0,10.72,15.36,15.36,30.36
4343075,250,J3490,,,,,,,INF LEVAQUIN 750MG/150ML PM BAG,20.75,8.3,0,17.64,17.64,SKIPPED,15.77,15.77,17.64,17.64,17.64,8.74,10.17,10.17,0,6.22,8.92,8.92,17.64
4343076,250,90662,,,,,,,CLN FLU HIGHDOSE (MILLS/MOODY)65yr+MCR,1,0.4,0,1,0.85,SKIPPED,1,1,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343077,250,J3490,,,,,,,CLINIMIX PLAIN 4.25/10 IV SOL 1000ML BAG,29.27,11.71,0,24.88,24.88,SKIPPED,22.25,22.25,24.88,24.88,24.88,12.34,14.34,14.34,0,8.78,12.59,12.59,24.88
4343078,250,J3490,,,,,,,"HEPARIN 1,000UNIT/ML 10ML VL",14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343079,250,J3490,,,,,,,VISIPAQUE 320MG 50ML BTL,183.03,73.21,0,155.58,155.58,SKIPPED,139.1,139.1,155.58,155.58,155.58,77.13,89.68,89.68,0,54.91,78.7,78.7,155.58
4343080,250,J3490,,,,,,,VISIPAQUE 320MG 100ML BTL,365.91,146.36,0,311.02,311.02,SKIPPED,278.09,278.09,311.02,311.02,311.02,154.19,179.3,179.3,0,109.77,157.34,157.34,311.02
4343081,250,J3490,,,,,,,VISIPAQUE 320MG 150ML BTL,505.13,202.05,0,429.36,429.36,SKIPPED,383.9,383.9,429.36,429.36,429.36,212.87,247.51,247.51,0,151.54,217.21,217.21,429.36
4343082,250,J0248,,,,,,,INF REMDESIVIR 100MG INJ SDV,1659.84,663.94,0,1410.86,1410.86,SKIPPED,1261.48,1261.48,1410.86,1410.86,1410.86,699.46,813.32,813.32,0,497.95,713.73,713.73,1410.86
4343083,250,J3490,,,,,,,IOPIDINE 0.5%OPTH SOL 5ML,230.81,92.32,0,196.19,196.19,SKIPPED,175.42,175.42,196.19,196.19,196.19,97.26,113.1,113.1,0,69.24,99.25,99.25,196.19
4343084,250,M0245,,,,,,,INF BAMLANIVIMAB 700MG/20ML,2100,840,0,1785,1785,SKIPPED,1596,1596,1785,1785,1785,884.94,1029,1029,0,630,903,903,1785
4343085,636,91301,,,,,,,COVID VACCINE 100MCG/0.5ML MODERNA,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4343086,250,,,,,,,,INF DECADRON 10MG/1ML (1ML VIAL),21.87,8.75,0,18.59,18.59,SKIPPED,16.62,16.62,18.59,18.59,18.59,9.21,10.72,10.72,0,6.56,9.4,9.4,18.59
4343087,636,91300,,,,,,,COVID-19 PFIZER-BIONTECH VACCINE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4343088,250,91303,,,,,,,COVID VACCINE 0.5ML JANSSEN,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343089,250,,,,,,,,INF PRIVIGEN 10G,1590.65,636.26,0,1352.05,1352.05,SKIPPED,1208.89,1208.89,1352.05,1352.05,1352.05,670.3,779.42,779.42,0,477.2,683.98,683.98,1352.05
4343090,250,,,,,,,,INF PRIVIGEN 20G,3181.29,1272.52,0,2704.1,2704.1,SKIPPED,2417.78,2417.78,2704.1,2704.1,2704.1,1340.59,1558.83,1558.83,0,954.39,1367.95,1367.95,2704.1
4343091,250,,,,,,,,INF PRIVIGEN 40G,6362.58,2545.03,0,5408.19,5408.19,SKIPPED,4835.56,4835.56,5408.19,5408.19,5408.19,2681.19,3117.66,3117.66,0,1908.77,2735.91,2735.91,5408.19
4343092,250,,,,,,,,ZIPRASIDONE 20MG/ML,84613.54,33845.42,0,71921.51,71921.51,SKIPPED,64306.29,64306.29,71921.51,71921.51,71921.51,35656.14,41460.63,41460.63,0,25384.06,36383.82,36383.82,71921.51
4343093,250,,,,,,,,CIVANTI 130MG/18ML,1340.51,536.2,0,1139.43,1139.43,SKIPPED,1018.79,1018.79,1139.43,1139.43,1139.43,564.89,656.85,656.85,0,402.15,576.42,576.42,1139.43
4343094,250,,,,,,,,PHARMACT TO DOSE,7,2.8,0,5.95,5.95,SKIPPED,5.32,5.32,5.95,5.95,5.95,2.95,3.43,3.43,0,2.1,3.01,3.01,5.95
4343095,250,90697,,,,,,,TV VAXELIS(STATE ONLY),1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343096,250,,,,,,,,METHYLERGONOVINE 0.2MG/ML,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343097,250,,,,,,,,VANCOMYCIN 1500MG/300ML,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343098,250,,,,,,,,VANCOMYCIN 500MCG/100ML BAG,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343099,250,,,,,,,,VANCOMYCIN 1G / 200ML BAG,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343100,250,,,,,,,,VANCOMYCIN 2G/400ML,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343101,250,,,,,,,,CHLORHEXIDINE GLUCONATE ORAL RINSE 0.12%,47.35,18.94,0,40.25,40.25,SKIPPED,35.99,35.99,40.25,40.25,40.25,19.95,23.2,23.2,0,14.2,20.36,20.36,40.25
4343102,250,,,,,,,,ALBUMIN 5% 500ML,58.74,23.5,0,49.93,49.93,SKIPPED,44.64,44.64,49.93,49.93,49.93,24.75,28.78,28.78,0,17.62,25.26,25.26,49.93
4343103,250,M0247,,,,,,,SOTROVIMAB 500MG/8ML,837.9,335.16,0,712.22,712.22,SKIPPED,636.8,636.8,712.22,712.22,712.22,353.09,410.57,410.57,0,251.37,360.3,360.3,712.22
4343104,250,,,,,,,,INF VANCOMYCIN 2G / 400ML BAG,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343105,250,,,,,,,,IC GREEN 25MG KIT,363.67,145.47,0,309.12,309.12,SKIPPED,276.39,276.39,309.12,309.12,309.12,153.25,178.2,178.2,0,109.1,156.38,156.38,309.12
4343106,250,,,,,,,,FENTANYL ICU BAG,16.95,6.78,0,14.41,14.41,SKIPPED,12.88,12.88,14.41,14.41,14.41,7.14,8.31,8.31,0,5.08,7.29,7.29,14.41
4343107,250,,,,,,,,MIDAZOLAM ICU DRIP,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343108,250,,,,,,,,VANCOMYCIN 1.25G/250ML BAG,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343109,250,,,,,,,,VANCOMYCIN INJ 1.75G/350ML,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343110,250,,,,,,,,INF REGEN-COV,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343111,250,,,,,,,,MIDAZOLAM 50MG/10ML,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343112,250,,,,,,,,DEXMEDETOMIDINE 200MCG/50ML,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343113,250,,,,,,,,ACTEMRA 400MG/20ML,391.93,156.77,0,333.14,333.14,SKIPPED,297.87,297.87,333.14,333.14,333.14,165.16,192.05,192.05,0,117.58,168.53,168.53,333.14
4343114,250,,,,,,,,FENTANYL 2000MCG/100ML ICU DRIP,14,5.6,0,11.9,11.9,SKIPPED,10.64,10.64,11.9,11.9,11.9,5.9,6.86,6.86,0,4.2,6.02,6.02,11.9
4343115,250,,,,,,,,POST HEMI KIT,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343116,250,,,,,,,,CLINIMIX E 5/15,20,8,0,17,17,SKIPPED,15.2,15.2,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,17
4343117,250,,,,,,,,XELJANZ 5MG,55.35,22.14,0,47.05,47.05,SKIPPED,42.07,42.07,47.05,47.05,47.05,23.32,27.12,27.12,0,16.6,23.8,23.8,47.05
4343118,250,,,,,,,,OLUMIANT 2MG,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343119,250,,,,,,,,LEVOPHED 4MG/250ML PREMIX BAG,115,46,0,97.75,97.75,SKIPPED,87.4,87.4,97.75,97.75,97.75,48.46,56.35,56.35,0,34.5,49.45,49.45,97.75
4343120,250,,,,,,,,APIXABAN 5MG,28.15,11.26,0,23.93,23.93,SKIPPED,21.39,21.39,23.93,23.93,23.93,11.86,13.79,13.79,0,8.44,12.1,12.1,23.93
4343121,250,J2350,,,,,,,OCREVUS 300MG/10ML,5680.73,2272.29,0,4828.62,4828.62,SKIPPED,63.54,63.54,4828.62,4828.62,4828.62,2393.86,2783.56,2783.56,0,1704.22,2442.71,2442.71,4828.62
4343122,250,91307,,,,,,,COVID-19 (PEDI) PFIZER-BIONTECH VACCINE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4343123,250,,,,,,,,XPERIENCE NO RINSE ANTIMICROBIAL,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343124,250,90694,,,,,,,FLUAD QUADRIVALENT HIGH DOSE,371.99,148.8,0,316.19,316.19,SKIPPED,16.05,16.05,316.19,316.19,316.19,156.76,182.28,182.28,0,111.6,159.96,159.96,316.19
4343125,250,,,,,,,,TRALEMENT,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343126,250,,,,,,,,ADENOSINE 90MG/30ML,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343127,250,90697,,,,,,,DTaP-IPV-Hib-Hepatitis B Recmb,887.83,355.13,0,754.66,754.66,SKIPPED,674.75,674.75,754.66,754.66,754.66,374.13,435.04,435.04,0,266.35,381.77,381.77,754.66
4343128,250,,,,,,,,DTaP INFANRIX,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343129,250,,,,,,,,LEQVIO 284MG/1.5ML,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343130,250,,,,,,,,CLINDAMYCIN BAG 600MG/50mL,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343131,250,,,,,,,,CLINDAMYCIN BAG 30MG/50mL,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343132,250,,,,,,,,CEFTRIAXONE 1G / 50MLBAG,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343133,250,,,,,,,,cefTRIAXone SOD-DEXTROSE 2GM/50ML BAG,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343134,250,,,,,,,,ceFAZolin 1GM/50ML BAG,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343135,250,,,,,,,,CEFEPIME 1GM/50MLBAG,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343136,250,,,,,,,,CEFEPIME 2GM/100ML BAG,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343137,250,,,,,,,,TV MENQUADFI (STATE ONLY),1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343138,250,,,,,,,,CEFAZOLIN SOUDIUM INJ 2GM,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343139,250,,,,,,,,COVID-19 INFANT 6M-4YRS PFIZER,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343140,250,,,,,,,,MENQUADFI,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343141,250,,,,,,,,TICAGRELOR 90MG,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343142,250,,,,,,,,PRASUGREL 10MG TAB,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343143,250,,,,,,,,GENTAMICIN 800MG/20ML VIAL,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343144,250,,,,,,,,BOTOX,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343145,250,,,,,,,,ZOSYN PREMIX,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343146,250,,,,,,,,LIDO EPI MPF 1% 10ML,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343147,250,,,,,,,,DESMOPRESSIN ACETATE 4mcg/1ml 10ml vial,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343148,250,,,,,,,,FLUZONE QUAD 2022-23,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343149,250,,,,,,,,CLN FLUZONE 2022-23,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343150,250,,,,,,,,CLN FLUZONE HD 2022-23,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343151,250,,,,,,,,TV FLUzone (STATE ONLY),1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4343152,250,,,,,,,,BUPRENORPHINE 0.3MG/ML,1,0.4,0,0.85,0.85,SKIPPED,0.76,0.76,0.85,0.85,0.85,0.42,0.49,0.49,0,0.3,0.43,0.43,0.85
4375000,963,,,,,,,,ANES 0-30 MIN,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,0,557.79,557.79,0,341.5,0,0,0
4375001,964,,,,,,,,ANES 0-30 MIN,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,479.7,557.79,557.79,0,341.5,489.49,489.49,0
4375002,963,300,,,,,,,"ANES ADMIN 0-30 MIN SKIN, UPPER",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,4.9,557.79,557.79,0,341.5,5,5,0
4375003,963,300,,,,,,,"ANES ADMIN 30-60 MIN SKIN, UPPER",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,4.9,696.37,696.37,0,426.35,5,5,0
4375004,963,300,,,,,,,"ANES ADMIN 60-90 MIN SKIN, UPPER",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,4.9,859.74,859.74,0,526.37,5,5,0
4375005,963,300,,,,,,,"ANES ADMIN 90-120 SKIN, UPPER",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,4.9,1025.26,1025.26,0,627.71,5,5,0
4375006,963,400,,,,,,,"ANES ADMIN 0-30 MIN SKIN, LOWER",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,2.94,557.79,557.79,0,341.5,3,3,0
4375007,963,400,,,,,,,"ANES ADMIN 30-60 MIN SKIN, LOWER",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,2.94,696.37,696.37,0,426.35,3,3,0
4375008,963,400,,,,,,,"ANES ADMIN 60-90 MIN SKIN, LOWER",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,2.94,859.74,859.74,0,526.37,3,3,0
4375009,963,400,,,,,,,"ANES ADMIN 90-120 MIN SKIN, LOWER",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,2.94,1025.26,1025.26,0,627.71,3,3,0
4375010,963,404,,,,,,,ANES ADMIN 0-30 MIN BREAST,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,4.9,557.79,557.79,0,341.5,5,5,0
4375011,963,404,,,,,,,ANES ADMIN 30-60 MIN BREAST,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,4.9,696.37,696.37,0,426.35,5,5,0
4375012,963,404,,,,,,,ANES ADMIN 60-90 BREAST,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,4.9,859.74,859.74,0,526.37,5,5,0
4375013,963,404,,,,,,,ANES ADMIN 90-120 MIN BREAST,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,4.9,1025.26,1025.26,0,627.71,5,5,0
4375014,963,600,,,,,,,ANES ADMIN 0-30 MIN C-SPINE,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,9.8,557.79,557.79,0,341.5,10,10,0
4375015,963,600,,,,,,,ANES ADMIN 30-60 MIN -SPINE,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,9.8,696.37,696.37,0,426.35,10,10,0
4375016,963,600,,,,,,,ANES ADMIN 60-90 MIN C-SPINE,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,9.8,859.74,859.74,0,526.37,10,10,0
4375017,963,600,,,,,,,ANES ADMIN 90-120 MIN C-SPINE,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,9.8,1025.26,1025.26,0,627.71,10,10,0
4375018,963,620,,,,,,,ANES ADMIN 0-30 MIN,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,9.8,557.79,557.79,0,341.5,10,10,0
4375019,963,620,,,,,,,ANES ADMIN 30-60 MIN T-SPINE,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,9.8,696.37,696.37,0,426.35,10,10,0
4375020,963,620,,,,,,,ANES ADMIN 60-90 MIN T-SPINE,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,9.8,859.74,859.74,0,526.37,10,10,0
4375021,963,620,,,,,,,ANES ADMIN 90-120 MIN T-SPINE,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,9.8,1025.26,1025.26,0,627.71,10,10,0
4375022,963,630,,,,,,,ANES ADMIN 0-30 MIN L-SPINE,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,7.84,557.79,557.79,0,341.5,8,8,0
4375023,963,630,,,,,,,ANES ADMIN 30-60 MIN L-SPINE,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,7.84,696.37,696.37,0,426.35,8,8,0
4375024,963,630,,,,,,,ANES ADMIN 60-90 MIN L-SPINE,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,7.84,859.74,859.74,0,526.37,8,8,0
4375025,963,630,,,,,,,ANES ADMIN 90-120 MIN L-SPINE,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,7.84,1025.26,1025.26,0,627.71,8,8,0
4375026,963,740,,,,,,,ANES ADMIN 0-30 MIN UPPER GI,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,4.9,557.79,557.79,0,341.5,5,5,0
4375027,963,740,,,,,,,ANES ADMIN 30-60 MIN UPPER GI,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,4.9,696.37,696.37,0,426.35,5,5,0
4375028,963,740,,,,,,,ANES ADMIN 60-90 MIN UPPER GI,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,4.9,859.74,859.74,0,526.37,5,5,0
4375029,963,740,,,,,,,ANES ADMIN 90-120 UPPER GI,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,4.9,1025.26,1025.26,0,627.71,5,5,0
4375033,963,,,,,,,,ANES 30-60 MIN,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,0,696.37,696.37,0,426.35,0,0,0
4375034,964,,,,,,,,ANES 30-60 MIN,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,598.88,696.37,696.37,0,426.35,611.1,611.1,0
4375035,963,142,,,,,,,ANES ADMIN 0-30 MIN LENS,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,3.92,557.79,557.79,0,341.5,4,4,0
4375036,963,142,,,,,,,ANES ADMIN 30-60 MIN LENS,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,3.92,696.37,696.37,0,426.35,4,4,0
4375037,963,142,,,,,,,ANES ADMIN 60-90 MIN LENS,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,3.92,859.74,859.74,0,526.37,4,4,0
4375038,963,142,,,,,,,ANES ADMIN 90-120 MIN LENS,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,3.92,1025.26,1025.26,0,627.71,4,4,0
4375040,963,750,,,,,,,"ANES ADMIN 0-30 MIN HERNIA, UPPER",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,3.92,557.79,557.79,0,341.5,4,4,0
4375041,963,750,,,,,,,"ANES ADMIN 30-60 MIN HERNIA, UPPER",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,3.92,696.37,696.37,0,426.35,4,4,0
4375042,963,750,,,,,,,"ANES ADMIN 60-90 MIN HERNIA, UPPER",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,3.92,859.74,859.74,0,526.37,4,4,0
4375043,963,750,,,,,,,"ANES ADMIN 90-120 MIN HERNIA, UPPER",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,3.92,1025.26,1025.26,0,627.71,4,4,0
4375044,963,790,,,,,,,ANES ADMIN 0-30 MIN INTRAPERITONEAL,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,6.86,557.79,557.79,0,341.5,7,7,0
4375045,963,790,,,,,,,ANES ADMIN 30-60 MIN INTRAPERITONEAL,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,6.86,696.37,696.37,0,426.35,7,7,0
4375046,963,790,,,,,,,ANES ADMIN 60-90 MIN INTRAPERITONEAL,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,6.86,859.74,859.74,0,526.37,7,7,0
4375047,963,790,,,,,,,ANES ADMIN 90-120 MIN INTRAPERITONEAL,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,6.86,1025.26,1025.26,0,627.71,7,7,0
4375048,963,810,,,,,,,ANES ADMIN 0-30 MIN LOWER GI,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,4.9,557.79,557.79,0,341.5,5,5,0
4375049,963,810,,,,,,,ANES ADMIN 30-60 MIN LOWER GI,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,4.9,696.37,696.37,0,426.35,5,5,0
4375050,963,810,,,,,,,ANES ADMIN 60-90 MIN LOWER GI,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,4.9,859.74,859.74,0,526.37,5,5,0
4375051,963,810,,,,,,,ANES ADMIN 90-120 MIN LOWER GI,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,4.9,1025.26,1025.26,0,627.71,5,5,0
4375052,963,830,,,,,,,"ANES ADMIN 0-30MIN HERNIA, LOWER",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,3.92,557.79,557.79,0,341.5,4,4,0
4375053,963,830,,,,,,,"ANES ADMIN 30-60 MIN HERNIA, LOWER",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,3.92,696.37,696.37,0,426.35,4,4,0
4375054,963,830,,,,,,,"ANES ADMIN 60-90 MIN HERNIA, LOWER",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,3.92,859.74,859.74,0,526.37,4,4,0
4375055,963,830,,,,,,,"ANES ADMIN 90-120 MIN HERNIA, LOWER",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,3.92,1025.26,1025.26,0,627.71,4,4,0
4375056,963,1480,,,,,,,ANES ADMIN 0-30 MIN PODIATRY,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,2.94,557.79,557.79,0,341.5,3,3,0
4375057,963,1480,,,,,,,ANES ADMIN 30-60 MIN PODIATRY,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,2.94,696.37,696.37,0,426.35,3,3,0
4375058,963,1480,,,,,,,ANES ADMIN 60-90 MIN PODIATRY,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,2.94,859.74,859.74,0,526.37,3,3,0
4375059,963,1480,,,,,,,ANES ADMIN 90-120 MIN PODIATRY,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,2.94,1025.26,1025.26,0,627.71,3,3,0
4375060,963,840,,,,,,,"ANES ADMIN 0-30 MIN, LOWER ABDOMEN",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,5.88,557.79,557.79,0,341.5,6,6,0
4375061,963,840,,,,,,,"ANES ADMIN 30-60 MIN, LOWER ABDOMEN",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,5.88,696.37,696.37,0,426.35,6,6,0
4375062,963,840,,,,,,,"ANES ADMIN 60-90 MIN, LOWER ABDOMEN",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,5.88,859.74,859.74,0,526.37,6,6,0
4375063,963,840,,,,,,,"ANES ADMIN 90-120 MIN, LOWER ABDOMEN",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,5.88,1025.26,1025.26,0,627.71,6,6,0
4375066,963,,,,,,,,ANES 60-90 MIN,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,0,859.74,859.74,0,526.37,0,0,0
4375067,964,,,,,,,,ANES 60-90 MIN,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,739.38,859.74,859.74,0,526.37,754.47,754.47,0
4375068,963,352,,,,,,,"ANES ADMIN 0-30 MIN, NECK",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,4.9,557.79,557.79,0,341.5,5,5,0
4375069,963,352,,,,,,,"ANES ADMIN 30-60 MIN, NECK",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,4.9,696.37,696.37,0,426.35,5,5,0
4375070,963,352,,,,,,,"ANES ADMIN 60-90 MIN, NECK",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,4.9,859.74,859.74,0,526.37,5,5,0
4375071,963,352,,,,,,,"ANES ADMIN 90-120, NECK",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,4.9,1025.26,1025.26,0,627.71,5,5,0
4375072,963,410,,,,,,,"ANES ADMIN 0 -30, CORRECT HEART RHYTHM",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,3.92,557.79,557.79,0,341.5,4,4,0
4375073,963,410,,,,,,,"ABES ADMIN 30-60, CORRECT HEART RHYTHM",1492.22,596.89,0,1268.39,1268.39,SKIPPED,1134.09,1134.09,1268.39,1268.39,1268.39,3.92,731.19,731.19,0,447.67,4,4,0
4375074,963,410,,,,,,,"ANES ADMIN 60 - 90, CORRECT HEART RHYTHM",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,3.92,859.74,859.74,0,526.37,4,4,0
4375075,963,410,,,,,,,"ANES ADMIN 90-120, CORRECT HEART RHYTHM",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,3.92,1025.26,1025.26,0,627.71,4,4,0
4375076,963,920,,,,,,,"ANES ADMIN 0-30, GENITALIA SURGERY",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,2.94,557.79,557.79,0,341.5,3,3,0
4375077,963,920,,,,,,,"ANES ADMIN 30-60, GENITALIA SURGERY",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,2.94,696.37,696.37,0,426.35,3,3,0
4375078,963,920,,,,,,,"ANESA ADMIN 60-90, GENITALIA SURGERY",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,2.94,859.74,859.74,0,526.37,3,3,0
4375079,963,920,,,,,,,"ANES ADMIN 90-120, GENITALIA SURGERY",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,2.94,1025.26,1025.26,0,627.71,3,3,0
4375080,963,1464,,,,,,,"ANES ADMIN 0-30, ANKLE/FT ARTHROSCOPY",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,2.94,557.79,557.79,0,341.5,3,3,0
4375081,963,1464,,,,,,,"ANES ADMIN 30-60, ANKLE/FT ARTHROSCOPY",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,2.94,696.37,696.37,0,426.35,3,3,0
4375082,963,1464,,,,,,,"ANES ADMIN 60-90, ANKLE/FT ARTHROSCOPY",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,2.94,859.74,859.74,0,526.37,3,3,0
4375083,963,1464,,,,,,,"ANES ADMIN 90-120, ANKLE/FT ARTHROSCOPY",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,2.94,1025.26,1025.26,0,627.71,3,3,0
4375084,963,1951,,,,,,,"ANES ADMIN 0-30 MIN, ANESTH BURN LESS 4%",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,2.94,557.79,557.79,0,341.5,3,3,0
4375085,963,1951,,,,,,,"ANES ADMIN 30-60 MIN, BURN LESS 4 PERCEN",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,2.94,696.37,696.37,0,426.35,3,3,0
4375086,963,1951,,,,,,,"ANES ADMIN 60-90 MIN, BURN LESS 4 PERCEN",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,2.94,859.74,859.74,0,526.37,3,3,0
4375087,963,1951,,,,,,,"ANES ADMIN 90-120 MIN, BURN LESS 4 PERCE",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,2.94,1025.26,1025.26,0,627.71,3,3,0
4375088,963,1470,,,,,,,"ANES ADMIN 0-30, LOWER LEG",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,2.94,557.79,557.79,0,341.5,3,3,0
4375089,963,1470,,,,,,,"ANES ADMIN 30-60 MIN, LOWER LEG",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,2.94,696.37,696.37,0,426.35,3,3,0
4375090,963,1470,,,,,,,"ANES ADMIN 60-90 MIN, LOWER LEG",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,2.94,859.74,859.74,0,526.37,3,3,0
4375091,963,1470,,,,,,,"ANES ADMIN 90-120 MIN, LOWER LEG",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,2.94,1025.26,1025.26,0,627.71,3,3,0
4375092,963,1610,,,,,,,"ANES ADMIN 0-30 MIN, SHOULDER",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,4.9,557.79,557.79,0,341.5,5,5,0
4375093,963,1610,,,,,,,"ANES ADMIN 30-60 MIN, SHOULDER",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,4.9,696.37,696.37,0,426.35,5,5,0
4375094,963,1610,,,,,,,"ANES ADMIN 60-90 MIN, SHOULDER",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,4.9,859.74,859.74,0,526.37,5,5,0
4375095,963,1610,,,,,,,"ANES ADMIN 90-120 MIN, SHOULDER",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,4.9,1025.26,1025.26,0,627.71,5,5,0
4375099,963,,,,,,,,ANES 90-120 MIN,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,0,1025.26,1025.26,0,627.71,0,0,0
4375100,964,,,,,,,,ANES 90-120 MIN,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,881.73,1025.26,1025.26,0,627.71,899.72,899.72,0
4375101,963,752,,,,,,,"ANES ADMIN 0-30 MIN, REPAIR OF HERNIA",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,5.88,557.79,557.79,0,341.5,6,6,0
4375102,963,752,,,,,,,"ANES ADMIN 30-60 MIN, REPAIR OF HERNIA",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,5.88,696.37,696.37,0,426.35,6,6,0
4375103,963,752,,,,,,,"ANES ADMIN 60-90 MIN, REPAIR OF HERNIA",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,5.88,859.74,859.74,0,526.37,6,6,0
4375104,963,752,,,,,,,"ANES ADMIN 90-120 MIN, REPAIR OF HERNIA",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,5.88,1025.26,1025.26,0,627.71,6,6,0
4375105,963,99151,,,,,,,MOD SED <5YR SAME PHYS,59.56,23.82,0,59.56,50.63,SKIPPED,59.56,59.56,50.63,50.63,50.63,27.49,29.18,29.18,0,17.87,28.05,28.05,0
4375106,963,99152,,,,,,,MOD SED 5YR OR > SAME PHYS,30.39,12.16,0,30.39,25.83,SKIPPED,30.39,30.39,25.83,25.83,25.83,13.64,14.89,14.89,0,9.12,13.92,13.92,0
4375107,963,99153,,,,,,,MOD SED EA ADDTL 15MIN SAME PHYS,25.53,10.21,0,25.53,21.7,SKIPPED,25.53,25.53,21.7,21.7,21.7,11.63,12.51,12.51,0,7.66,11.87,11.87,0
4375108,963,99155,,,,,,,MOD SED <5YR OTHER PHYS,233.37,93.35,0,233.37,198.36,SKIPPED,233.37,233.37,198.36,198.36,198.36,90.81,114.35,114.35,0,70.01,92.66,92.66,0
4375109,963,99156,,,,,,,MOD SED 5YR OR > OTHER PHYS,183.54,73.42,0,183.54,156.01,SKIPPED,183.54,183.54,156.01,156.01,156.01,83.35,89.93,89.93,0,55.06,85.05,85.05,0
4375110,963,99157,,,,,,,MOD SED EA ADDTL 15MIN OTHER PHYS,139.79,55.92,0,139.79,118.82,SKIPPED,139.79,139.79,118.82,118.82,118.82,68.38,68.5,68.5,0,41.94,69.78,69.78,0
4375124,963,,,,,,,,ANES EA ADDL 30 MIN,409.31,163.72,0,347.91,347.91,SKIPPED,311.08,311.08,347.91,347.91,347.91,0,200.56,200.56,0,122.79,0,0,0
4375125,963,,,,,,,,ANES EA ADD'L 30 MIN,409.31,163.72,0,347.91,347.91,SKIPPED,311.08,311.08,347.91,347.91,347.91,0,200.56,200.56,0,122.79,0,0,0
4375157,963,,,,,,,,OBSTET ANES,595.25,238.1,0,505.96,505.96,SKIPPED,452.39,452.39,505.96,505.96,505.96,0,291.67,291.67,0,178.58,0,0,0
4375183,370,,,,,,,,ANES MAT'L EA ADDL 3,156.6,62.64,0,133.11,133.11,SKIPPED,119.02,119.02,133.11,133.11,133.11,65.99,76.73,76.73,0,46.98,67.34,67.34,133.11
4375185,370,,,,,,,,ANES MAT'L 0-30 MIN,468.39,187.36,0,398.13,398.13,SKIPPED,355.98,355.98,398.13,398.13,398.13,197.38,229.51,229.51,0,140.52,201.41,201.41,398.13
4375190,370,,,,,,,,ANES MAT'L 30-60 MIN,831.76,332.7,0,707,707,SKIPPED,632.14,632.14,707,707,707,350.51,407.56,407.56,0,249.53,357.66,357.66,707
4375195,370,,,,,,,,ANES MAT'L 60-90 MIN,1150.83,460.33,0,978.21,978.21,SKIPPED,874.63,874.63,978.21,978.21,978.21,484.96,563.91,563.91,0,345.25,494.86,494.86,978.21
4375199,370,,,,,,,,ANES MAT'L 90-120 MI,1399.2,559.68,0,1189.32,1189.32,SKIPPED,1063.39,1063.39,1189.32,1189.32,1189.32,589.63,685.61,685.61,0,419.76,601.66,601.66,1189.32
4375200,963,940,,,,,,,"ANES ADMIN 0-30 MIN, VAGINAL",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,2.94,557.79,557.79,0,341.5,3,3,0
4375201,963,940,,,,,,,"ANES ADMIN 30-60 MIN, VAGINAL",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,2.94,696.37,696.37,0,426.35,3,3,0
4375202,963,940,,,,,,,"ANES ADMIN 60-90 MIN, VAGINAL",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,2.94,859.74,859.74,0,526.37,3,3,0
4375203,963,940,,,,,,,"ANES ADMIN 90-120 MIN, VAGINAL",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,2.94,1025.26,1025.26,0,627.71,3,3,0
4375205,963,,,,,,,,EPIDURAL 0-30MIN,1194.61,477.84,0,1015.42,1015.42,SKIPPED,907.9,907.9,1015.42,1015.42,1015.42,0,585.36,585.36,0,358.38,0,0,0
4375206,964,,,,,,,,EPIDURAL 0-30MIN,1194.61,477.84,0,1015.42,1015.42,SKIPPED,907.9,907.9,1015.42,1015.42,1015.42,503.41,585.36,585.36,0,358.38,513.68,513.68,0
4375225,963,1996,,,,,,,EPIDURAL,186.08,74.43,0,158.17,158.17,SKIPPED,141.42,141.42,158.17,158.17,158.17,2.94,91.18,91.18,0,55.82,3,3,0
4375226,964,1996,,,,,,,EPIDURAL,177.22,70.89,0,150.64,150.64,SKIPPED,134.69,134.69,150.64,150.64,150.64,74.68,86.84,86.84,0,53.17,76.2,76.2,0
4375230,963,,,,,,,,INTUBATION,471.35,188.54,0,400.65,400.65,SKIPPED,358.23,358.23,400.65,400.65,400.65,0,230.96,230.96,0,141.4,0,0,0
4375231,963,902,,,,,,,"ANES ADMIN 0 - 30 MIN, ANORECTAL",1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,4.9,557.79,557.79,0,341.5,5,5,0
4375232,963,902,,,,,,,"ANES ADMIN 30 - 60 MIN, ANORECTAL",1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,4.9,696.37,696.37,0,426.35,5,5,0
4375233,963,902,,,,,,,"ANES ADMIN 60 - 90 MIN, ANORECTAL",1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,4.9,859.74,859.74,0,526.37,5,5,0
4375234,963,902,,,,,,,"ANES ADMIN 90 - 120 MIN, ANORECTAL",2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,4.9,1025.26,1025.26,0,627.71,5,5,0
4375235,963,1230,,,,,,,ANES ADMIN 0-30 MIN FEMUR,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,5.88,557.79,557.79,0,341.5,6,6,0
4375236,963,1230,,,,,,,ANES ADMIN 30-60 MIN FEMUR,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,5.88,696.37,696.37,0,426.35,6,6,0
4375237,963,1230,,,,,,,ANES ADMIN 60-90 MIN FEMUR,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,5.88,859.74,859.74,0,526.37,6,6,0
4375238,963,1230,,,,,,,ANES ADMIN 90-120 MIN FEMUR,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,5.88,1025.26,1025.26,0,627.71,6,6,0
4375239,963,540,,,,,,,ANES ADMIN 0-30 MIN CHEST,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,11.76,557.79,557.79,0,341.5,12,12,0
4375240,963,540,,,,,,,ANES ADMIN 30-60 MIN CHEST,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,11.76,696.37,696.37,0,426.35,12,12,0
4375241,963,540,,,,,,,ANES ADMIN 60-90 MIN CHEST,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,11.76,859.74,859.74,0,526.37,12,12,0
4375242,963,540,,,,,,,ANES ADMIN 90-120 MIN CHEST,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,11.76,1025.26,1025.26,0,627.71,12,12,0
4375243,963,350,,,,,,,ANES ADMIN 0-30 MIN NECK VESSEL,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,9.8,557.79,557.79,0,341.5,10,10,0
4375244,963,350,,,,,,,ANES ADMIN 30-60 MIN NECK VESSEL,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,9.8,696.37,696.37,0,426.35,10,10,0
4375245,963,350,,,,,,,ANES ADMIN 60-90 MIN NECK VESSEL,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,9.8,859.74,859.74,0,526.37,10,10,0
4375246,963,350,,,,,,,ANES ADMIN 90-120 MIN NECK VESSEL,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,9.8,1025.26,1025.26,0,627.71,10,10,0
4375247,963,1820,,,,,,,ANES ADMIN 0-30 MIN LOWER ARM PRO,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,2.94,557.79,557.79,0,341.5,3,3,0
4375248,963,1820,,,,,,,ANES ADMIN 30-60 MIN LOWER LEG PRO,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,2.94,696.37,696.37,0,426.35,3,3,0
4375249,963,1820,,,,,,,ANES ADMIN 60-90 MIN LOWER LEG PRO,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,2.94,859.74,859.74,0,526.37,3,3,0
4375250,963,1820,,,,,,,ANES ADMIN 90-120 MIN LOWER LEG PRO,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,2.94,1025.26,1025.26,0,627.71,3,3,0
4375251,963,1462,,,,,,,ANES ADMIN 0-30 MIN LOWER LEG,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,2.94,557.79,557.79,0,341.5,3,3,0
4375252,963,1462,,,,,,,ANES ADMIN 30-60 MIN LOWER LEG,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,2.94,696.37,696.37,0,426.35,3,3,0
4375253,963,1462,,,,,,,ANES ADMIN 60-90 MIN LOWER LEG,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,2.94,859.74,859.74,0,526.37,3,3,0
4375254,963,1462,,,,,,,ANES ADMIN 90-120 MIN LOWER LEG,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,2.94,1025.26,1025.26,0,627.71,3,3,0
4375255,963,1830,,,,,,,ANES ADMIN 0-30 MIN LOWER LEG SURG,1133.1,453.24,0,963.14,963.14,SKIPPED,861.16,861.16,963.14,963.14,963.14,2.94,555.22,555.22,0,339.93,3,3,0
4375256,963,1830,,,,,,,ANES ADMIN 30-60 MIN LOWER LEG SURG,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,2.94,696.37,696.37,0,426.35,3,3,0
4375257,963,1830,,,,,,,ANES ADMIN 60-90 MIN LOWER LEG SURG,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,2.94,859.74,859.74,0,526.37,3,3,0
4375258,963,1830,,,,,,,ANES ADMIN 90-120 MIN LOWER LEG SURG,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,2.94,1025.26,1025.26,0,627.71,3,3,0
4375259,963,1710,,,,,,,ANES ADMIN 0-30 MIN ELBOW AREA,1133.1,453.24,0,963.14,963.14,SKIPPED,861.16,861.16,963.14,963.14,963.14,2.94,555.22,555.22,0,339.93,3,3,0
4375260,963,1710,,,,,,,ANES ADMIN 30-60 MIN ELBOW AREA,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,2.94,696.37,696.37,0,426.35,3,3,0
4375261,963,1710,,,,,,,ANES ADMIN 60-90 MIN ELBOW AREA,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,2.94,859.74,859.74,0,526.37,3,3,0
4375262,963,1710,,,,,,,ANES ADMIN 90-120 MIN ELBOW AREA,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,2.94,1025.26,1025.26,0,627.71,3,3,0
4375263,963,1400,,,,,,,ANES ADMIN 0-30 MIN KNEE JOINT,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,3.92,557.79,557.79,0,341.5,4,4,0
4375264,963,1400,,,,,,,ANES ADMIN 30-60 MIN KNEE JOINT,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,3.92,696.37,696.37,0,426.35,4,4,0
4375265,963,1400,,,,,,,ANES ADMIN 60-90 MIN KNEE JOINT,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,3.92,859.74,859.74,0,526.37,4,4,0
4375266,963,1400,,,,,,,ANES ADMIN 90-120 MIN KNEE JOINT,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,3.92,1025.26,1025.26,0,627.71,4,4,0
4375267,963,1620,,,,,,,ANES ADMIN 0-30 MIN SHOULDER(CLOSED),1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,3.92,557.79,557.79,0,341.5,4,4,0
4375268,963,1620,,,,,,,ANES ADMIN 30-60 MIN SHOULDER(CLOSED),1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,3.92,696.37,696.37,0,426.35,4,4,0
4375269,963,1620,,,,,,,ANES ADMIN 60-90 MIN SHOULDER(CLOSED),1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,3.92,859.74,859.74,0,526.37,4,4,0
4375270,963,1620,,,,,,,ANES ADMIN 90-120 MIN SHOULDER(CLOSED),2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,3.92,1025.26,1025.26,0,627.71,4,4,0
4375271,963,1220,,,,,,,ANES ADMIN 0-30 MIN UPPER FEMUR,1138.34,455.34,0,967.59,967.59,SKIPPED,865.14,865.14,967.59,967.59,967.59,3.92,557.79,557.79,0,341.5,4,4,0
4375272,963,1220,,,,,,,ANES ADMIN 30-60 MIN UPPER FEMUR,1421.16,568.46,0,1207.99,1207.99,SKIPPED,1080.08,1080.08,1207.99,1207.99,1207.99,3.92,696.37,696.37,0,426.35,4,4,0
4375273,963,1220,,,,,,,ANES ADMIN 60-90 MIN UPPER FEMUR,1754.58,701.83,0,1491.39,1491.39,SKIPPED,1333.48,1333.48,1491.39,1491.39,1491.39,3.92,859.74,859.74,0,526.37,4,4,0
4375274,963,1220,,,,,,,ANES ADMIN 90-120 MIN UPPER FEMUR,2092.37,836.95,0,1778.51,1778.51,SKIPPED,1590.2,1590.2,1778.51,1778.51,1778.51,3.92,1025.26,1025.26,0,627.71,4,4,0
4375275,963,64417,,,,,,,ANES AXILLARY NERVE INJ,125.06,50.02,0,125.06,106.3,SKIPPED,125.06,125.06,106.3,106.3,106.3,66.93,61.28,61.28,SKIPPED,SKIPPED,68.3,68.3,0
4380060,430,97110,,,,,,,THERAPUTIC EX 8-22MIN & EACH ADDL 15 MIN,108.69,43.48,0,108.69,92.39,SKIPPED,108.69,108.69,92.39,92.39,92.39,45.81,53.26,53.26,0,32.61,46.74,46.74,92.39
4380065,430,97150,,,,,,,THERAPUTIC GRP 8-22MIN & EACH ADDL 15MIN,68.22,27.29,0,68.22,57.99,SKIPPED,68.22,68.22,57.99,57.99,57.99,28.74,33.43,33.43,0,20.47,29.33,29.33,57.99
4380070,430,97542,,,,,,,WHEELCHAIR MGMT 8-22MIN &EACH ADDL 15MIN,107.1,42.84,0,107.1,91.04,SKIPPED,107.1,107.1,91.04,91.04,91.04,45.13,52.48,52.48,0,32.13,46.05,46.05,91.04
4380077,430,95852,,,,,,,ROM HAND,173.82,69.53,0,147.75,147.75,SKIPPED,28.98,28.98,147.75,147.75,147.75,73.25,85.17,85.17,0,52.15,74.74,74.74,147.75
4380078,430,95834,,,,,,,BODY MMT W/HAND,381.65,152.66,0,324.4,324.4,SKIPPED,290.05,290.05,324.4,324.4,324.4,160.83,187.01,187.01,0,114.5,164.11,164.11,324.4
4380083,430,97003,,,,,,,INITIAL EVAL ADD'L,108.69,43.48,0,92.39,92.39,SKIPPED,82.6,82.6,92.39,92.39,92.39,45.81,53.26,53.26,0,32.61,46.74,46.74,92.39
4383251,430,97532,,,,,,,COG SKILLS 8-22MIN & EA ADDL 15 MIN,97.83,39.13,0,83.16,83.16,SKIPPED,74.35,74.35,83.16,83.16,83.16,41.23,47.94,47.94,0,29.35,42.07,42.07,83.16
4383255,430,97003,,,,,,,INITIAL EVAL-SHORT 0-30M,218.83,87.53,0,186.01,186.01,SKIPPED,166.31,166.31,186.01,186.01,186.01,92.22,107.23,107.23,0,65.65,94.1,94.1,186.01
4383258,430,97003,,,,,,,INITIAL EVAL LONG30-60MIN,324.18,129.67,0,275.55,275.55,SKIPPED,246.38,246.38,275.55,275.55,275.55,136.61,158.85,158.85,0,97.25,139.4,139.4,275.55
4383259,430,97004,,,,,,,RE-EVALUATION,176.89,70.76,0,150.36,150.36,SKIPPED,134.44,134.44,150.36,150.36,150.36,74.54,86.68,86.68,0,53.07,76.06,76.06,150.36
4383274,430,97530,,,,,,,THERAPEUTIC ACT ADD'L,97.83,39.13,0,97.83,83.16,SKIPPED,97.83,97.83,83.16,83.16,83.16,41.23,47.94,47.94,0,29.35,42.07,42.07,83.16
4383275,430,97530,,,,,,,THERAPEUTIC ACT 8-22MIN &EACH ADDL 15MIN,97.83,39.13,0,97.83,83.16,SKIPPED,97.83,97.83,83.16,83.16,83.16,41.23,47.94,47.94,0,29.35,42.07,42.07,83.16
4383280,430,97535,,,,,,,ADL 8-22MIN & EACH ADDL 15 MIN,114.85,45.94,0,114.85,97.62,SKIPPED,114.85,114.85,97.62,97.62,97.62,48.4,56.28,56.28,0,34.46,49.39,49.39,97.62
4383285,430,97112,,,,,,,NEUROMUSCULAR RE-ED,113.25,45.3,0,113.25,96.26,SKIPPED,113.25,113.25,96.26,96.26,96.26,47.73,55.49,55.49,0,33.98,48.7,48.7,96.26
4383286,430,92610,,,,,,,CLINICAL EVAL SWALLOW,262.12,104.85,0,262.12,222.8,SKIPPED,262.12,262.12,222.8,222.8,222.8,110.46,128.44,128.44,0,78.64,112.71,112.71,222.8
4383288,430,97542,,,,,,,WHEELCHAIR MGMT ADD'L,107.1,42.84,0,107.1,91.04,SKIPPED,107.1,107.1,91.04,91.04,91.04,45.13,52.48,52.48,0,32.13,46.05,46.05,91.04
4383290,430,97760,,,,,,,ORTHOTIC MGMT 8-22MIN & EA ADDL 15 MIN,121.02,48.41,0,121.02,102.87,SKIPPED,121.02,121.02,102.87,102.87,102.87,51,59.3,59.3,0,36.31,52.04,52.04,102.87
4383350,430,97762,,,,,,,OROTHO MGMT 0-15MINS,121.02,48.41,0,102.87,102.87,SKIPPED,91.98,91.98,102.87,102.87,102.87,51,59.3,59.3,0,36.31,52.04,52.04,102.87
4383356,430,G0283,,,,,,,E STIM UNATTENDED,198.61,79.44,0,168.82,168.82,SKIPPED,71.58,71.58,168.82,168.82,168.82,83.69,97.32,97.32,0,59.58,85.4,85.4,168.82
4383357,430,97024,,,,,,,DIATHERMY,167.65,67.06,0,142.5,142.5,SKIPPED,34.1,34.1,142.5,142.5,142.5,70.65,82.15,82.15,0,50.3,72.09,72.09,142.5
4383358,430,97533,,,,,,,SENSORY INTEGRATION,189.21,75.68,0,165.35,160.83,SKIPPED,165.35,165.35,160.83,160.83,160.83,79.73,92.71,92.71,0,56.76,81.36,81.36,160.83
4383377,430,97035,,,,,,,ULTRASOUND THERAPY,212.54,85.02,0,180.66,180.66,SKIPPED,64.79,64.79,180.66,180.66,180.66,89.56,104.14,104.14,0,63.76,91.39,91.39,180.66
4390041,440,92610,,,,,,,SP-EVAL/SWAL/ORAL/FU,280.88,112.35,0,280.88,238.75,SKIPPED,280.88,280.88,238.75,238.75,238.75,118.36,137.63,137.63,0,84.26,120.78,120.78,238.75
4390045,440,92526,,,,,,,EVAL SWAL/ORAL/FUN/F,347.52,139.01,0,347.52,295.39,SKIPPED,347.52,347.52,295.39,295.39,295.39,146.44,170.28,170.28,0,104.26,149.43,149.43,295.39
4390055,440,92522,,,,,,,EVALUATE SPEECH PRODUCTION,187.76,75.1,0,187.76,159.6,SKIPPED,187.76,187.76,159.6,159.6,159.6,79.13,92,92,0,56.33,80.74,80.74,159.6
4390233,440,97129,,,,,,,COGNITIVE SPEECH THERAPY FIRST 15,238.7,95.48,0,202.9,202.9,SKIPPED,114.24,114.24,202.9,202.9,202.9,100.59,116.96,116.96,0,71.61,102.64,102.64,202.9
4390234,440,97130,,,,,,,COGNITIVE SPEECH THER-EA ADDL 15 MIN,108.49,43.4,0,108.49,92.22,SKIPPED,108.49,108.49,92.22,92.22,92.22,45.72,53.16,53.16,0,32.55,46.65,46.65,92.22
4390236,440,97532,,,,,,,COGNITIVE SKILLS DEV,97.83,39.13,0,83.16,83.16,SKIPPED,74.35,74.35,83.16,83.16,83.16,41.23,47.94,47.94,0,29.35,42.07,42.07,83.16
4390237,440,97532,,,,,,,COGNITIVE SKILLS ADDL 15,97.83,39.13,0,83.16,83.16,SKIPPED,74.35,74.35,83.16,83.16,83.16,41.23,47.94,47.94,0,29.35,42.07,42.07,83.16
4390238,440,92611,,,,,,,MOTION FLUO/SWALLOW,777.25,310.9,0,660.66,660.66,SKIPPED,422.75,422.75,660.66,660.66,660.66,327.54,380.85,380.85,0,233.18,334.22,334.22,660.66
4391345,440,92521,,,,,,,MED EVAL SPEECH/LG/H,566.2,226.48,0,550.62,481.27,SKIPPED,550.62,550.62,481.27,481.27,481.27,238.6,277.44,277.44,0,169.86,243.47,243.47,481.27
4391355,440,92507,,,,,,,TRT-SPEECH/LANG,187.76,75.1,0,187.76,159.6,SKIPPED,187.76,187.76,159.6,159.6,159.6,79.13,92,92,0,56.33,80.74,80.74,159.6
4391356,440,92610,,,,,,,CLINICAL EVAL OF SWALLOW,262.12,104.85,0,262.12,222.8,SKIPPED,262.12,262.12,222.8,222.8,222.8,110.46,128.44,128.44,0,78.64,112.71,112.71,222.8
4391365,440,92507,,,,,,,SPEECH/LANG/HEAR/RX,387.82,155.13,0,378.43,329.65,SKIPPED,378.43,378.43,329.65,329.65,329.65,163.42,190.03,190.03,0,116.35,166.76,166.76,329.65
4400002,410,31500,,,,,,,INSERT EMERGENCY AIR WAY,875.16,350.06,0,847.88,743.89,SKIPPED,847.88,847.88,743.89,743.89,743.89,368.79,428.83,428.83,0,262.55,376.32,376.32,743.89
4400010,410,,,,,,,,RT RESPIRATORY TRANSPOR,846.92,338.77,0,719.88,719.88,SKIPPED,643.66,643.66,719.88,719.88,719.88,356.9,414.99,414.99,0,254.08,364.18,364.18,719.88
4400011,410,94761,,,,,,,RT PULSE OXIMETRY W/ EXERCISE,87.52,35.01,0,74.39,74.39,SKIPPED,22.18,22.18,74.39,74.39,74.39,36.88,42.88,42.88,0,26.26,37.63,37.63,74.39
4400012,301,80047,,,,,,,CHEM8,211.26,84.5,0,179.57,179.57,SKIPPED,52.17,52.17,179.57,179.57,179.57,89.02,11.53,11.53,0,11.53,90.84,90.84,179.57
4400013,305,85347,,,,,,,"ACTIVATED CLOTTING TIME, POC.",87.91,35.16,0,74.72,74.72,SKIPPED,19.99,19.99,74.72,74.72,74.72,37.04,3.6,3.6,0,3.97,37.8,37.8,74.72
4400020,410,94799,,,,,,,RT TRACHEOSTOMY CARE,85.24,34.1,0,85.24,72.45,SKIPPED,85.24,85.24,72.45,72.45,72.45,35.92,41.77,41.77,0,25.57,36.65,36.65,72.45
4400025,410,94664,,,,,,,RT NEBULIZER INITIAL,156.03,62.41,0,156.03,132.63,SKIPPED,156.03,156.03,132.63,132.63,132.63,65.75,76.45,76.45,0,46.81,67.09,67.09,132.63
4400030,271,,,,,,,,RT OXYGEN SET UP,88.1,35.24,0,74.88,74.88,SKIPPED,66.96,66.96,74.88,74.88,74.88,37.12,43.17,43.17,0,26.43,37.88,37.88,74.88
4400035,271,,,,,,,,RT INSENTIVE SPIRO. INITIAL,71.44,28.58,0,60.72,60.72,SKIPPED,54.29,54.29,60.72,60.72,60.72,30.11,35.01,35.01,0,21.43,30.72,30.72,60.72
4400040,410,,,,,,,,Capnography SUB/Hour,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4400045,410,94664,,,,,,,Aerogen Nebulizer Initia,156.03,62.41,0,156.03,132.63,SKIPPED,156.03,156.03,132.63,132.63,132.63,65.75,76.45,76.45,0,46.81,67.09,67.09,132.63
4400050,410,99406,,,,,,,RT SMOKING/TOBACCO COUNSEL,41.95,16.78,0,41.95,35.66,SKIPPED,41.95,41.95,35.66,35.66,35.66,17.68,20.56,20.56,0,12.58,18.04,18.04,35.66
4400065,410,94761,,,,,,,RT PULSE OXIMETRY W/ EXERCISE,49.74,19.9,0,42.28,42.28,SKIPPED,22.18,22.18,42.28,42.28,42.28,20.96,24.37,24.37,0,14.92,21.39,21.39,42.28
4400080,410,94681,,,,,,,RT CARBON MONOXIDE READ,107.1,42.84,0,107.1,91.04,SKIPPED,107.1,107.1,91.04,91.04,91.04,45.13,52.48,52.48,0,32.13,46.05,46.05,91.04
4400158,271,,,,,,,,RT OXYGEN W/EQPT PER HR,35.72,14.29,0,30.36,30.36,SKIPPED,27.15,27.15,30.36,30.36,30.36,15.05,17.5,17.5,0,10.72,15.36,15.36,30.36
4400160,410,G0424,,,,,,,RT PULM REHAB,117.93,47.17,0,100.24,100.24,SKIPPED,68.21,68.21,100.24,100.24,100.24,49.7,57.79,57.79,0,35.38,50.71,50.71,100.24
4400165,410,94150,,,,,,,RT PEAK FLOW METER,142.72,57.09,0,142.72,121.31,SKIPPED,142.72,142.72,121.31,121.31,121.31,60.14,69.93,69.93,0,42.82,61.37,61.37,121.31
4400185,271,,,,,,,,RT AEROSOL INITIAL,33.19,13.28,0,28.21,28.21,SKIPPED,25.22,25.22,28.21,28.21,28.21,13.98,16.26,16.26,0,9.96,14.27,14.27,28.21
4400190,410,94664,,,,,,,RT MDI INSTRUCT INITIAL,111.77,44.71,0,111.77,95,SKIPPED,111.77,111.77,95,95,95,47.1,54.77,54.77,0,33.53,48.06,48.06,95
4400210,410,94664,,,,,,,Aerogen Nebulizer Subsequent Treatment w,43.43,17.37,0,43.43,36.92,SKIPPED,43.43,43.43,36.92,36.92,36.92,18.3,21.28,21.28,0,13.03,18.67,18.67,36.92
4400215,410,94640,,,,,,,RT CONTINUEOUS NEB INITIAL,91.54,36.62,0,91.54,77.81,SKIPPED,91.54,91.54,77.81,77.81,77.81,38.57,44.85,44.85,0,27.46,39.36,39.36,77.81
4400220,410,94640,,,,,,,RT CONTINUEOUS NEB SUB/HR,88.32,35.33,0,88.32,75.07,SKIPPED,88.32,88.32,75.07,75.07,75.07,37.22,43.28,43.28,0,26.5,37.98,37.98,75.07
4402057,301,82803,,,,,,,ABG,435.94,174.38,0,370.55,370.55,SKIPPED,99.07,99.07,370.55,370.55,370.55,183.7,21.9,21.9,0,21.9,187.45,187.45,370.55
4402058,300,82803,,,,,,,VENOUS BLOOD GAS,311.85,124.74,0,265.07,265.07,SKIPPED,99.07,99.07,265.07,265.07,265.07,131.42,21.9,21.9,0,21.9,134.1,134.1,265.07
4402060,410,82800,,,,,,,PH BLOOD,119.42,47.77,0,101.51,101.51,SKIPPED,41.8,41.8,101.51,101.51,101.51,50.32,9.24,9.24,0,9.24,51.35,51.35,101.51
4404121,271,,,,,,,,RT AEROSOL SUB/HR,47.46,18.98,0,40.34,40.34,SKIPPED,36.07,36.07,40.34,40.34,40.34,20,23.26,23.26,0,14.24,20.41,20.41,40.34
4404290,410,99406,,,,,,,RT SMOKING CESSATION,26.26,10.5,0,26.26,22.32,SKIPPED,26.26,26.26,22.32,22.32,22.32,11.06,12.87,12.87,0,7.88,11.29,11.29,22.32
4404300,410,,,,,,,,DISP PEDI OXIMETER P,91.54,36.62,0,77.81,77.81,SKIPPED,69.57,69.57,77.81,77.81,77.81,38.57,44.85,44.85,0,27.46,39.36,39.36,77.81
4404395,410,31502,,,,,,,RT TRACH CARE,164.01,65.6,69.11,164.01,139.41,SKIPPED,164.01,164.01,139.41,139.41,139.41,69.11,80.36,80.36,SKIPPED,SKIPPED,70.52,70.52,139.41
4404400,410,,,,,,,,RT INCENTIVE SPIROMETER SUB,72.91,29.16,0,61.97,61.97,SKIPPED,55.41,55.41,61.97,61.97,61.97,30.72,35.73,35.73,0,21.87,31.35,31.35,61.97
4404475,410,,,,,,,,RT PEP THERAPY INITIAL,62.04,24.82,0,52.73,52.73,SKIPPED,47.15,47.15,52.73,52.73,52.73,26.15,30.4,30.4,0,18.61,26.68,26.68,52.73
4404478,410,94640,,,,,,,RT EZ-PAP INST W/EQUIP,142.72,57.09,0,142.72,121.31,SKIPPED,142.72,142.72,121.31,121.31,121.31,60.14,69.93,69.93,0,42.82,61.37,61.37,121.31
4404480,410,,,,,,,,RT PEP THERAPY SUB,97.83,39.13,0,83.16,83.16,SKIPPED,74.35,74.35,83.16,83.16,83.16,41.23,47.94,47.94,0,29.35,42.07,42.07,83.16
4404485,410,94640,,,,,,,RT EZ-PAP SUBSEQUENT,97.83,39.13,0,97.83,83.16,SKIPPED,97.83,97.83,83.16,83.16,83.16,41.23,47.94,47.94,0,29.35,42.07,42.07,83.16
4404493,410,94150,,,,,,,RT PEAK FLOW,121.02,48.41,0,121.02,102.87,SKIPPED,121.02,121.02,102.87,102.87,102.87,51,59.3,59.3,0,36.31,52.04,52.04,102.87
4404527,410,94664,,,,,,,RT MDI TX SUBSEQUENT,34.02,13.61,0,34.02,28.92,SKIPPED,34.02,34.02,28.92,28.92,28.92,14.34,16.67,16.67,0,10.21,14.63,14.63,28.92
4404585,410,94002,,,,,,,RT BI-PAP INITIAL,151.96,60.78,0,151.96,129.17,SKIPPED,151.96,151.96,129.17,129.17,129.17,64.03,74.46,74.46,0,45.59,65.34,65.34,129.17
4404590,410,94003,,,,,,,RT BI-PAP SUB/HR,77.6,31.04,0,77.6,65.96,SKIPPED,77.6,77.6,65.96,65.96,65.96,32.7,38.02,38.02,0,23.28,33.37,33.37,65.96
4404598,410,94799,,,,,,,Intubation Assist,167.14,66.86,0,167.14,142.07,SKIPPED,167.14,167.14,142.07,142.07,142.07,70.43,81.9,81.9,0,50.14,71.87,71.87,142.07
4404618,410,,,,,,,,RT AMBULATION W/OXYGEN,100.92,40.37,0,85.78,85.78,SKIPPED,76.7,76.7,85.78,85.78,85.78,42.53,49.45,49.45,0,30.28,43.4,43.4,85.78
4404721,271,,,,,,,,RT INCENTIVE SPIRO. SUB TX,88.1,35.24,0,74.88,74.88,SKIPPED,66.96,66.96,74.88,74.88,74.88,37.12,43.17,43.17,0,26.43,37.88,37.88,74.88
4404823,410,94667,,,,,,,RT PERCUSSION INITAL,100.92,40.37,0,100.92,85.78,SKIPPED,100.92,100.92,85.78,85.78,85.78,42.53,49.45,49.45,0,30.28,43.4,43.4,85.78
4404845,410,94668,,,,,,,RT PERCUSSION SUB TX,100.92,40.37,0,100.92,85.78,SKIPPED,100.92,100.92,85.78,85.78,85.78,42.53,49.45,49.45,0,30.28,43.4,43.4,85.78
4404850,410,94760,,,,,,,RT PULSE OXIMETER TEST,107.1,42.84,0,91.04,91.04,SKIPPED,13.63,13.63,91.04,91.04,91.04,45.13,52.48,52.48,0,32.13,46.05,46.05,91.04
4404855,410,94761,,,,,,,RT PULSE OX/HR,29.36,11.74,0,24.96,24.96,SKIPPED,22.18,22.18,24.96,24.96,24.96,12.37,14.39,14.39,0,8.81,12.62,12.62,24.96
4404865,410,94762,,,,,,,RT PULSE OX STUDY OVERNIGHT,316.42,126.57,0,316.42,268.96,SKIPPED,316.42,316.42,268.96,268.96,268.96,133.34,155.05,155.05,0,94.93,136.06,136.06,268.96
4404870,410,94664,,,,,,,RT CONSULT/ASSESSMEN,121.02,48.41,0,121.02,102.87,SKIPPED,121.02,121.02,102.87,102.87,102.87,51,59.3,59.3,0,36.31,52.04,52.04,102.87
4404992,271,,,,,,,,RT SPUTUM COLL,89.42,35.77,0,76.01,76.01,SKIPPED,67.96,67.96,76.01,76.01,76.01,37.68,43.82,43.82,0,26.83,38.45,38.45,76.01
4405835,410,94640,,,,,,,RT NEBULIZER TX W/MEDS,114.85,45.94,0,114.85,97.62,SKIPPED,114.85,114.85,97.62,97.62,97.62,48.4,56.28,56.28,0,34.46,49.39,49.39,97.62
4405836,410,94640,,,,,,,RT SUBS NEBULIZER TX W/MEDS,114.85,45.94,0,114.85,97.62,SKIPPED,114.85,114.85,97.62,97.62,97.62,48.4,56.28,56.28,0,34.46,49.39,49.39,97.62
4406154,410,94002,,,,,,,RT VOL VENT INITIAL,376.98,150.79,0,376.98,320.43,SKIPPED,376.98,376.98,320.43,320.43,320.43,158.86,184.72,184.72,0,113.09,162.1,162.1,320.43
4406358,410,94003,,,,,,,RT VENTILATOR SUB/DAY,508.84,203.54,0,508.84,432.51,SKIPPED,508.84,508.84,432.51,432.51,432.51,214.42,249.33,249.33,0,152.65,218.8,218.8,432.51
4406455,460,94762,,,,,,,RT CONT OVERNIGHT STUDY,316.42,126.57,0,316.42,268.96,SKIPPED,316.42,316.42,268.96,268.96,268.96,133.34,155.05,155.05,0,94.93,136.06,136.06,268.96
4406552,460,94060,,,,,,,RT SPIROMETRY PRE&POST,532.16,212.86,0,452.34,452.34,SKIPPED,230.14,230.14,452.34,452.34,452.34,224.25,260.76,260.76,0,159.65,228.83,228.83,452.34
4406654,410,,,,,,,,RT SUCTION SETUP W/EQPT,65.12,26.05,0,55.35,55.35,SKIPPED,49.49,49.49,55.35,55.35,55.35,27.44,31.91,31.91,0,19.54,28,28,55.35
4406655,410,93922,,,,,,,TRANSCUTANEOUS OXIMETRY 1 2 LEV 1 LIMB,657.58,263.03,0,558.94,558.94,SKIPPED,498.94,498.94,558.94,558.94,558.94,277.1,322.21,322.21,0,197.27,282.76,282.76,558.94
4406656,410,93922,,,,,,,TRANSCUTANEOUS OXIMETRY BILAT W MANEUVER,657.58,263.03,0,558.94,558.94,SKIPPED,498.94,498.94,558.94,558.94,558.94,277.1,322.21,322.21,0,197.27,282.76,282.76,558.94
4406756,410,,,,,,,,RT SUCTION PER DAY,57.36,22.94,0,48.76,48.76,SKIPPED,43.59,43.59,48.76,48.76,48.76,24.17,28.11,28.11,0,17.21,24.66,24.66,48.76
4406858,410,92950,,,,,,,RT CPR RESUS,352.18,140.87,0,352.18,299.35,SKIPPED,352.18,352.18,299.35,299.35,299.35,148.41,172.57,172.57,0,105.65,151.44,151.44,299.35
4406859,410,94667,,,,,,,RT OSCILLATING PEP TX INTL.,182.26,72.9,0,182.26,154.92,SKIPPED,182.26,182.26,154.92,154.92,154.92,76.8,89.31,89.31,0,54.68,78.37,78.37,154.92
4406860,410,94668,,,,,,,RT OSCILLATING PEP TX SUB.,138.03,55.21,0,138.03,117.33,SKIPPED,138.03,138.03,117.33,117.33,117.33,58.16,67.63,67.63,0,41.41,59.35,59.35,117.33
4406861,271,,,,,,,,RT HIGH FLOW OXYGEN INITIAL,186.22,74.49,0,158.29,158.29,SKIPPED,141.53,141.53,158.29,158.29,158.29,78.47,91.25,91.25,0,55.87,80.07,80.07,158.29
4406862,271,,,,,,,,RT HIGH FLOW OXYGEN SUB HR,71.44,28.58,0,60.72,60.72,SKIPPED,54.29,54.29,60.72,60.72,60.72,30.11,35.01,35.01,0,21.43,30.72,30.72,60.72
4406863,410,G0424,,,,,,,PULMONARY REHAB W/ EXERCISE,50.94,20.38,0,50.94,43.3,SKIPPED,50.94,50.94,43.3,43.3,43.3,21.46,24.96,24.96,0,15.28,21.9,21.9,43.3
4406864,976,G0424,,,,,,,PULMONARY REHAB W/ EXERCISE,33.8,13.52,0,33.8,28.73,SKIPPED,33.8,33.8,28.73,28.73,28.73,15.23,16.56,16.56,0,10.14,15.54,15.54,0
4406865,410,E0482,,,,,,,Cough Assist Airway Clearance,611,244.4,0,611,519.35,SKIPPED,611,611,519.35,519.35,519.35,257.48,299.39,299.39,0,183.3,262.73,262.73,519.35
4406866,976,99453,,,,,,,REMOTE PT. MONITOR/PHYSIOLOGIC PARAM.,131.51,52.6,0,131.51,111.78,SKIPPED,131.51,131.51,111.78,111.78,111.78,20.34,64.44,64.44,0,39.45,20.76,20.76,0
4430003,420,97760,,,,,,,ORTHOTIC MGMT&TRAINING,121.02,48.41,0,121.02,102.87,SKIPPED,121.02,121.02,102.87,102.87,102.87,51,59.3,59.3,0,36.31,52.04,52.04,102.87
4430004,420,97760,,,,,,,ORTHOTIC MGMT&TR ADDL',60.57,24.23,0,60.57,51.48,SKIPPED,60.57,60.57,51.48,51.48,51.48,25.53,29.68,29.68,0,18.17,26.05,26.05,51.48
4430006,420,G0283,,,,,,,UNATTEND ELE STIM NOWND,20.11,8.04,0,20.11,17.09,SKIPPED,20.11,20.11,17.09,17.09,17.09,8.48,9.85,9.85,0,6.03,8.65,8.65,17.09
4430012,420,97542,,,,,,,WHEELCHAIR MOBILITY,133.35,53.34,0,133.35,113.35,SKIPPED,133.35,133.35,113.35,113.35,113.35,56.19,65.34,65.34,0,40,57.34,57.34,113.35
4430013,420,97112,,,,,,,NEUROMUSCULAR RE-EDU,189.21,75.68,0,168.77,160.83,SKIPPED,168.77,168.77,160.83,160.83,160.83,79.73,92.71,92.71,0,56.76,81.36,81.36,160.83
4430014,420,97112,,,,,,,NEUROMUSCULAR RE-EDU,189.21,75.68,0,168.77,160.83,SKIPPED,168.77,168.77,160.83,160.83,160.83,79.73,92.71,92.71,0,56.76,81.36,81.36,160.83
4430016,420,97535,,,,,,,ADL 8-22 MIN & EACH ADDL 15 MIN,114.85,45.94,0,114.85,97.62,SKIPPED,114.85,114.85,97.62,97.62,97.62,48.4,56.28,56.28,0,34.46,49.39,49.39,97.62
4430017,420,97535,,,,,,,ADL ADD'L 15 MIN,114.85,45.94,0,114.85,97.62,SKIPPED,114.85,114.85,97.62,97.62,97.62,48.4,56.28,56.28,0,34.46,49.39,49.39,97.62
4430020,420,97001,,,,,,,INITIAL EVAL 0-30MIN,215.63,86.25,0,183.29,183.29,SKIPPED,163.88,163.88,183.29,183.29,183.29,90.87,105.66,105.66,0,64.69,92.72,92.72,183.29
4430022,420,97001,,,,,,,INITIAL EVAL 30-60MI,324.18,129.67,0,275.55,275.55,SKIPPED,246.38,246.38,275.55,275.55,275.55,136.61,158.85,158.85,0,97.25,139.4,139.4,275.55
4430026,420,97164,,,,,,,PT RE-EVALUATION,176.89,70.76,0,176.89,150.36,SKIPPED,176.89,176.89,150.36,150.36,150.36,74.54,86.68,86.68,0,53.07,76.06,76.06,150.36
4430050,420,97014,,,,,,,TNS SET UP & 1ST DAY,231.18,92.47,0,196.5,196.5,SKIPPED,75,75,196.5,196.5,196.5,97.42,113.28,113.28,0,69.35,99.41,99.41,196.5
4430065,420,29580,,,,,,,APPLICATION UNNABOOT,305.68,122.27,0,259.83,259.83,SKIPPED,193.23,193.23,259.83,259.83,259.83,128.81,149.78,149.78,0,91.7,131.44,131.44,259.83
4430078,420,97124,,,,,,,MASSAGE,131.87,52.75,0,131.87,112.09,SKIPPED,131.87,131.87,112.09,112.09,112.09,55.57,64.62,64.62,0,39.56,56.7,56.7,112.09
4430085,420,97140,,,,,,,MANUAL THERAPY/15 M,167.65,67.06,0,142.5,142.5,SKIPPED,134.66,134.66,142.5,142.5,142.5,70.65,82.15,82.15,0,50.3,72.09,72.09,142.5
4430087,420,97010,,,,,,,MOIST HEAT-20 MIN,107.1,42.84,0,91.04,91.04,SKIPPED,30.68,30.68,91.04,91.04,91.04,45.13,52.48,52.48,0,32.13,46.05,46.05,91.04
4430130,420,97116,,,,,,,GAIT TRAINING,198.61,79.44,0,168.82,168.82,SKIPPED,146.58,146.58,168.82,168.82,168.82,83.69,97.32,97.32,0,59.58,85.4,85.4,168.82
4430140,420,G0283,,,,,,,ELECTRICAL STIMULATI,246.73,98.69,0,209.72,209.72,SKIPPED,71.58,71.58,209.72,209.72,209.72,103.97,120.9,120.9,0,74.02,106.09,106.09,209.72
4430212,420,97035,,,,,,,ULTRASOUND,223.4,89.36,0,189.89,189.89,SKIPPED,64.79,64.79,189.89,189.89,189.89,94.14,109.47,109.47,0,67.02,96.06,96.06,189.89
4430213,420,97150,,,,,,,THERAPUTIC GRP 8-22MIN & EACH ADDL 15MIN,68.22,27.29,0,68.22,57.99,SKIPPED,68.22,68.22,57.99,57.99,57.99,28.74,33.43,33.43,0,20.47,29.33,29.33,57.99
4431070,420,97110,,,,,,,EXERCISE 16-30 MIN,200.08,80.03,0,170.07,170.07,SKIPPED,148.3,148.3,170.07,170.07,170.07,84.31,98.04,98.04,0,60.02,86.03,86.03,170.07
4431075,420,97110,,,,,,,EXERCISE 8-22 MIN & EA ADDL 15,131.87,52.75,0,131.87,112.09,SKIPPED,131.87,131.87,112.09,112.09,112.09,55.57,64.62,64.62,0,39.56,56.7,56.7,112.09
4431085,420,97110,,,,,,,EXERCISE EA ADDL 15M,133.35,53.34,0,133.35,113.35,SKIPPED,133.35,133.35,113.35,113.35,113.35,56.19,65.34,65.34,0,40,57.34,57.34,113.35
4432360,420,97116,,,,,,,CRUTCH TRAINING,133.35,53.34,0,133.35,113.35,SKIPPED,133.35,133.35,113.35,113.35,113.35,56.19,65.34,65.34,0,40,57.34,57.34,113.35
4432380,420,97597,,,,,,,SELECTIVE DEBRIDEMEN,221.92,88.77,0,188.63,188.63,SKIPPED,115.9,115.9,188.63,188.63,188.63,93.52,108.74,108.74,0,66.58,95.43,95.43,188.63
4432391,420,97140,,,,,,,MANUAL THERAPY ADD'L,167.65,67.06,0,142.5,142.5,SKIPPED,134.66,134.66,142.5,142.5,142.5,70.65,82.15,82.15,0,50.3,72.09,72.09,142.5
4433100,420,97012,,,,,,,TRACTION SET UP,291.74,116.7,0,247.98,247.98,SKIPPED,71.58,71.58,247.98,247.98,247.98,122.94,142.95,142.95,0,87.52,125.45,125.45,247.98
4433200,420,97535,,,,,,,OVERHEAD SET UP,226.62,90.65,0,192.63,192.63,SKIPPED,167.06,167.06,192.63,192.63,192.63,95.5,111.04,111.04,0,67.99,97.45,97.45,192.63
4433500,420,97012,,,,,,,INTERMITTANT TRAC,105.6,42.24,0,89.76,89.76,SKIPPED,71.58,71.58,89.76,89.76,89.76,44.5,51.74,51.74,0,31.68,45.41,45.41,89.76
4433860,420,97032,,,,,,,ELECTRODE PLUS,34.19,13.68,0,34.19,29.06,SKIPPED,34.19,34.19,29.06,29.06,29.06,14.41,16.75,16.75,0,10.26,14.7,14.7,29.06
4433870,420,97033,,,,,,,IONTO-PHONOPHORESIS,169.13,67.65,0,143.76,143.76,SKIPPED,100.56,100.56,143.76,143.76,143.76,71.28,82.87,82.87,0,50.74,72.73,72.73,143.76
4433880,420,97530,,,,,,,FUNCT ACT 8-22 MIN & EA ADDL 15 MIN,148.88,59.55,0,148.88,126.55,SKIPPED,148.88,148.88,126.55,126.55,126.55,62.74,72.95,72.95,0,44.66,64.02,64.02,126.55
4433885,420,97530,,,,,,,FUNCT ACT EA ADDL 15,148.88,59.55,0,148.88,126.55,SKIPPED,148.88,148.88,126.55,126.55,126.55,62.74,72.95,72.95,0,44.66,64.02,64.02,126.55
4433890,420,29540,,,,,,,STRAPPING,96.22,38.49,0,81.79,81.79,SKIPPED,56.43,56.43,81.79,81.79,81.79,40.54,47.15,47.15,0,28.87,41.37,41.37,81.79
4433911,420,97024,,,,,,,DIATHERMY,159.88,63.95,0,135.9,135.9,SKIPPED,34.1,34.1,135.9,135.9,135.9,67.38,78.34,78.34,0,47.96,68.75,68.75,135.9
4433912,420,G0283,,,,,,,E STIM UNATTENDED,189.21,75.68,0,160.83,160.83,SKIPPED,71.58,71.58,160.83,160.83,160.83,79.73,92.71,92.71,0,56.76,81.36,81.36,160.83
4433913,420,97161,,,,,,,PT EVAL LOW COMPLEXITY 20 MIN.,210.77,84.31,0,210.77,179.15,SKIPPED,210.77,210.77,179.15,179.15,179.15,88.82,103.28,103.28,0,63.23,90.63,90.63,179.15
4433914,420,97162,,,,,,,PT EVAL MOD. COMPLEXITY 30 MIN.,263.47,105.39,0,263.47,223.95,SKIPPED,263.47,263.47,223.95,223.95,223.95,111.02,129.1,129.1,0,79.04,113.29,113.29,223.95
4433915,420,97163,,,,,,,PT EVAL HIGH COMPLEXITY 45 MIN.,316.17,126.47,0,316.17,268.74,SKIPPED,316.17,316.17,268.74,268.74,268.74,133.23,154.92,154.92,0,94.85,135.95,135.95,268.74
4433916,420,97164,,,,,,,PT RE-EVAL EST PLAN OF CARE 20 MIN.,142.84,57.14,0,142.84,121.41,SKIPPED,142.84,142.84,121.41,121.41,121.41,60.19,69.99,69.99,0,42.85,61.42,61.42,121.41
4460001,740,95810,,,,,,,PSG,4578.03,1831.21,0,3891.33,3891.33,SKIPPED,2436.04,2436.04,3891.33,3891.33,3891.33,1929.18,2243.23,2243.23,0,1373.41,1968.55,1968.55,3891.33
4460002,740,95811,,,,,,,CPAP,4990.52,1996.21,0,4241.94,4241.94,SKIPPED,2563.91,2563.91,4241.94,4241.94,4241.94,2103,2445.35,2445.35,0,1497.16,2145.92,2145.92,4241.94
4460003,740,95811,,,,,,,SPLIT,4990.52,1996.21,0,4241.94,4241.94,SKIPPED,2563.91,2563.91,4241.94,4241.94,4241.94,2103,2445.35,2445.35,0,1497.16,2145.92,2145.92,4241.94
4460004,740,,,,,,,,ASV,4578.03,1831.21,0,3891.33,3891.33,SKIPPED,3479.3,3479.3,3891.33,3891.33,3891.33,1929.18,2243.23,2243.23,0,1373.41,1968.55,1968.55,3891.33
4460005,740,95805,,,,,,,MSLT,4578.03,1831.21,0,3891.33,3891.33,SKIPPED,1800.16,1800.16,3891.33,3891.33,3891.33,1929.18,2243.23,2243.23,0,1373.41,1968.55,1968.55,3891.33
4460006,740,95806,,,,,,,SLEEP STUDY UNATTREESP EFFT,820.42,328.17,0,697.36,697.36,SKIPPED,525.06,525.06,697.36,697.36,697.36,345.72,402.01,402.01,0,246.13,352.78,352.78,697.36
4460007,740,G0399,,,,,,,HOME SLEEP STUDY W/ TYPE III PRTBLE MON,782.34,312.94,0,664.99,664.99,SKIPPED,647.52,647.52,664.99,664.99,664.99,329.68,383.35,383.35,0,234.7,336.41,336.41,664.99
4495806,960,95806,,,,,,,SLEEP STUDY UNATTRESP EFFT PROF,147.65,59.06,0,147.65,125.5,SKIPPED,147.65,147.65,125.5,125.5,125.5,49.48,72.35,72.35,0,44.3,50.49,50.49,0
4495810,960,95810,,,,,,,PSG PROF,293.53,117.41,0,293.53,249.5,SKIPPED,293.53,293.53,249.5,249.5,249.5,132.7,143.83,143.83,0,88.06,135.41,135.41,0
4495811,960,95811,,,,,,,SPLIT PRO,305.33,122.13,0,305.33,259.53,SKIPPED,305.33,305.33,259.53,259.53,259.53,137.72,149.61,149.61,0,91.6,140.53,140.53,0
4495812,960,95811,,,,,,,CPAP PROF,305.33,122.13,0,305.33,259.53,SKIPPED,305.33,305.33,259.53,259.53,259.53,137.72,149.61,149.61,0,91.6,140.53,140.53,0
4500032,110,,,,,,,,LEVEL I PRIVATE,151.94,60.78,0,4322,129.15,SKIPPED,94.2,94.2,129.15,0,129.15,4235.56,0,0,0,0,4322,4322,0
4500033,110,,,,,,,,LEVEL II PRIVATE,164.09,65.64,0,4322,139.48,SKIPPED,101.74,101.74,139.48,0,139.48,4235.56,0,0,0,0,4322,4322,0
4500034,110,,,,,,,,LEVEL III PRIVATE,188.4,75.36,0,4322,160.14,SKIPPED,116.81,116.81,160.14,0,160.14,4235.56,0,0,0,0,4322,4322,0
4500036,120,,,,,,,,LEVEL I SEMI-PRIVATE,133.71,53.48,0,4322,113.65,SKIPPED,82.9,82.9,113.65,0,113.65,4235.56,0,0,0,0,4322,4322,0
4500037,120,,,,,,,,LEVEL II SEMI-PRIVATE,145.87,58.35,0,4322,123.99,SKIPPED,90.44,90.44,123.99,0,123.99,4235.56,0,0,0,0,4322,4322,0
4500040,110,,,,,,,,SUITE PRIVATE,212.72,85.09,0,4322,180.81,SKIPPED,131.89,131.89,180.81,0,180.81,4235.56,0,0,0,0,4322,4322,0
4510001,975,99201,,,,,,,NEW PATENT LEVEL 1,95.69,38.28,0,95.69,81.34,SKIPPED,95.69,95.69,81.34,81.34,81.34,29.4,46.89,46.89,0,28.71,30,30,0
4510002,975,99202,,,,,,,NEW PATIENT LEVEL 2,173.82,69.53,0,173.82,147.75,SKIPPED,173.82,173.82,147.75,147.75,147.75,53.59,85.17,85.17,0,52.15,54.68,54.68,0
4510003,975,99203,,,,,,,NEW PATIENT LEVEL 3,228.08,91.23,0,228.08,193.87,SKIPPED,228.08,228.08,193.87,193.87,193.87,91.23,111.76,111.76,0,68.42,93.09,93.09,0
4510004,975,99204,,,,,,,NEW PATIENT LEVEL 4,327.24,130.9,0,327.24,278.15,SKIPPED,327.24,327.24,278.15,278.15,278.15,148.22,160.35,160.35,0,98.17,151.24,151.24,0
4510005,511,99205,,,,,,,NEW PATIENT LEVEL 5,410.71,164.28,0,410.71,349.1,SKIPPED,410.71,410.71,349.1,349.1,0,173.08,201.25,201.25,0,123.21,176.61,176.61,349.1
4510006,975,99211,,,,,,,EST PATIENT LEVEL 1,32.98,13.19,0,32.98,28.03,SKIPPED,32.98,32.98,28.03,28.03,28.03,9.85,16.16,16.16,0,9.89,10.05,10.05,0
4510007,975,99212,,,,,,,EST PATIENT LEVEL 2,90.99,36.4,0,90.99,77.34,SKIPPED,90.99,90.99,77.34,77.34,77.34,39.69,44.59,44.59,0,27.3,40.5,40.5,0
4510008,975,99213,,,,,,,EST PATIENT LEVEL 3,173.82,69.53,0,173.82,147.75,SKIPPED,173.82,173.82,147.75,147.75,147.75,73.47,85.17,85.17,0,52.15,74.97,74.97,0
4510009,975,99214,,,,,,,EST PATIENT LEVEL 4,215.63,86.25,0,215.63,183.29,SKIPPED,215.63,215.63,183.29,183.29,183.29,108.16,105.66,105.66,0,64.69,110.37,110.37,0
4510010,511,99215,,,,,,,EST PATIENT LEVEL 5,311.66,124.66,0,311.66,264.91,SKIPPED,311.66,311.66,264.91,264.91,0,131.33,152.71,152.71,0,93.5,134.01,134.01,264.91
4510011,975,20552,,,,,,,INJ TRIGGER PT 1-2 MUSCLE PROF,136.99,54.8,0,136.99,116.44,SKIPPED,136.99,136.99,116.44,116.44,116.44,41.2,67.13,67.13,SKIPPED,SKIPPED,42.04,42.04,0
4510012,975,20553,,,,,,,INJ TRIGGER PT 3-MORE MUS PROF,155.88,62.35,0,155.88,132.5,SKIPPED,155.88,155.88,132.5,132.5,132.5,46.8,76.38,76.38,SKIPPED,SKIPPED,47.76,47.76,0
4510013,975,27096,,,,,,,INJ SACROJOINT STEROID PROF,302.54,121.02,0,302.54,257.16,SKIPPED,302.54,302.54,257.16,257.16,257.16,90.62,148.24,148.24,0,90.76,92.47,92.47,0
4510014,975,62273,,,,,,,INJ EPIDURAL BLOOD-CLOT,411.59,164.64,0,411.59,349.85,SKIPPED,411.59,411.59,349.85,349.85,349.85,124.02,201.68,201.68,SKIPPED,SKIPPED,126.55,126.55,0
4510015,975,62282,,,,,,,INJ LUMBAR/SACRA EPIDURAL,520.89,208.36,0,520.89,442.76,SKIPPED,520.89,520.89,442.76,442.76,442.76,157.63,255.24,255.24,SKIPPED,SKIPPED,160.85,160.85,0
4510016,975,62320,,,,,,,INJ CERV/THOR W/WO CONTR,361.9,144.76,0,361.9,307.62,SKIPPED,361.9,361.9,307.62,307.62,307.62,108.82,177.33,177.33,0,108.57,111.04,111.04,0
4510017,975,62322,,,,,,,INJ SACRAL/LUM W/WO CONTR,313.75,125.5,0,313.75,266.69,SKIPPED,313.75,313.75,266.69,266.69,266.69,88.61,153.74,153.74,0,94.12,90.42,90.42,0
4510018,975,62318,,,,,,,INJ CATH CERV/THOR,1663.05,665.22,0,1413.59,1413.59,SKIPPED,1263.92,1263.92,1413.59,1413.59,1413.59,112.12,814.89,814.89,0,498.92,114.41,114.41,0
4510019,975,62319,,,,,,,INJ CATH LUMBAR/SACRAL,1557.47,622.99,0,1323.85,1323.85,SKIPPED,1183.68,1183.68,1323.85,1323.85,1323.85,107.87,763.16,763.16,0,467.24,110.07,110.07,0
4510020,975,64490,,,,,,,INJ PARAVERT CERV,382.68,153.07,0,382.68,325.28,SKIPPED,382.68,382.68,325.28,325.28,325.28,115.77,187.51,187.51,SKIPPED,SKIPPED,118.13,118.13,0
4510021,975,64491,,,,,,,INJ PARAVERT CERVICAL ADD,217.23,86.89,0,184.65,184.65,SKIPPED,0,0,184.65,184.65,184.65,65.26,106.44,106.44,0,65.17,66.59,66.59,0
4510022,975,64493,,,,,,,INJ PARAVERT LUMBAR,316.42,126.57,0,316.42,268.96,SKIPPED,316.42,316.42,268.96,268.96,268.96,98.6,155.05,155.05,SKIPPED,SKIPPED,100.61,100.61,0
4510023,975,64494,,,,,,,INJ PARAVERT LUMBAR ADD,181.59,72.64,0,154.35,154.35,SKIPPED,0,0,154.35,154.35,154.35,56.18,88.98,88.98,0,54.48,57.33,57.33,0
4510024,320,77002,,,,,,,FLUORO NEEDLE PLACE,704.24,281.7,0,598.6,598.6,SKIPPED,340.92,340.92,598.6,598.6,598.6,296.76,345.08,345.08,0,211.27,302.82,302.82,598.6
4510025,320,77003,,,,,,,FLUORO CATH SPINE,701.14,280.46,0,595.97,595.97,SKIPPED,331.83,331.83,595.97,595.97,595.97,295.46,343.56,343.56,0,210.34,301.49,301.49,595.97
4510026,320,72275,,,,,,,RADIOL SUPV EPIDUROLOGY,1065.77,426.31,0,905.9,905.9,SKIPPED,393.8,393.8,905.9,905.9,905.9,449.11,522.23,522.23,0,319.73,458.28,458.28,905.9
4510027,975,27096,,,,,,,INJ SACROJNT STEROID BIL PROF,302.54,121.02,0,302.54,257.16,SKIPPED,302.54,302.54,257.16,257.16,257.16,90.62,148.24,148.24,0,90.76,92.47,92.47,0
4510028,975,99080,,,,,,,PHYSICAL MEDICINE REPORT,91.54,36.62,0,77.81,77.81,SKIPPED,69.57,69.57,77.81,77.81,77.81,0,44.85,44.85,0,27.46,0,0,0
4510029,975,99144,,,,,,,CONSCIOUS SEDATION,359.95,143.98,0,305.96,305.96,SKIPPED,273.56,273.56,305.96,305.96,305.96,0,176.38,176.38,0,107.98,0,0,0
4510030,975,99366,,,,,,,MEDICAL CONFERENCE 30 MIN,269.89,107.96,0,229.41,229.41,SKIPPED,202.87,202.87,229.41,229.41,229.41,0,132.25,132.25,0,80.97,0,0,0
4510031,975,99366,,,,,,,MEDICAL CONFERENCE 60 MIN,476.27,190.51,0,404.83,404.83,SKIPPED,202.87,202.87,404.83,404.83,404.83,0,233.37,233.37,0,142.88,0,0,0
4510032,975,64492,,,,,,,INJ PARAVERT CER/THOR 3RD,221.04,88.42,0,187.88,187.88,SKIPPED,0,0,187.88,187.88,187.88,65.99,108.31,108.31,0,66.31,67.34,67.34,0
4510033,975,64495,,,,,,,INJ PARAVERTLUMB/SAC 3RD,190.65,76.26,0,162.05,162.05,SKIPPED,0,0,162.05,162.05,162.05,56.93,93.42,93.42,0,57.2,58.09,58.09,0
4510034,360,20552,,,,,,,FAC INJ TRIG PT 1-2 MUSCL,946.24,378.5,24.26,804.3,804.3,SKIPPED,143.64,143.64,804.3,804.3,804.3,398.74,24.26,24.26,SKIPPED,SKIPPED,406.88,406.88,804.3
4510035,360,20553,,,,,,,FAC INJ TRIF PT 3+ MUSCUL,1103.03,441.21,28.3,937.58,937.58,SKIPPED,167.58,167.58,937.58,937.58,937.58,464.81,28.3,28.3,SKIPPED,SKIPPED,474.3,474.3,937.58
4510036,360,27096,,,,,,,FAC INJ SACROJOINT STEROI,1656.89,662.76,0,1408.36,1408.36,SKIPPED,409.12,409.12,1408.36,1408.36,1408.36,698.21,0,0,0,497.07,712.46,712.46,1408.36
4510037,360,62273,,,,,,,FAC INJ EPIDURAL BLOOD-CL,1959.36,783.74,252.66,1959.36,1665.46,SKIPPED,1959.36,1959.36,1665.46,1665.46,1665.46,825.67,252.66,252.66,SKIPPED,SKIPPED,842.52,842.52,1665.46
4510038,360,62282,,,,,,,FAC INJ LUMBAR/SACRA EPID,3893.94,1557.58,269.69,3309.85,3309.85,SKIPPED,3192.86,3192.86,3309.85,3309.85,3309.85,1640.9,269.69,269.69,SKIPPED,SKIPPED,1674.39,1674.39,3309.85
4510039,360,62320,,,,,,,FAC INJ CERV/THOR W/WO CO,2773.87,1109.55,0,2581.06,2357.79,SKIPPED,2581.06,2581.06,2357.79,2357.79,2357.79,1168.9,252.66,252.66,0,832.16,1192.76,1192.76,2357.79
4510040,360,62322,,,,,,,FAC INJ SACR/LUM W/WO CON,2680.73,1072.29,0,2581.06,2278.62,SKIPPED,2581.06,2581.06,2278.62,2278.62,2278.62,1129.66,252.66,252.66,0,804.22,1152.71,1152.71,2278.62
4510041,360,62318,,,,,,,FAC INJ CATH CERV/THOR,3113.45,1245.38,0,2646.43,2646.43,SKIPPED,2366.22,2366.22,2646.43,2646.43,2646.43,1312,0,0,0,934.04,1338.78,1338.78,2646.43
4510042,360,62319,,,,,,,FAC INJ CATH LUMBAR/SACRA,3088.8,1235.52,0,2625.48,2625.48,SKIPPED,2347.49,2347.49,2625.48,2625.48,2625.48,1301.62,0,0,0,926.64,1328.18,1328.18,2625.48
4510043,360,64490,,,,,,,FAC INJ PARAVERT CERV,941.69,376.68,269.69,941.69,800.44,SKIPPED,941.69,941.69,800.44,800.44,800.44,396.83,269.69,269.69,SKIPPED,SKIPPED,404.93,404.93,800.44
4510044,360,64491,,,,,,,FAC INJ PARAVERT CERVICAL,318.01,127.2,0,270.31,270.31,SKIPPED,0,0,270.31,270.31,270.31,134.01,0,0,0,95.4,136.74,136.74,270.31
4510045,360,64493,,,,,,,FAC INJ PARAVERT LUMBAR,899.88,359.95,269.69,899.88,764.9,SKIPPED,899.88,899.88,764.9,764.9,764.9,379.21,269.69,269.69,SKIPPED,SKIPPED,386.95,386.95,764.9
4510046,360,64494,,,,,,,FACINJ PARAVERT LUMBAR AD,316.42,126.57,0,268.96,268.96,SKIPPED,0,0,268.96,268.96,268.96,133.34,0,0,0,94.93,136.06,136.06,268.96
4510047,975,64450,,,,,,,INJ N BLOCK OTHER PERIPH,144.2,57.68,0,144.2,122.57,SKIPPED,144.2,144.2,122.57,122.57,122.57,46.2,70.66,70.66,0,43.26,47.14,47.14,0
4510048,360,64492,,,,,,,FAC INJ PARA CER/THOR 3RD,470.12,188.05,0,399.6,399.6,SKIPPED,0,0,399.6,399.6,399.6,198.11,0,0,0,141.04,202.15,202.15,399.6
4510049,360,64495,,,,,,,FAC INJ PARA LUMB/SAC 3RD,470.12,188.05,0,399.6,399.6,SKIPPED,0,0,399.6,399.6,399.6,198.11,0,0,0,141.04,202.15,202.15,399.6
4510050,975,20610,,,,,,,INJECTION SHOULDER PROF,166.44,66.58,0,141.47,141.47,SKIPPED,138.51,138.51,141.47,141.47,141.47,49.19,81.56,81.56,0,49.93,50.19,50.19,0
4510051,360,20610,,,,,,,FAC INJECTION SHOULDER,1474.64,589.86,0,1253.44,1253.44,SKIPPED,138.51,138.51,1253.44,1253.44,1253.44,621.42,24.83,24.83,0,442.39,634.1,634.1,1253.44
4510052,975,20610,,,,,,,INJECTION HIP PROF,166.44,66.58,0,141.47,141.47,SKIPPED,138.51,138.51,141.47,141.47,141.47,49.19,81.56,81.56,0,49.93,50.19,50.19,0
4510053,360,20610,,,,,,,FAC INJECTION HIP,1474.64,589.86,0,1253.44,1253.44,SKIPPED,138.51,138.51,1253.44,1253.44,1253.44,621.42,24.83,24.83,0,442.39,634.1,634.1,1253.44
4510054,975,20610,,,,,,,INJECTION KNEE PROF,166.44,66.58,0,141.47,141.47,SKIPPED,138.51,138.51,141.47,141.47,141.47,49.19,81.56,81.56,0,49.93,50.19,50.19,0
4510055,360,20610,,,,,,,FAC CHG INJECT KNEE,1474.64,589.86,0,1253.44,1253.44,SKIPPED,138.51,138.51,1253.44,1253.44,1253.44,621.42,24.83,24.83,0,442.39,634.1,634.1,1253.44
4510056,360,20605,,,,,,,FACILITY INJECTION BURSA/ELBOW,1096.88,438.75,0,932.35,932.35,SKIPPED,116.28,116.28,932.35,932.35,932.35,462.23,20.78,20.78,0,329.06,471.66,471.66,932.35
4510057,975,20605,,,,,,,INJECTION BURSA/ELBOW PROF,114.85,45.94,0,114.85,97.62,SKIPPED,114.85,114.85,97.62,97.62,97.62,40.49,56.28,56.28,0,34.46,41.32,41.32,0
4510058,360,64633,,,,,,,DESTROY CERV/THOR FACET JNT,3385.49,1354.2,510.13,3385.49,2877.67,SKIPPED,3385.49,3385.49,2877.67,2877.67,2877.67,1426.64,510.13,510.13,SKIPPED,SKIPPED,1455.76,1455.76,2877.67
4510059,360,64634,,,,,,,DESTROY CERV/THOR FACET JNT ADDTL.,1695.63,678.25,0,1441.29,1441.29,SKIPPED,0,0,1441.29,1441.29,1441.29,714.54,0,0,0,508.69,729.12,729.12,1441.29
4510060,360,64635,,,,,,,DESTROY LUMB/SAC FACET JNT,3821.7,1528.68,510.13,3821.7,3248.44,SKIPPED,3821.7,3821.7,3248.44,3248.44,3248.44,1610.46,510.13,510.13,SKIPPED,SKIPPED,1643.33,1643.33,3248.44
4510061,360,64636,,,,,,,DESTROY LUMB/SAC FACET JNT ADDTL.,2158.5,863.4,0,1834.72,1834.72,SKIPPED,0,0,1834.72,1834.72,1834.72,909.6,0,0,0,647.55,928.16,928.16,1834.72
4510062,975,64633,,,,,,,DESTROY CERV/THOR FACET JNT PROF,542.45,216.98,0,542.45,461.08,SKIPPED,542.45,542.45,461.08,461.08,461.08,210.38,265.8,265.8,SKIPPED,SKIPPED,214.67,214.67,0
4510063,975,64634,,,,,,,DESTROY CERV/THOR FACET JNT ADDTL. PROF,165.18,66.07,0,140.4,140.4,SKIPPED,0,0,140.4,140.4,140.4,73.58,80.94,80.94,0,49.55,75.08,75.08,0
4510064,975,64635,,,,,,,DESTROY LUMB/SAC FACET JNT PROF,534.91,213.96,0,534.91,454.67,SKIPPED,534.91,534.91,454.67,454.67,454.67,210.52,262.11,262.11,SKIPPED,SKIPPED,214.82,214.82,0
4510065,975,64636,,,,,,,DESTROY LUMB/SAC FACET JNT ADDTL. PROF,144.23,57.69,0,122.6,122.6,SKIPPED,0,0,122.6,122.6,122.6,64.89,70.67,70.67,0,43.27,66.21,66.21,0
4510066,360,64483,,,,,,,TRANSFORMINAL ESI LUMBAR,2421.7,968.68,269.69,2421.7,2058.44,SKIPPED,2421.7,2421.7,2058.44,2058.44,2058.44,1020.5,269.69,269.69,SKIPPED,SKIPPED,1041.33,1041.33,2058.44
4510067,975,64483,,,,,,,TRANSFORMINAL ESI LUMBAR,405.24,162.1,0,405.24,344.45,SKIPPED,405.24,405.24,344.45,344.45,344.45,122.01,198.57,198.57,SKIPPED,SKIPPED,124.5,124.5,0
4510068,360,64420,,,,,,,N BLOCK INJ INTERCOST SNG,1317.32,526.93,252.66,1317.32,1119.72,SKIPPED,1317.32,1317.32,1119.72,1119.72,1119.72,555.12,252.66,252.66,SKIPPED,SKIPPED,566.45,566.45,1119.72
4510069,975,64420,,,,,,,N BLOCK INJ INTERCOST SNG PROF,242.97,97.19,0,242.97,206.52,SKIPPED,242.97,242.97,206.52,206.52,206.52,64.74,119.06,119.06,SKIPPED,SKIPPED,66.06,66.06,0
4510070,360,63663,,,,,,,REVISE SPINE ELTRAD PREQ ARAY,14089.76,5635.9,1051.35,14089.76,11976.3,SKIPPED,14089.76,14089.76,11976.3,11976.3,11976.3,5937.43,1051.35,1051.35,SKIPPED,SKIPPED,6058.6,6058.6,11976.3
4510071,975,63663,,,,,,,REVISE SPINE ELTRAD PREQ ARAY,1085.46,434.18,0,1085.46,922.64,SKIPPED,1085.46,1085.46,922.64,922.64,922.64,492.15,531.88,531.88,SKIPPED,SKIPPED,502.19,502.19,0
4510072,360,63661,,,,,,,RMV SPINE ELTRAD PERQ ARAY,4719.82,1887.93,510.13,4719.82,4011.85,SKIPPED,4719.82,4719.82,4011.85,4011.85,4011.85,1988.93,510.13,510.13,SKIPPED,SKIPPED,2029.52,2029.52,4011.85
4510073,975,63661,,,,,,,RMV SPINE ELTRAD PERQ ARAY,776.3,310.52,0,776.3,659.86,SKIPPED,776.3,776.3,659.86,659.86,659.86,356.08,380.39,380.39,SKIPPED,SKIPPED,363.35,363.35,0
4510074,360,63688,,,,,,,REVISE/RMV NEURORECEIVER,6260.92,2504.37,1051.35,6260.92,5321.78,SKIPPED,6260.92,6260.92,5321.78,5321.78,5321.78,2638.36,1051.35,1051.35,SKIPPED,SKIPPED,2692.2,2692.2,5321.78
4510075,975,63688,,,,,,,REVISE/RMV NEURORECEIVER,976.94,390.78,0,976.94,830.4,SKIPPED,976.94,976.94,830.4,830.4,830.4,403.34,478.7,478.7,SKIPPED,SKIPPED,411.57,411.57,0
4510077,975,63685,,,,,,,INSERT/REDO SPINE GENERATOR,968.9,387.56,0,968.9,823.56,SKIPPED,968.9,968.9,823.56,823.56,823.56,392.24,474.76,474.76,SKIPPED,SKIPPED,400.25,400.25,0
4510078,360,64479,,,,,,,TRAMSFORMINAL ESI CERV./THOR.,2338.46,935.38,269.69,2338.46,1987.69,SKIPPED,2338.46,2338.46,1987.69,1987.69,1987.69,985.43,269.69,269.69,SKIPPED,SKIPPED,1005.54,1005.54,1987.69
4510079,975,64479,,,,,,,TRAMSFORMINAL ESI CERV./THOR.,475.99,190.4,0,475.99,404.59,SKIPPED,475.99,475.99,404.59,404.59,404.59,143.86,233.24,233.24,SKIPPED,SKIPPED,146.8,146.8,0
4510080,360,62367,,,,,,,ANALYZE SPINE INFUSION PUMP,653.97,261.59,0,555.87,555.87,SKIPPED,124.45,124.45,555.87,555.87,555.87,275.59,0,0,0,196.19,281.21,281.21,555.87
4510081,975,62367,,,,,,,ANALYZE SPINE INFUSION PUMP,92.04,36.82,0,92.04,78.23,SKIPPED,92.04,92.04,78.23,78.23,78.23,27.39,45.1,45.1,0,27.61,27.95,27.95,0
4510082,360,64400,,,,,,,N BLOCK INJ TRIGEMINAL,729.02,291.61,0,619.67,619.67,SKIPPED,408.69,408.69,619.67,619.67,619.67,307.21,61.21,61.21,0,218.71,313.48,313.48,619.67
4510083,975,64400,,,,,,,N BLOCK INJ TRIGEMINAL,257.09,102.84,0,257.09,218.53,SKIPPED,257.09,257.09,218.53,218.53,218.53,53.92,125.97,125.97,0,77.13,55.02,55.02,0
4510084,278,,,,,,,,IMPLANTABLE NEUROSTIMULATOR(SJM),101294,40517.6,0,86099.9,86099.9,SKIPPED,76983.44,76983.44,86099.9,86099.9,86099.9,42685.29,49634.06,49634.06,0,30388.2,43556.42,43556.42,86099.9
4510085,272,,,,,,,,35CM TUNNELING TOOL SC-4254,750,300,0,637.5,637.5,SKIPPED,570,570,637.5,637.5,637.5,316.05,367.5,367.5,0,225,322.5,322.5,637.5
4510086,272,,,,,,,,CERVICAL/EPIDURAL PREP TRAY,25.4,10.16,0,21.59,21.59,SKIPPED,19.3,19.3,21.59,21.59,21.59,10.7,12.45,12.45,0,7.62,10.92,10.92,21.59
4510087,360,64640,,,,,,,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL,2214.95,885.98,141.18,1882.71,1882.71,SKIPPED,417.24,417.24,1882.71,1882.71,1882.71,933.38,141.18,141.18,SKIPPED,SKIPPED,952.43,952.43,1882.71
4510088,975,64640,,,,,,,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL,342.34,136.94,0,342.34,290.99,SKIPPED,342.34,342.34,290.99,290.99,290.99,130.2,167.75,167.75,SKIPPED,SKIPPED,132.86,132.86,0
4510089,360,64421,,,,,,,MULTIPLE NERVE BLOCK INJECTIONS RIB NERV,1995.4,798.16,269.69,1995.4,1696.09,SKIPPED,1995.4,1995.4,1696.09,1696.09,1696.09,840.86,269.69,269.69,SKIPPED,SKIPPED,858.02,858.02,1696.09
4510090,975,64421,,,,,,,MULTIPLE NERVE BLOCK INJECTIONS RIB NERV,333.1,133.24,0,333.1,283.14,SKIPPED,333.1,333.1,283.14,283.14,283.14,27.34,163.22,163.22,SKIPPED,SKIPPED,27.9,27.9,0
4510091,270,,,,,,,,RADIATION GLOVES 8.5,91.04,36.42,0,77.38,77.38,SKIPPED,69.19,69.19,77.38,77.38,77.38,38.37,44.61,44.61,0,27.31,39.15,39.15,77.38
4510092,270,,,,,,,,CHLORAPREP SMALL 6ML,8.67,3.47,0,7.37,7.37,SKIPPED,6.59,6.59,7.37,7.37,7.37,3.66,4.25,4.25,0,2.6,3.73,3.73,7.37
4510093,272,,,,,,,,LOR SYRINGE,5.5,2.2,0,4.68,4.68,SKIPPED,4.18,4.18,4.68,4.68,4.68,2.32,2.7,2.7,0,1.65,2.37,2.37,4.68
4510094,270,,,,,,,,"TACTILE TOUHY S/SU 18G 3 1/2""",14.39,5.76,0,12.23,12.23,SKIPPED,10.94,10.94,12.23,12.23,12.23,6.07,7.05,7.05,0,4.32,6.19,6.19,12.23
4510095,270,,,,,,,,"TACTILE TOUHY (THIN) 20G 3 1/2""",9.22,3.69,0,7.84,7.84,SKIPPED,7.01,7.01,7.84,7.84,7.84,3.88,4.52,4.52,0,2.77,3.96,3.96,7.84
4510096,272,,,,,,,,"EPIDURAL NEEDLE(LONG TOUHY) 18G 5""",30.14,12.06,0,25.62,25.62,SKIPPED,22.91,22.91,25.62,25.62,25.62,12.7,14.77,14.77,0,9.04,12.96,12.96,25.62
4510097,272,,,,,,,,"SPINAL NEEDLE (LONG) 22G 5""",10.56,4.22,0,8.98,8.98,SKIPPED,8.03,8.03,8.98,8.98,8.98,4.45,5.17,5.17,0,3.17,4.54,4.54,8.98
4510098,270,,,,,,,,10ML SLIP-TIP SYRINGE,0.23,0.09,0,0.2,0.2,SKIPPED,0.17,0.17,0.2,0.2,0.2,0.1,0.11,0.11,0,0.07,0.1,0.1,0.2
4510099,270,,,,,,,,C-ARM DRAPE COVERS(DOME BAG),3.34,1.34,0,2.84,2.84,SKIPPED,2.54,2.54,2.84,2.84,2.84,1.41,1.64,1.64,0,1,1.44,1.44,2.84
4510100,270,,,,,,,,PAIN MNGT. DRAPE 6 5/8 DIAM.,14.26,5.7,0,12.12,12.12,SKIPPED,10.84,10.84,12.12,12.12,12.12,6.01,6.99,6.99,0,4.28,6.13,6.13,12.12
4510101,272,,,,,,,,NITRO LOR SYRINGE SLIP TIP,4.5,1.8,0,3.82,3.82,SKIPPED,3.42,3.42,3.82,3.82,3.82,1.9,2.2,2.2,0,1.35,1.94,1.94,3.82
4510102,272,,,,,,,,"SPINAL NEEDLE (LONG) 20G 6""",11.6,4.64,0,9.86,9.86,SKIPPED,8.82,8.82,9.86,9.86,9.86,4.89,5.68,5.68,0,3.48,4.99,4.99,9.86
4510103,270,,,,,,,,GROUNDING PAD,35.28,14.11,0,29.99,29.99,SKIPPED,26.81,26.81,29.99,29.99,29.99,14.87,17.29,17.29,0,10.58,15.17,15.17,29.99
4510104,272,,,,,,,,CANNULA NEEDLE (MULTI SIZE),36,14.4,0,30.6,30.6,SKIPPED,27.36,27.36,30.6,30.6,30.6,15.17,17.64,17.64,0,10.8,15.48,15.48,30.6
4510105,270,,,,,,,,ARISTA,535.5,214.2,0,455.18,455.18,SKIPPED,406.98,406.98,455.18,455.18,455.18,225.66,262.4,262.4,0,160.65,230.27,230.27,455.18
4510106,278,,,,,,,,FIXATE,4475,1790,0,3803.75,3803.75,SKIPPED,3401,3401,3803.75,3803.75,3803.75,1885.76,2192.75,2192.75,0,1342.5,1924.25,1924.25,3803.75
4510107,278,,,,,,,,CLIK ANCHOR LONG,988,395.2,0,839.8,839.8,SKIPPED,750.88,750.88,839.8,839.8,839.8,416.34,484.12,484.12,0,296.4,424.84,424.84,839.8
4510108,272,,,,,,,,CLIK ANCHOR HEX WRENCH 7.6CM,187.5,75,0,159.38,159.38,SKIPPED,142.5,142.5,159.38,159.38,159.38,79.02,91.88,91.88,0,56.25,80.63,80.63,159.38
4510109,278,,,,,,,,CLIK ANCHOR SHORT,5638,2255.2,0,4792.3,4792.3,SKIPPED,4284.88,4284.88,4792.3,4792.3,4792.3,2375.85,2762.62,2762.62,0,1691.4,2424.34,2424.34,4792.3
4510110,278,,,,,,,,PRECISION MONTAGE MRI GENERATOR KIT,70713,28285.2,0,60106.05,60106.05,SKIPPED,53741.88,53741.88,60106.05,60106.05,60106.05,29798.46,34649.37,34649.37,0,21213.9,30406.59,30406.59,60106.05
4510111,360,62362,,,,,,,IMPLANT SPINE INFUSION PUMP,10232.96,4093.18,1051.35,10232.96,8698.02,SKIPPED,10232.96,10232.96,8698.02,8698.02,8698.02,4312.17,1051.35,1051.35,SKIPPED,SKIPPED,4400.17,4400.17,8698.02
4510112,975,62362,,,,,,,IMPLANT SPINE INFUSION PUMP,1017.14,406.86,0,1017.14,864.57,SKIPPED,1017.14,1017.14,864.57,864.57,864.57,415.83,498.4,498.4,SKIPPED,SKIPPED,424.32,424.32,0
4510113,360,62365,,,,,,,RMV SPINE INFUSION DEVICE,8769.59,3507.84,1051.35,8769.59,7454.15,SKIPPED,8769.59,8769.59,7454.15,7454.15,7454.15,3695.5,1051.35,1051.35,SKIPPED,SKIPPED,3770.92,3770.92,7454.15
4510114,975,62365,,,,,,,RMV SPINE INFUSION DEVICE,783.95,313.58,0,783.95,666.36,SKIPPED,783.95,783.95,666.36,666.36,666.36,319.79,384.14,384.14,SKIPPED,SKIPPED,326.32,326.32,0
4510115,360,62355,,,,,,,RMV SPINAL CANAL CATH,6317.22,2526.89,510.13,6317.22,5369.64,SKIPPED,6317.22,6317.22,5369.64,5369.64,5369.64,2662.07,510.13,510.13,SKIPPED,SKIPPED,2716.4,2716.4,5369.64
4510116,975,62355,,,,,,,RMV SPINAL CANAL CATH,706.23,282.49,0,706.23,600.3,SKIPPED,706.23,706.23,600.3,600.3,600.3,295.67,346.05,346.05,SKIPPED,SKIPPED,301.7,301.7,0
4510119,360,63685,,,,,,,INSERT/REDO SPINE GENERATOR,8966.58,3586.63,1051.35,8966.58,7621.59,SKIPPED,8966.58,8966.58,7621.59,7621.59,7621.59,3778.52,1051.35,1051.35,SKIPPED,SKIPPED,3855.63,3855.63,7621.59
4510121,360,62321,,,,,,,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG,957.21,382.88,0,957.21,813.63,SKIPPED,957.21,957.21,813.63,813.63,813.63,403.37,252.66,252.66,0,287.16,411.6,411.6,813.63
4510122,975,62321,,,,,,,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG,388.56,155.42,0,388.56,330.28,SKIPPED,388.56,388.56,330.28,330.28,330.28,117.48,190.39,190.39,0,116.57,119.88,119.88,0
4510123,360,62323,,,,,,,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG,957.21,382.88,0,957.21,813.63,SKIPPED,957.21,957.21,813.63,813.63,813.63,403.37,252.66,252.66,0,287.16,411.6,411.6,813.63
4510124,975,62323,,,,,,,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG,359.33,143.73,0,359.33,305.43,SKIPPED,359.33,359.33,305.43,305.43,305.43,108.8,176.07,176.07,0,107.8,111.02,111.02,0
4510125,360,62325,,,,,,,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG,957.21,382.88,0,957.21,813.63,SKIPPED,957.21,957.21,813.63,813.63,813.63,403.37,269.69,269.69,0,287.16,411.6,411.6,813.63
4510126,975,62325,,,,,,,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG,380.46,152.18,0,380.46,323.39,SKIPPED,380.46,380.46,323.39,323.39,323.39,122.25,186.43,186.43,0,114.14,124.74,124.74,0
4510127,278,,,,,,,,INFINION CX 70CM,18750,7500,0,15937.5,15937.5,SKIPPED,14250,14250,15937.5,15937.5,15937.5,7901.25,9187.5,9187.5,0,5625,8062.5,8062.5,15937.5
4510128,278,C1823,,,,,,,SPECTRA WAVEWRITER IPG,84855,33942,0,72126.75,72126.75,SKIPPED,0,0,72126.75,72126.75,72126.75,35757.9,41578.95,41578.95,0,25456.5,36487.65,36487.65,72126.75
4510129,272,,,,,,,,PRECISION CHARGING SYSTEM,9162.5,3665,0,7788.12,7788.12,SKIPPED,6963.5,6963.5,7788.12,7788.12,7788.12,3861.08,4489.62,4489.62,0,2748.75,3939.88,3939.88,7788.12
4510130,272,,,,,,,,FREELINK REMOTE CONTROL,4475,1790,0,3803.75,3803.75,SKIPPED,3401,3401,3803.75,3803.75,3803.75,1885.76,2192.75,2192.75,0,1342.5,1924.25,1924.25,3803.75
4510131,278,,,,,,,,LINEAR ST 50CM 8 CONTACT LEAD KIT,7700,3080,0,6545,6545,SKIPPED,5852,5852,6545,6545,6545,3244.78,3773,3773,0,2310,3311,3311,6545
4510132,360,62327,,,,,,,NJX INTERLAMINAR LMBR/SAC,1081.8,432.72,0,1081.8,919.53,SKIPPED,1081.8,1081.8,919.53,919.53,919.53,455.87,269.69,269.69,0,324.54,465.17,465.17,919.53
4510133,975,62327,,,,,,,NJX INTERLAMINAR LMBR/SAC,231.13,92.45,0,231.13,196.46,SKIPPED,231.13,231.13,196.46,196.46,196.46,114.79,113.25,113.25,0,69.34,117.13,117.13,0
4510134,360,62268,,,,,,,DRAIN SPINAL CORD CYST,1724.8,689.92,269.69,1724.8,1466.08,SKIPPED,1724.8,1724.8,1466.08,1466.08,1466.08,726.83,269.69,269.69,SKIPPED,SKIPPED,741.66,741.66,1466.08
4510135,975,62268,,,,,,,DRAIN SPINAL CORD CYST,624.48,249.79,0,624.48,530.81,SKIPPED,624.48,624.48,530.81,530.81,530.81,280.41,306,306,SKIPPED,SKIPPED,286.13,286.13,0
4510136,360,62267,,,,,,,INTERDISCAL PERQ ASPIR DX,1654.31,661.72,246.58,1654.31,1406.16,SKIPPED,1654.31,1654.31,1406.16,1406.16,1406.16,697.12,246.58,246.58,SKIPPED,SKIPPED,711.35,711.35,1406.16
4510137,975,62267,,,,,,,INTERDISCAL PERQ ASPIR DX,383.05,153.22,0,383.05,325.59,SKIPPED,383.05,383.05,325.59,325.59,325.59,169.26,187.69,187.69,SKIPPED,SKIPPED,172.71,172.71,0
4510138,360,64447,,,,,,,INJECTION ANESTHETIC AGENT FEMORAL NERVE,1587.45,634.98,0,1349.33,1349.33,SKIPPED,314.64,314.64,1349.33,1349.33,1349.33,668.95,38.69,38.69,0,476.24,682.6,682.6,1349.33
4510139,975,64447,,,,,,,INJECTION ANESTHETIC AGENT FEMORAL NERVE,161.96,64.78,0,161.96,137.67,SKIPPED,161.96,161.96,137.67,137.67,137.67,57.99,79.36,79.36,0,48.59,59.17,59.17,0
4510140,360,62361,,,,,,,IMPLT/REPLACE FS NON-PROGRAM PUMP,10667.5,4267,1051.35,10667.5,9067.38,SKIPPED,10667.5,10667.5,9067.38,9067.38,9067.38,4495.29,1051.35,1051.35,SKIPPED,SKIPPED,4587.03,4587.03,9067.38
4510141,975,62361,,,,,,,IMPLT/REPLACE FS NON-PROGRAM PUMP,1015.34,406.14,0,1015.34,863.04,SKIPPED,1015.34,1015.34,863.04,863.04,863.04,462.44,497.52,497.52,SKIPPED,SKIPPED,471.88,471.88,0
4510142,360,62350,,,,,,,ITHCL/EDRL CATH PMP W/O LAM,8498.82,3399.53,1051.35,8498.82,7224,SKIPPED,8498.82,8498.82,7224,7224,7224,3581.4,1051.35,1051.35,SKIPPED,SKIPPED,3654.49,3654.49,7224
4510143,975,62350,,,,,,,ITHCL/EDRL CATH PMP W/O LAM,954.9,381.96,0,954.9,811.66,SKIPPED,954.9,954.9,811.66,811.66,811.66,431.94,467.9,467.9,SKIPPED,SKIPPED,440.75,440.75,0
4510144,360,95991,,,,,,,RFLMAIN IMPLT PMP/RSVP DLVR SPI/BRN PHY/,656.39,262.56,0,557.93,557.93,SKIPPED,192.61,192.61,557.93,557.93,557.93,276.6,0,0,0,196.92,282.25,282.25,557.93
4510145,975,95991,,,,,,,RFLMAIN IMPLT PMP/RSVP DLVR SPI/BRN PHY/,95.32,38.13,0,95.32,81.02,SKIPPED,95.32,95.32,81.02,81.02,81.02,44,46.71,46.71,0,28.6,44.9,44.9,0
4510146,272,,,,,,,,TORQUE WRENCH REF#1101,87.5,35,0,74.38,74.38,SKIPPED,66.5,66.5,74.38,74.38,74.38,36.88,42.88,42.88,0,26.25,37.63,37.63,74.38
4510147,278,,,,,,,,SLIM TIP DRG REF#MN10450-50A,9875,3950,0,8393.75,8393.75,SKIPPED,7505,7505,8393.75,8393.75,8393.75,4161.32,4838.75,4838.75,0,2962.5,4246.25,4246.25,8393.75
4510148,278,,,,,,,,SLIM TIP DRG REF#MN10450-90A,9875,3950,0,8393.75,8393.75,SKIPPED,7505,7505,8393.75,8393.75,8393.75,4161.32,4838.75,4838.75,0,2962.5,4246.25,4246.25,8393.75
4510149,278,,,,,,,,DRG ACCESSORIE REF#7885,2125,850,0,1806.25,1806.25,SKIPPED,1615,1615,1806.25,1806.25,1806.25,895.48,1041.25,1041.25,0,637.5,913.75,913.75,1806.25
4510150,272,,,,,,,,"EPIDRAL NEEDLE 14 GUAGE 6""",175,70,0,148.75,148.75,SKIPPED,133,133,148.75,148.75,148.75,73.74,85.75,85.75,0,52.5,75.25,75.25,148.75
4510151,278,,,,,,,,PROCLAIM DRG REF#3664,123645,49458,0,105098.25,105098.25,SKIPPED,93970.2,93970.2,105098.25,105098.25,105098.25,52104,60586.05,60586.05,0,37093.5,53167.35,53167.35,105098.25
4510152,272,,,,,,,,PROCLAIM DRG REF#7883,5762.5,2305,0,4898.12,4898.12,SKIPPED,4379.5,4379.5,4898.12,4898.12,4898.12,2428.32,2823.62,2823.62,0,1728.75,2477.88,2477.88,4898.12
4510153,360,46060,,,,,,,INCISION RECTAL ABSCESS,5366.75,2146.7,748.53,5366.75,4561.74,SKIPPED,5366.75,5366.75,4561.74,4561.74,4561.74,2261.55,748.53,748.53,SKIPPED,SKIPPED,2307.7,2307.7,4561.74
4510154,975,46060,,,,,,,INCISION RECTAL ABSCESS,1101.71,440.68,0,1101.71,936.45,SKIPPED,1101.71,1101.71,936.45,936.45,936.45,535.22,539.84,539.84,SKIPPED,SKIPPED,546.14,546.14,0
4510155,360,43450,,,,,,,UNGUIDED SOUND/BOUGIE 1./MULTI PASS,1807.2,722.88,269.69,1807.2,1536.12,SKIPPED,1807.2,1807.2,1536.12,1536.12,1536.12,761.56,269.69,269.69,SKIPPED,SKIPPED,777.1,777.1,1536.12
4510156,975,43450,,,,,,,UNGUIDED SOUND/BOUGIE 1./MULTI PASS,185.41,74.16,0,185.41,157.6,SKIPPED,185.41,185.41,157.6,157.6,157.6,86.63,90.85,90.85,SKIPPED,SKIPPED,88.4,88.4,0
4510157,360,22867,,,,,,,DEV W. DCMPR LUMBAR/SINGLE LEVEL,18473.39,7389.36,0,18473.39,15702.38,SKIPPED,18473.39,18473.39,15702.38,15702.38,15702.38,7784.69,0,0,0,5542.02,7943.56,7943.56,15702.38
4510158,975,22867,,,,,,,DEV W. DCMPR LUMBAR/SINGLE LEVEL,2214.22,885.69,0,2214.22,1882.09,SKIPPED,2214.22,2214.22,1882.09,1882.09,1882.09,1148.64,1084.97,1084.97,0,664.27,1172.08,1172.08,0
4510159,360,20604,,,,,,,ARTHROCNT ASPIRA/INJ SMALL JNT/BURSA,717.66,287.06,0,610.01,610.01,SKIPPED,181.26,181.26,610.01,610.01,610.01,302.42,34.36,34.36,0,215.3,308.59,308.59,610.01
4510160,975,20604,,,,,,,ARTHROCNT ASPIRA/INJ SMALL JNT/BURSA,106.46,42.58,0,106.46,90.49,SKIPPED,106.46,106.46,90.49,90.49,90.49,50.4,52.17,52.17,0,31.94,51.43,51.43,0
4510161,360,20606,,,,,,,ARTHROCNT ASPIRA/INJ W/US,885.01,354,0,752.26,752.26,SKIPPED,198.36,198.36,752.26,752.26,752.26,372.94,37.25,37.25,0,265.5,380.55,380.55,752.26
4510162,975,20606,,,,,,,ARTHROCNT ASPIRA/INJ W/US,122.34,48.94,0,122.34,103.99,SKIPPED,122.34,122.34,103.99,103.99,103.99,56.78,59.95,59.95,0,36.7,57.94,57.94,0
4510163,360,64450,,,,,,,INJECTION AA&/STEROID OTHER PERIPHERAL N,1463.23,585.29,0,1243.75,1243.75,SKIPPED,249.66,249.66,1243.75,1243.75,1243.75,616.61,38.69,38.69,0,438.97,629.19,629.19,1243.75
4510164,278,,,,,,,,VERSA KATH CERVICAL CATH,168.5,67.4,0,143.22,143.22,SKIPPED,128.06,128.06,143.22,143.22,143.22,71.01,82.56,82.56,0,50.55,72.46,72.46,143.22
4510165,272,,,,,,,,COUDE TOUHY NEEDLE,50,20,0,42.5,42.5,SKIPPED,38,38,42.5,42.5,42.5,21.07,24.5,24.5,0,15,21.5,21.5,42.5
4510166,278,,,,,,,,VALVULOTOME,3747.5,1499,0,3185.38,3185.38,SKIPPED,2848.1,2848.1,3185.38,3185.38,3185.38,1579.2,1836.28,1836.28,0,1124.25,1611.43,1611.43,3185.38
4510167,360,27279,,,,,,,ARTHRODESIS SACROILIAC JOINT PERCUTANEOU,16712.66,6685.06,0,16712.66,14205.76,SKIPPED,16712.66,16712.66,14205.76,14205.76,14205.76,7042.71,0,0,0,5013.8,7186.44,7186.44,14205.76
4510168,975,27279,,,,,,,ARTHRODESIS SACROILIAC JOINT PERCUTANEOU,1825.22,730.09,0,1825.22,1551.44,SKIPPED,1825.22,1825.22,1551.44,1551.44,1551.44,906.13,894.36,894.36,0,547.57,924.62,924.62,0
4510169,360,22899,,,,,,,ULISTED PROC SPINE(INTRACEPT ABLATION),4395.72,1758.29,0,3736.36,3736.36,SKIPPED,1020.78,1020.78,3736.36,3736.36,3736.36,1852.36,0,0,0,1318.72,1890.16,1890.16,3736.36
4510170,975,22899,,,,,,,ULISTED PROC SPINE(INTRACEPT ABLATION),1278.9,511.56,0,1087.06,1087.06,SKIPPED,1020.78,1020.78,1087.06,1087.06,1087.06,0,626.66,626.66,0,383.67,0,0,0
4510171,278,C1713,,,,,,,IMPLANT FOR MILD PROCEDURE,6250,2500,0,5312.5,5312.5,SKIPPED,4750,4750,5312.5,5312.5,5312.5,2633.75,3062.5,3062.5,0,1875,2687.5,2687.5,5312.5
4510172,272,,,,,,,,ascenda cath,257.5,103,0,218.88,218.88,SKIPPED,195.7,195.7,218.88,218.88,218.88,108.52,126.18,126.18,0,77.25,110.73,110.73,218.88
4510173,360,62287,,,,,,,PERCUTANEOUS DISKECTOMY,11097.37,4438.95,510.13,11097.37,9432.76,SKIPPED,11097.37,11097.37,9432.76,9432.76,9432.76,4676.43,510.13,510.13,SKIPPED,SKIPPED,4771.87,4771.87,9432.76
4510174,975,62287,,,,,,,PERCUTANEOUS DISKECTOMY,3560.45,1424.18,0,3560.45,3026.38,SKIPPED,3560.45,3560.45,3026.38,3026.38,3026.38,633.8,1744.62,1744.62,SKIPPED,SKIPPED,646.73,646.73,0
4510175,278,,,,,,,,NALU LEAD KIT (4CONTACT 40CM),2500,1000,0,2125,2125,SKIPPED,1900,1900,2125,2125,2125,1053.5,1225,1225,0,750,1075,1075,2125
4510176,278,,,,,,,,"NALU NEURO STIM(PORTED, DUAL 4)",32675,13070,0,27773.75,27773.75,SKIPPED,24833,24833,27773.75,27773.75,27773.75,13769.24,16010.75,16010.75,0,9802.5,14050.25,14050.25,27773.75
4510177,360,64555,,,,,,,"PERQ IMPLANT NEUROSTIM ELECTROD, PERIPHE",11200.35,4480.14,1051.35,11200.35,9520.3,SKIPPED,11200.35,11200.35,9520.3,9520.3,9520.3,4719.83,1051.35,1051.35,SKIPPED,SKIPPED,4816.15,4816.15,9520.3
4510178,975,64555,,,,,,,"PERQ IMPLANT NEUROSTIM ELECTROD, PERIPHE",668.54,267.42,0,668.54,568.26,SKIPPED,668.54,668.54,568.26,568.26,568.26,358.78,327.58,327.58,SKIPPED,SKIPPED,366.1,366.1,0
4520005,521,10060,,,,,,,DRAIN SKIN ABSCESS,210.36,84.14,0,210.36,178.81,SKIPPED,210.36,210.36,178.81,178.81,178.81,88.64,103.08,103.08,0,63.11,90.45,90.45,0
4520006,521,10120,,,,,,,REMOVAL FOREIGN BODY,223.54,89.42,0,223.54,190.01,SKIPPED,223.54,223.54,190.01,190.01,190.01,94.2,109.53,109.53,SKIPPED,SKIPPED,96.12,96.12,0
4520007,521,11104,,,,,,,PUNCH BX OF SKIN LESION,169.1,67.64,0,169.1,143.74,SKIPPED,169.1,169.1,143.74,143.74,143.74,71.26,82.86,82.86,0,50.73,72.71,72.71,0
4520008,521,11200,,,,,,,ELECTROCAUTERY 15 OR LESS,158.44,63.38,0,158.44,134.67,SKIPPED,158.44,158.44,134.67,134.67,134.67,66.77,77.64,77.64,0,47.53,68.13,68.13,0
4520009,521,11300,,,,,,,SHAVE BIOPSY,77.28,30.91,0,77.28,65.69,SKIPPED,77.28,77.28,65.69,65.69,65.69,32.57,37.87,37.87,0,23.18,33.23,33.23,0
4520010,521,11401,,,,,,,EXCISION OF ARM LESION,223.98,89.59,0,223.98,190.38,SKIPPED,223.98,223.98,190.38,190.38,190.38,94.38,109.75,109.75,SKIPPED,SKIPPED,96.31,96.31,0
4520011,521,11402,,,,,,,EXCISION OF BENIGN LESION,247.26,98.9,0,247.26,210.17,SKIPPED,247.26,247.26,210.17,210.17,210.17,104.19,121.16,121.16,SKIPPED,SKIPPED,106.32,106.32,0
4520012,521,11403,,,,,,,EXCISION OF SKIN NEOPLASM,318.36,127.34,0,318.36,270.61,SKIPPED,318.36,318.36,270.61,270.61,270.61,134.15,156,156,SKIPPED,SKIPPED,136.89,136.89,0
4520013,521,11420,,,,,,,#EX BN LZ SP NK H/F,175.58,70.23,0,175.58,149.24,SKIPPED,175.58,175.58,149.24,149.24,149.24,73.99,86.03,86.03,SKIPPED,SKIPPED,75.5,75.5,0
4520014,521,11440,,,,,,,EXCISION OF LESION,222.06,88.82,0,222.06,188.75,SKIPPED,222.06,222.06,188.75,188.75,188.75,93.58,108.81,108.81,SKIPPED,SKIPPED,95.49,95.49,0
4520015,521,11441,,,,,,,REMOVAL OF SKIN LESION,283.16,113.26,0,283.16,240.69,SKIPPED,283.16,283.16,240.69,240.69,240.69,119.32,138.75,138.75,SKIPPED,SKIPPED,121.76,121.76,0
4520016,521,11600,,,,,,,EXCISION OF SQUAMOUS CELL,259.08,103.63,0,259.08,220.22,SKIPPED,259.08,259.08,220.22,220.22,220.22,109.17,126.95,126.95,SKIPPED,SKIPPED,111.4,111.4,0
4520017,521,11602,,,,,,,EX MALIG LESION 1.1-2.0CM,354.92,141.97,0,354.92,301.68,SKIPPED,354.92,354.92,301.68,301.68,301.68,149.57,173.91,173.91,SKIPPED,SKIPPED,152.62,152.62,0
4520018,521,11640,,,,,,,EXC OF MALIGNANT LESION F,270.96,108.38,0,270.96,230.32,SKIPPED,270.96,270.96,230.32,230.32,230.32,114.18,132.77,132.77,SKIPPED,SKIPPED,116.51,116.51,0
4520019,521,11720,,,,,,,DEBRIDE NAIL 1-5,32.32,12.93,0,32.32,27.47,SKIPPED,32.32,32.32,27.47,27.47,27.47,13.62,15.84,15.84,0,9.7,13.9,13.9,0
4520020,521,11730,,,,,,,AVULSION OF NAIL,121.56,48.62,0,121.56,103.33,SKIPPED,121.56,121.56,103.33,103.33,103.33,51.22,59.56,59.56,0,36.47,52.27,52.27,0
4520021,521,11765,,,,,,,REMOVAL OF TOENAIL,202.68,81.07,0,202.68,172.28,SKIPPED,202.68,202.68,172.28,172.28,172.28,85.41,99.31,99.31,0,60.8,87.15,87.15,0
4520022,521,11976,,,,,,,REMOVE OF CONTRACEPTIVE D,204.8,81.92,0,204.8,174.08,SKIPPED,204.8,204.8,174.08,174.08,174.08,86.3,100.35,100.35,0,61.44,88.06,88.06,0
4520023,521,12001,,,,,,,SUTURING OF LACERATION,96.58,38.63,0,96.58,82.09,SKIPPED,96.58,96.58,82.09,82.09,82.09,40.7,47.32,47.32,0,28.97,41.53,41.53,0
4520024,521,12002,,,,,,,SUTURE LAC 2.6 7.6 CM,127.84,51.14,0,127.84,108.66,SKIPPED,127.84,127.84,108.66,108.66,108.66,53.87,62.64,62.64,0,38.35,54.97,54.97,0
4520025,521,12004,,,,,,,WOUND REPAIR 12 CM,159.12,63.65,0,159.12,135.25,SKIPPED,159.12,159.12,135.25,135.25,135.25,67.05,77.97,77.97,0,47.74,68.42,68.42,0
4520026,521,12013,,,,,,,WOUND REPAIR FACE,126.52,50.61,0,126.52,107.54,SKIPPED,126.52,126.52,107.54,107.54,107.54,53.31,61.99,61.99,0,37.96,54.4,54.4,0
4520027,521,13131,,,,,,,COMPLX FACE LACERATION,544.64,217.86,0,544.64,462.94,SKIPPED,544.64,544.64,462.94,462.94,462.94,229.52,266.87,266.87,SKIPPED,SKIPPED,234.2,234.2,0
4520028,521,17000,,,,,,,DESTRUCT PREMALG LESION,113.48,45.39,0,113.48,96.46,SKIPPED,113.48,113.48,96.46,96.46,96.46,47.82,55.61,55.61,0,34.04,48.8,48.8,0
4520029,521,17003,,,,,,,DESTRUCT PREMALG LESION 2-14,5.24,2.1,0,4.45,4.45,SKIPPED,0,0,4.45,4.45,4.45,2.2,2.57,2.57,0,1.57,2.25,2.25,0
4520030,521,17004,,,,,,,DESTROY PREMAL LESIONS 15>,214.82,85.93,0,214.82,182.6,SKIPPED,214.82,214.82,182.6,182.6,182.6,90.52,105.26,105.26,SKIPPED,SKIPPED,92.37,92.37,0
4520034,521,17260,,,,,,,DESTRUCTION OF LESION,175.4,70.16,0,175.4,149.09,SKIPPED,175.4,175.4,149.09,149.09,149.09,73.91,85.95,85.95,0,52.62,75.42,75.42,0
4520035,521,17340,,,,,,,CRYOTHERAPY,106.04,42.42,0,106.04,90.13,SKIPPED,106.04,106.04,90.13,90.13,90.13,44.69,51.96,51.96,0,31.81,45.6,45.6,0
4520037,521,20550,,,,,,,JOINT INJECTION,86.02,34.41,0,86.02,73.12,SKIPPED,86.02,86.02,73.12,73.12,73.12,36.25,42.15,42.15,SKIPPED,SKIPPED,36.99,36.99,0
4520038,521,20600,,,,,,,ARTHROCENTESIS/RT/LTJT INJ SM,77.7,31.08,0,77.7,66.04,SKIPPED,77.7,77.7,66.04,66.04,66.04,32.74,38.07,38.07,0,23.31,33.41,33.41,0
4520039,521,20605,,,,,,,ARTHROCENTESIS/RT/LT JT INJ ME,82.12,32.85,0,82.12,69.8,SKIPPED,82.12,82.12,69.8,69.8,69.8,34.6,40.24,40.24,0,24.64,35.31,35.31,0
4520040,510,20610,,,,,,,ARTHROCENT/RT/LT INJ LG,195.3,78.12,0,166,166,SKIPPED,138.51,138.51,166,166,0,82.3,95.7,95.7,0,58.59,83.98,83.98,166
4520042,521,86580,,,,,,,TB SKIN TEST ADM,20,8,0,20,17,SKIPPED,20,20,17,17,17,8.43,9.8,9.8,0,6,8.6,8.6,0
4520048,521,29075,,,,,,,CAST APPLICATION,134.38,53.75,0,134.38,114.22,SKIPPED,134.38,134.38,114.22,114.22,114.22,56.62,65.85,65.85,SKIPPED,SKIPPED,57.78,57.78,0
4520049,521,29125,,,,,,,WRIST SPLINT,85.76,34.3,0,85.76,72.9,SKIPPED,85.76,85.76,72.9,72.9,72.9,36.14,42.02,42.02,0,25.73,36.88,36.88,0
4520050,521,36415,,,,,,,LAB HANDLING FEE,18.9,7.56,0,16.06,16.06,SKIPPED,0,0,16.06,16.06,16.06,7.97,9.26,9.26,0,5.67,8.13,8.13,0
4520052,975,46320,,,,,,,ENUCLERAT OF HEMORRHOID,265.55,106.22,0,265.55,225.72,SKIPPED,265.55,265.55,225.72,225.72,225.72,123.97,130.12,130.12,SKIPPED,SKIPPED,126.5,126.5,0
4520053,521,55250,,,,,,,VASECTOMY,498.52,199.41,0,498.52,423.74,SKIPPED,498.52,498.52,423.74,423.74,423.74,210.07,244.27,244.27,SKIPPED,SKIPPED,214.36,214.36,0
4520055,521,58100,,,,,,,ENDOMETRIAL BIOPSY,188.32,75.33,0,188.32,160.07,SKIPPED,188.32,188.32,160.07,160.07,160.07,79.36,92.28,92.28,SKIPPED,SKIPPED,80.98,80.98,0
4520056,521,69209,,,,,,,Removal of impacted cerumen with irrigat,29.42,11.77,0,29.42,25.01,SKIPPED,29.42,29.42,25.01,25.01,25.01,12.4,14.42,14.42,0,8.83,12.65,12.65,0
4520067,521,90707,,,,,,,MMR,49.4,19.76,0,42.08,41.99,SKIPPED,42.08,42.08,41.99,41.99,41.99,20.82,24.21,24.21,0,14.82,21.24,21.24,0
4520069,521,90713,,,,,,,IPV,72.5,29,0,61.62,61.62,SKIPPED,29.93,29.93,61.62,61.62,61.62,30.56,35.52,35.52,0,21.75,31.18,31.18,0
4520070,521,90716,,,,,,,VARICELLA(CHICKEN POX),80.9,32.36,0,80.9,68.76,SKIPPED,80.9,80.9,68.76,68.76,68.76,34.09,39.64,39.64,0,24.27,34.79,34.79,0
4520074,521,90732,,,,,,,PNEUMOCOCCAL VACCINE,36.8,14.72,0,36.8,31.28,SKIPPED,36.8,36.8,31.28,31.28,31.28,15.5,18.03,18.03,0,11.04,15.82,15.82,0
4520076,521,90744,,,,,,,HEP B,89.3,35.72,0,75.9,75.9,SKIPPED,19.51,19.51,75.9,75.9,75.9,37.63,43.76,43.76,0,26.79,38.4,38.4,0
4520077,521,90746,,,,,,,HEP B,89.3,35.72,0,75.9,75.9,SKIPPED,45.97,45.97,75.9,75.9,75.9,37.63,43.76,43.76,0,26.79,38.4,38.4,0
4520078,521,96372,,,,,,,INJECTION ADM,43.5,17.4,0,43.5,36.98,SKIPPED,43.5,43.5,36.98,36.98,36.98,18.34,21.32,21.32,0,13.05,18.71,18.71,0
4520081,521,11301,,,,,,,SHAVE SKIN LESION,116.68,46.67,0,116.68,99.18,SKIPPED,116.68,116.68,99.18,99.18,99.18,49.17,57.17,57.17,0,35,50.17,50.17,0
4520082,521,11302,,,,,,,SHAVE SKIN LESION,137.72,55.09,0,137.72,117.06,SKIPPED,137.72,137.72,117.06,117.06,117.06,58.04,67.48,67.48,0,41.32,59.22,59.22,0
4520083,521,11303,,,,,,,SHAVE SKIN LESION,161.96,64.78,0,161.96,137.67,SKIPPED,161.96,161.96,137.67,137.67,137.67,68.25,79.36,79.36,0,48.59,69.64,69.64,0
4520084,521,11305,,,,,,,SHAVE SKIN LESION,85.76,34.3,0,85.76,72.9,SKIPPED,85.76,85.76,72.9,72.9,72.9,36.14,42.02,42.02,0,25.73,36.88,36.88,0
4520085,521,11306,,,,,,,SHAVE SKIN LESION,114.12,45.65,0,114.12,97,SKIPPED,114.12,114.12,97,97,97,48.09,55.92,55.92,0,34.24,49.07,49.07,0
4520086,521,11307,,,,,,,SHAVE SKIN LESION,146.58,58.63,0,146.58,124.59,SKIPPED,146.58,146.58,124.59,124.59,124.59,61.77,71.82,71.82,SKIPPED,SKIPPED,63.03,63.03,0
4520087,521,11308,,,,,,,SHAVE SKIN LESION,117.6,47.04,0,117.6,99.96,SKIPPED,117.6,117.6,99.96,99.96,99.96,49.56,57.62,57.62,0,35.28,50.57,50.57,0
4520089,521,11312,,,,,,,SHAVE SKIN LESION,170.22,68.09,0,170.22,144.69,SKIPPED,170.22,170.22,144.69,144.69,144.69,71.73,83.41,83.41,SKIPPED,SKIPPED,73.19,73.19,0
4520090,521,94664,,,,,,,NEBULIZER UPDRAFT,46.2,18.48,0,46.2,39.27,SKIPPED,46.2,46.2,39.27,39.27,39.27,19.47,22.64,22.64,0,13.86,19.87,19.87,0
4520091,521,94799,,,,,,,OXYGEN THERAPY,46.2,18.48,0,46.2,39.27,SKIPPED,46.2,46.2,39.27,39.27,39.27,19.47,22.64,22.64,0,13.86,19.87,19.87,0
4520094,521,95115,,,,,,,ALLERGY,18.9,7.56,0,18.9,16.06,SKIPPED,18.9,18.9,16.06,16.06,16.06,7.97,9.26,9.26,0,5.67,8.13,8.13,0
4520100,521,99201,,,,,,,CLINIC PHYSICIAN LVL 1 NEW,57.86,23.14,0,57.86,49.18,SKIPPED,57.86,57.86,49.18,49.18,49.18,24.38,28.35,28.35,0,17.36,24.88,24.88,0
4520101,521,99202,,,,,,,CLINIC PHYSICIAN LVL 2 NEW,109.14,43.66,0,109.14,92.77,SKIPPED,109.14,109.14,92.77,92.77,92.77,45.99,53.48,53.48,0,32.74,46.93,46.93,0
4520102,521,99203,,,,,,,CLINIC PHYSICIAN LVL 3 NEW,165.38,66.15,0,165.38,140.57,SKIPPED,165.38,165.38,140.57,140.57,140.57,69.69,81.04,81.04,0,49.61,71.11,71.11,0
4520103,521,99204,,,,,,,CLINIC PHYSICIAN LVL 4 NEW,279.46,111.78,0,279.46,237.54,SKIPPED,279.46,279.46,237.54,237.54,237.54,117.77,136.94,136.94,0,83.84,120.17,120.17,0
4520104,521,99205,,,,,,,CLINIC PHYSICIAN LVL 5 NEW,364.9,145.96,0,364.9,310.16,SKIPPED,364.9,364.9,310.16,310.16,310.16,153.77,178.8,178.8,0,109.47,156.91,156.91,0
4520105,521,99211,,,,,,,CLINIC PHYSICIAN LVL 1 ESTABLISHED,19.94,7.98,0,19.94,16.95,SKIPPED,19.94,19.94,16.95,16.95,16.95,8.4,9.77,9.77,0,5.98,8.57,8.57,0
4520106,521,99212,,,,,,,CLINIC PHYSICIAN LVL 2 ESTABLISHED,55.02,22.01,0,55.02,46.77,SKIPPED,55.02,55.02,46.77,46.77,46.77,23.19,26.96,26.96,0,16.51,23.66,23.66,0
4520107,521,99213,,,,,,,CLINIC PHYSICIAN LVL 3 ESTABLISHED,110.92,44.37,0,110.92,94.28,SKIPPED,110.92,110.92,94.28,94.28,94.28,46.75,54.35,54.35,0,33.28,47.7,47.7,0
4520108,521,99214,,,,,,,CLINIC PHYSICIAN LVL 4 ESTABLISHED,170,68,0,170,144.5,SKIPPED,170,170,144.5,144.5,144.5,71.64,83.3,83.3,0,51,73.1,73.1,0
4520109,521,99215,,,,,,,CLINIC PHYSICIAN LVL 5 ESTABLISHED,240.28,96.11,0,240.28,204.24,SKIPPED,240.28,240.28,204.24,204.24,204.24,101.25,117.74,117.74,0,72.08,103.32,103.32,0
4520113,521,99341,,,,,,,HOME VISIT NEW PATIENT,118.52,47.41,0,100.74,100.74,SKIPPED,90.08,90.08,100.74,100.74,100.74,49.94,58.07,58.07,0,35.56,50.96,50.96,0
4520114,521,99347,,,,,,,HOME VISIT ESTABLISHED,119.18,47.67,0,101.3,101.3,SKIPPED,90.58,90.58,101.3,101.3,101.3,50.22,58.4,58.4,0,35.75,51.25,51.25,0
4520115,521,99391,,,,,,,PM RE-EVAL PT INFANT,107.1,42.84,0,107.1,91.04,SKIPPED,107.1,107.1,91.04,91.04,91.04,45.13,52.48,52.48,0,32.13,46.05,46.05,0
4520116,521,99392,,,,,,,PREV VISIT & EST PT 1-4 YRS,112.4,44.96,0,112.4,95.54,SKIPPED,112.4,112.4,95.54,95.54,95.54,47.36,55.08,55.08,0,33.72,48.33,48.33,0
4520117,521,99394,,,,,,,PREV VISIT EST PT 12-17 YEARS,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
4520118,521,99395,,,,,,,PREV VIST EST 18-39 YRS,175.4,70.16,0,175.4,149.09,SKIPPED,175.4,175.4,149.09,149.09,149.09,73.91,85.95,85.95,0,52.62,75.42,75.42,0
4520119,521,99396,,,,,,,PREV VISIT EST PT 40-64 YRS,189,75.6,0,189,160.65,SKIPPED,189,189,160.65,160.65,160.65,79.64,92.61,92.61,0,56.7,81.27,81.27,0
4520121,521,99213,,,,,,,TX DOT PHYSICAL,80,32,0,80,68,SKIPPED,80,80,68,68,68,33.71,39.2,39.2,0,24,34.4,34.4,0
4520122,521,A4550,,,,,,,SURGICAL TRAY,81.9,32.76,0,69.62,69.62,SKIPPED,62.24,62.24,69.62,69.62,69.62,34.52,40.13,40.13,0,24.57,35.22,35.22,0
4520123,521,A4555,,,,,,,DRESSING,36.8,14.72,0,31.28,31.28,SKIPPED,27.97,27.97,31.28,31.28,31.28,15.5,18.03,18.03,0,11.04,15.82,15.82,0
4520124,521,A4565,,,,,,,CASTING SUPPLIES,127.1,50.84,0,108.04,108.04,SKIPPED,28.84,28.84,108.04,108.04,108.04,53.56,62.28,62.28,0,38.13,54.65,54.65,0
4520125,521,A4570,,,,,,,SPLINT,72.5,29,0,61.62,61.62,SKIPPED,55.1,55.1,61.62,61.62,61.62,30.56,35.52,35.52,0,21.75,31.18,31.18,0
4520128,521,A4576,,,,,,,COCKUP SPLINT,85.1,34.04,0,72.34,72.34,SKIPPED,64.68,64.68,72.34,72.34,72.34,35.86,41.7,41.7,0,25.53,36.59,36.59,0
4520129,521,A4580,,,,,,,AIR CAST,83,33.2,0,70.55,70.55,SKIPPED,63.08,63.08,70.55,70.55,70.55,34.98,40.67,40.67,0,24.9,35.69,35.69,0
4520132,771,90471,,,,,,,ADM OF INFLUENZA,5,2,0,5,4.25,SKIPPED,5,5,4.25,4.25,4.25,2.11,2.45,2.45,0,1.5,2.15,2.15,0
4520133,771,G0009,,,,,,,ADM OF PNEUMOCOCCAL VACC,18.9,7.56,0,18.9,16.06,SKIPPED,18.9,18.9,16.06,16.06,16.06,7.97,9.26,9.26,0,5.67,8.13,8.13,0
4520138,521,J0561,,,,,,,BICILLIN LA,39.9,15.96,0,33.92,33.92,SKIPPED,11.94,11.94,33.92,33.92,33.92,16.82,19.55,19.55,0,11.97,17.16,17.16,0
4520140,521,J0696,,,,,,,ROCEPHIN,59.9,23.96,0,50.92,50.92,SKIPPED,2.53,2.53,50.92,50.92,50.92,25.24,29.35,29.35,0,17.97,25.76,25.76,0
4520148,521,J1055,,,,,,,DEPO-PROVERA 150 MG,108.2,43.28,0,91.97,91.97,SKIPPED,82.23,82.23,91.97,91.97,91.97,45.6,53.02,53.02,0,32.46,46.53,46.53,0
4520149,521,J1100,,,,,,,INJ DECADRON,36.8,14.72,0,31.28,31.28,SKIPPED,0.03,0.03,31.28,31.28,31.28,15.5,18.03,18.03,0,11.04,15.82,15.82,0
4520150,521,J1110,,,,,,,DHE45 INJ,38.9,15.56,0,38.9,33.06,SKIPPED,38.9,38.9,33.06,33.06,33.06,16.4,19.06,19.06,0,11.67,16.73,16.73,0
4520151,521,J1200,,,,,,,BENADRYL 50 MG,38.9,15.56,0,33.06,33.06,SKIPPED,0.83,0.83,33.06,33.06,33.06,16.4,19.06,19.06,0,11.67,16.73,16.73,0
4520159,521,J2010,,,,,,,LINCOCIN,38.9,15.56,0,33.06,33.06,SKIPPED,7.63,7.63,33.06,33.06,33.06,16.4,19.06,19.06,0,11.67,16.73,16.73,0
4520162,521,J2550,,,,,,,PHENERGEN 25MG/50MG,1378.7,551.48,0,1171.9,1171.9,SKIPPED,1.28,1.28,1171.9,1171.9,1171.9,580.98,675.56,675.56,0,413.61,592.84,592.84,0
4520168,521,J3301,,,,,,,KENALOG,36.8,14.72,0,31.28,31.28,SKIPPED,1.71,1.71,31.28,31.28,31.28,15.5,18.03,18.03,0,11.04,15.82,15.82,0
4520170,521,J3420,,,,,,,B-12,36.8,14.72,0,31.28,31.28,SKIPPED,4.43,4.43,31.28,31.28,31.28,15.5,18.03,18.03,0,11.04,15.82,15.82,0
4520173,521,J7042,,,,,,,IV FLUIDS,58.8,23.52,0,49.98,49.98,SKIPPED,1.6,1.6,49.98,49.98,49.98,24.77,28.81,28.81,0,17.64,25.28,25.28,0
4520174,521,J7120,,,,,,,IV FLUIDS,58.8,23.52,0,49.98,49.98,SKIPPED,5.3,5.3,49.98,49.98,49.98,24.77,28.81,28.81,0,17.64,25.28,25.28,0
4520176,521,99386,,,,,,,PREV VISIT NEW PT 40-64YRS,281.4,112.56,0,281.4,239.19,SKIPPED,281.4,281.4,239.19,239.19,239.19,118.58,137.89,137.89,0,84.42,121,121,0
4520179,982,99309,,,,,,,NH SUBSEQUENT VISIT HIGH,197.44,78.98,0,167.82,167.82,SKIPPED,150.05,150.05,167.82,167.82,167.82,98.86,96.75,96.75,0,59.23,100.88,100.88,0
4520180,982,99310,,,,,,,NH UNSTABLE/NEW PROBLEM,293.74,117.5,0,249.68,249.68,SKIPPED,223.24,223.24,249.68,249.68,249.68,145.86,143.93,143.93,0,88.12,148.84,148.84,0
4520181,521,90633,,,,,,,HEP A,49.4,19.76,0,41.99,41.99,SKIPPED,31.12,31.12,41.99,41.99,41.99,20.82,24.21,24.21,0,14.82,21.24,21.24,0
4520184,521,11310,,,,,,,SHAVE SKIN LESION,103.76,41.5,0,103.76,88.2,SKIPPED,103.76,103.76,88.2,88.2,88.2,43.73,50.84,50.84,SKIPPED,SKIPPED,44.62,44.62,0
4520185,521,11311,,,,,,,SHAVE SKIN LESION,143.12,57.25,0,143.12,121.65,SKIPPED,143.12,143.12,121.65,121.65,121.65,60.31,70.13,70.13,SKIPPED,SKIPPED,61.54,61.54,0
4520186,521,11313,,,,,,,SHAVE SKIN LESION,219.38,87.75,0,219.38,186.47,SKIPPED,219.38,219.38,186.47,186.47,186.47,92.44,107.5,107.5,SKIPPED,SKIPPED,94.33,94.33,0
4520187,521,95117,,,,,,,IMMUNOTHERAPY INJECTIONS,21.28,8.51,0,21.28,18.09,SKIPPED,21.28,21.28,18.09,18.09,18.09,8.97,10.43,10.43,0,6.38,9.15,9.15,0
4520188,521,90460,,,,,,,ADMIN INJECT,43.5,17.4,0,43.5,36.98,SKIPPED,43.5,43.5,36.98,36.98,36.98,18.34,21.32,21.32,0,13.05,18.71,18.71,0
4520189,771,90471,,,,,,,ADMIN IMMUNIZATION (INITIAL),43.5,17.4,0,43.5,36.98,SKIPPED,43.5,43.5,36.98,36.98,36.98,18.34,21.32,21.32,0,13.05,18.71,18.71,0
4520190,521,90472,,,,,,,ADMIN IMMUNIZATION (EA ADDTL),27.18,10.87,0,27.18,23.1,SKIPPED,27.18,27.18,23.1,23.1,23.1,11.46,13.32,13.32,0,8.15,11.69,11.69,0
4520191,521,86403,,,,,,,PARTICLE AGGULT TEST,25.5,10.2,0,25.5,21.68,SKIPPED,25.5,25.5,21.68,21.68,21.68,10.75,9.69,9.69,0,9.69,10.97,10.97,0
4520192,521,99381,,,,,,,"INIT PM E/M, NEW PT, INFANT",104,41.6,0,104,88.4,SKIPPED,104,104,88.4,88.4,88.4,43.83,50.96,50.96,0,31.2,44.72,44.72,0
4520193,521,99382,,,,,,,INIT PM E/M NEW PT 1-4YRS,117.6,47.04,0,117.6,99.96,SKIPPED,117.6,117.6,99.96,99.96,99.96,49.56,57.62,57.62,0,35.28,50.57,50.57,0
4520194,521,99383,,,,,,,PREV VISIT NEW AGE 5-11YR,117.6,47.04,0,117.6,99.96,SKIPPED,117.6,117.6,99.96,99.96,99.96,49.56,57.62,57.62,0,35.28,50.57,50.57,0
4520195,521,99384,,,,,,,PREV VISIT NEW AGE 12-17Y,134.4,53.76,0,134.4,114.24,SKIPPED,134.4,134.4,114.24,114.24,114.24,56.63,65.86,65.86,0,40.32,57.79,57.79,0
4520196,521,99385,,,,,,,PREV VISIT NEW AGE 18-39Y,134.4,53.76,0,134.4,114.24,SKIPPED,134.4,134.4,114.24,114.24,114.24,56.63,65.86,65.86,0,40.32,57.79,57.79,0
4520197,521,99387,,,,,,,INIT PM EM NEW PT 65+,179.6,71.84,0,179.6,152.66,SKIPPED,179.6,179.6,152.66,152.66,152.66,75.69,88,88,0,53.88,77.23,77.23,0
4520198,521,99393,,,,,,,PREV VISIT EST AGE 5-11,104,41.6,0,104,88.4,SKIPPED,104,104,88.4,88.4,88.4,43.83,50.96,50.96,0,31.2,44.72,44.72,0
4520199,521,99397,,,,,,,PREV REEVAL EST PT 65 & OLDER,127.1,50.84,0,127.1,108.04,SKIPPED,127.1,127.1,108.04,108.04,108.04,53.56,62.28,62.28,0,38.13,54.65,54.65,0
4520200,521,99401,,,,,,,"PREVENT COUNSEL, INDIV",35.7,14.28,0,35.7,30.34,SKIPPED,35.7,35.7,30.34,30.34,30.34,15.04,17.49,17.49,0,10.71,15.35,15.35,0
4520202,521,99403,,,,,,,"PREVENT COUNSEL, INDIV",110.3,44.12,0,110.3,93.76,SKIPPED,110.3,110.3,93.76,93.76,93.76,46.48,54.05,54.05,0,33.09,47.43,47.43,0
4520203,521,99404,,,,,,,"PREVENT COUNSEL, INDIV",143.9,57.56,0,143.9,122.32,SKIPPED,143.9,143.9,122.32,122.32,122.32,60.64,70.51,70.51,0,43.17,61.88,61.88,0
4520205,521,17110,,,,,,,DESTRUCT BEN LESION 1-14,149.98,59.99,0,149.98,127.48,SKIPPED,149.98,149.98,127.48,127.48,127.48,63.2,73.49,73.49,0,44.99,64.49,64.49,0
4520206,521,99212,,,,,,,SPORTS PHYSICAL,40,16,0,40,34,SKIPPED,40,40,34,34,34,16.86,19.6,19.6,0,12,17.2,17.2,0
4520207,521,99213,,,,,,,CLINIC VISIT,110.92,44.37,0,110.92,94.28,SKIPPED,110.92,110.92,94.28,94.28,94.28,46.75,54.35,54.35,0,33.28,47.7,47.7,0
4520209,250,90649,,,,,,,(HPV) GUARDISIL,178.5,71.4,0,151.72,151.72,SKIPPED,146.29,146.29,151.72,151.72,151.72,75.22,87.46,87.46,0,53.55,76.76,76.76,151.72
4520211,521,90733,,,,,,,MENINGICOCCAL VACCINE,264.6,105.84,0,224.91,224.91,SKIPPED,123.17,123.17,224.91,224.91,224.91,111.5,129.65,129.65,0,79.38,113.78,113.78,0
4520212,521,11750,,,,,,,EXC OF NAIL PLATE&MATRIX,221.08,88.43,0,221.08,187.92,SKIPPED,221.08,221.08,187.92,187.92,187.92,93.16,108.33,108.33,SKIPPED,SKIPPED,95.06,95.06,0
4520213,521,87804,,,,,,,FLU SWAB,43.1,17.24,0,43.1,36.64,SKIPPED,43.1,43.1,36.64,36.64,36.64,18.16,13.9,13.9,0,13.9,18.53,18.53,0
4520218,521,90632,,,,,,,HEP A VACCINE ADULT,121.8,48.72,0,103.53,103.53,SKIPPED,65.11,65.11,103.53,103.53,103.53,51.32,59.68,59.68,0,36.54,52.37,52.37,0
4520219,521,86580,,,,,,,PPB TB TESTING,16.86,6.74,0,16.86,14.33,SKIPPED,16.86,16.86,14.33,14.33,14.33,7.1,8.26,8.26,0,5.06,7.25,7.25,0
4520220,521,29515,,,,,,,APPL LOWER LEG SPLINT,108.08,43.23,0,108.08,91.87,SKIPPED,108.08,108.08,91.87,91.87,91.87,45.54,52.96,52.96,0,32.42,46.47,46.47,0
4520221,521,11621,,,,,,,EX MAGL LESIN SCPL HND FT,324.7,129.88,0,324.7,276,SKIPPED,324.7,324.7,276,276,276,136.83,159.1,159.1,SKIPPED,SKIPPED,139.62,139.62,0
4520222,521,46050,,,,,,,I & D PERIANAL ABSCESS,210.82,84.33,0,210.82,179.2,SKIPPED,210.82,210.82,179.2,179.2,179.2,88.84,103.3,103.3,SKIPPED,SKIPPED,90.65,90.65,0
4520224,521,90736,,,,,,,ZOSTIVAX,225.8,90.32,0,225.8,191.93,SKIPPED,225.8,225.8,191.93,191.93,191.93,95.15,110.64,110.64,0,67.74,97.09,97.09,0
4520226,521,11400,,,,,,,"EXC BENIGN,TRUNK,ARMS",174.14,69.66,0,174.14,148.02,SKIPPED,174.14,174.14,148.02,148.02,148.02,73.38,85.33,85.33,SKIPPED,SKIPPED,74.88,74.88,0
4520228,521,11641,,,,,,,"EXC MALIGN LESION, FC, EA",338.28,135.31,0,338.28,287.54,SKIPPED,338.28,338.28,287.54,287.54,287.54,142.55,165.76,165.76,SKIPPED,SKIPPED,145.46,145.46,0
4520230,521,81025,,,,,,,URINE PREGNANCY,68.3,27.32,0,58.06,58.06,SKIPPED,32.72,32.72,58.06,58.06,58.06,28.78,7.23,7.23,0,7.23,29.37,29.37,0
4520234,982,99304,,,,,,,INITIAL NH E&M LOW,197.14,78.86,0,167.57,167.57,SKIPPED,149.83,149.83,167.57,167.57,167.57,97.01,96.6,96.6,0,59.14,98.99,98.99,0
4520235,982,99305,,,,,,,INITIAL NH E&M MODERATE,282.04,112.82,0,239.73,239.73,SKIPPED,214.35,214.35,239.73,239.73,239.73,140.28,138.2,138.2,0,84.61,143.14,143.14,0
4520236,982,99306,,,,,,,INITIAL NH E&M HIGH,361.06,144.42,0,306.9,306.9,SKIPPED,274.41,274.41,306.9,306.9,306.9,179.77,176.92,176.92,0,108.32,183.44,183.44,0
4520237,982,99307,,,,,,,SUBSEQ NH E&M STABLE,96.12,38.45,0,81.7,81.7,SKIPPED,73.05,73.05,81.7,81.7,81.7,47.54,47.1,47.1,0,28.84,48.51,48.51,0
4520238,982,99308,,,,,,,SUBSQT NH E&M MINOR,149.36,59.74,0,126.96,126.96,SKIPPED,113.51,113.51,126.96,126.96,126.96,74.85,73.19,73.19,0,44.81,76.38,76.38,0
4520240,521,99310,,,,,,,SUBSQT NH E&M UNSTABLE,293.74,117.5,0,249.68,249.68,SKIPPED,223.24,223.24,249.68,249.68,249.68,123.78,143.93,143.93,0,88.12,126.31,126.31,0
4520242,521,99312,,,,,,,SUBSQT NH FAC CARE LVL2,113.4,45.36,0,96.39,96.39,SKIPPED,86.18,86.18,96.39,96.39,96.39,47.78,55.57,55.57,0,34.02,48.76,48.76,0
4520244,521,99315,,,,,,,NH DISC = 30MIN,157.34,62.94,0,133.74,133.74,SKIPPED,119.58,119.58,133.74,133.74,133.74,66.31,77.1,77.1,0,47.2,67.66,67.66,0
4520245,982,99316,,,,,,,NH DC >30MIN,229.18,91.67,0,194.8,194.8,SKIPPED,174.18,174.18,194.8,194.8,194.8,113.1,112.3,112.3,0,68.75,115.41,115.41,0
4520246,982,99318,,,,,,,E&M NH YRLY STABLE,207.8,83.12,0,176.63,176.63,SKIPPED,157.93,157.93,176.63,176.63,176.63,103.84,101.82,101.82,0,62.34,105.96,105.96,0
4520249,521,29130,,,,,,,FINGER SPLINT,62.9,25.16,0,62.9,53.46,SKIPPED,62.9,62.9,53.46,53.46,53.46,26.51,30.82,30.82,0,18.87,27.05,27.05,0
4520250,521,82962,,,,,,,GLUCOMETER GLUCOSE,22.1,8.84,0,18.78,18.78,SKIPPED,12.46,12.46,18.78,18.78,18.78,9.31,10.83,10.83,0,6.63,9.5,9.5,0
4520251,521,96360,,,,,,,IV FLUID-1 HR,98,39.2,0,98,83.3,SKIPPED,98,98,83.3,83.3,83.3,41.3,48.02,48.02,0,29.4,42.14,42.14,0
4520252,521,96361,,,,,,,IV FLUID-ADDN'L,29.1,11.64,0,29.1,24.74,SKIPPED,29.1,29.1,24.74,24.74,24.74,12.26,14.26,14.26,0,8.73,12.51,12.51,0
4520255,521,20552,,,,,,,INJECT TRIGGER POINTS,82.84,33.14,0,82.84,70.41,SKIPPED,82.84,82.84,70.41,70.41,70.41,34.91,40.59,40.59,SKIPPED,SKIPPED,35.62,35.62,0
4520256,521,G0402,,,,,,,INITIAL PDREVENT EXAM,275.8,110.32,0,275.8,234.43,SKIPPED,275.8,275.8,234.43,234.43,234.43,116.22,135.14,135.14,0,82.74,118.59,118.59,0
4520257,521,J7613,,,,,,,ALBUTEROL,5.3,2.12,0,4.5,4.5,SKIPPED,0.08,0.08,4.5,4.5,4.5,2.23,2.6,2.6,0,1.59,2.28,2.28,0
4520258,521,J7644,,,,,,,ATROVENT,5.3,2.12,0,4.5,4.5,SKIPPED,0.51,0.51,4.5,4.5,4.5,2.23,2.6,2.6,0,1.59,2.28,2.28,0
4520259,521,90748,,,,,,,COMBIVAX-IMMUNIZATION,109.2,43.68,0,92.82,92.82,SKIPPED,42.06,42.06,92.82,92.82,92.82,46.02,53.51,53.51,0,32.76,46.96,46.96,0
4520261,521,90680,,,,,,,"ROTAVIRUS VACCINE, ORAL",112.4,44.96,0,96.98,95.54,SKIPPED,96.98,96.98,95.54,95.54,95.54,47.36,55.08,55.08,0,33.72,48.33,48.33,0
4520263,521,J7613,,,,,,,ALBUTEROL,4.2,1.68,0,3.57,3.57,SKIPPED,0.08,0.08,3.57,3.57,3.57,1.77,2.06,2.06,0,1.26,1.81,1.81,0
4520264,521,11620,,,,,,,"EXCIS, MAL LESION, SCALP",261.98,104.79,0,261.98,222.68,SKIPPED,261.98,261.98,222.68,222.68,222.68,110.4,128.37,128.37,SKIPPED,SKIPPED,112.65,112.65,0
4520265,521,J2001,,,,,,,XYLOCAINE,39.9,15.96,0,33.92,33.92,SKIPPED,0.02,0.02,33.92,33.92,33.92,16.82,19.55,19.55,0,11.97,17.16,17.16,0
4520267,521,11601,,,,,,,EX MALIG LESION .6 TO 1.0,408.5,163.4,0,408.5,347.22,SKIPPED,408.5,408.5,347.22,347.22,347.22,172.15,200.16,200.16,SKIPPED,SKIPPED,175.66,175.66,0
4520270,521,11604,,,,,,,EX MALIG LESION 3.1-4.0CM,467.96,187.18,0,467.96,397.77,SKIPPED,467.96,467.96,397.77,397.77,397.77,197.2,229.3,229.3,SKIPPED,SKIPPED,201.22,201.22,0
4520271,521,J3430,,,,,,,INJECT VIT K 2MG,42,16.8,0,35.7,35.7,SKIPPED,3.86,3.86,35.7,35.7,35.7,17.7,20.58,20.58,0,12.6,18.06,18.06,0
4520272,521,11422,,,,,,,EXC BEN LESION 1.1-2CM,294.52,117.81,0,294.52,250.34,SKIPPED,294.52,294.52,250.34,250.34,250.34,124.11,144.31,144.31,SKIPPED,SKIPPED,126.64,126.64,0
4520273,521,10160,,,,,,,PUNC ASP OF CYST,205.74,82.3,0,205.74,174.88,SKIPPED,205.74,205.74,174.88,174.88,174.88,86.7,100.81,100.81,0,61.72,88.47,88.47,0
4520274,521,J7614,,,,,,,XOPENEX .5MG,4.2,1.68,0,3.57,3.57,SKIPPED,1.48,1.48,3.57,3.57,3.57,1.77,2.06,2.06,0,1.26,1.81,1.81,0
4520275,521,10061,,,,,,,ABSCESS I&D COMP OR MULTI,387.94,155.18,0,387.94,329.75,SKIPPED,387.94,387.94,329.75,329.75,329.75,163.47,190.09,190.09,SKIPPED,SKIPPED,166.81,166.81,0
4520276,521,10121,,,,,,,INCISION & REMVE FGN BDY,400.8,160.32,0,400.8,340.68,SKIPPED,400.8,400.8,340.68,340.68,340.68,168.89,196.39,196.39,SKIPPED,SKIPPED,172.34,172.34,0
4520277,521,10140,,,,,,,"I&D HEMATOMA, SEROMA FLD",256.32,102.53,0,256.32,217.87,SKIPPED,256.32,256.32,217.87,217.87,217.87,108.02,125.6,125.6,SKIPPED,SKIPPED,110.22,110.22,0
4520278,521,11721,,,,,,,DEBRID OF NAIL 6 OR >,54.58,21.83,0,54.58,46.39,SKIPPED,54.58,54.58,46.39,46.39,46.39,23,26.74,26.74,0,16.37,23.47,23.47,0
4520279,521,11732,,,,,,,AVUL NAIL PLATE EA ADD,39.14,15.66,0,33.27,33.27,SKIPPED,0,0,33.27,33.27,33.27,16.49,19.18,19.18,0,11.74,16.83,16.83,0
4520280,521,11740,,,,,,,EVAC SUBUNGUAL HEMATOMA,70.82,28.33,0,70.82,60.2,SKIPPED,70.82,70.82,60.2,60.2,60.2,29.84,34.7,34.7,0,21.25,30.45,30.45,0
4520281,521,17111,,,,,,,DESTRUCT BENIGN LES 15OR>,184.78,73.91,0,184.78,157.06,SKIPPED,184.78,184.78,157.06,157.06,157.06,77.87,90.54,90.54,0,55.43,79.46,79.46,0
4520282,521,17250,,,,,,,CHEMICAL CAUTERY TISSUE,80.62,32.25,0,80.62,68.53,SKIPPED,80.62,80.62,68.53,68.53,68.53,33.98,39.5,39.5,0,24.19,34.67,34.67,0
4520283,521,20612,,,,,,,ASPIRATE/INJ GANGLION CYS,91.68,36.67,0,91.68,77.93,SKIPPED,91.68,91.68,77.93,77.93,77.93,38.63,44.92,44.92,SKIPPED,SKIPPED,39.42,39.42,0
4520284,521,64455,,,,,,,MORTON'S NEUROMA INJECT,76.76,30.7,0,76.76,65.25,SKIPPED,76.76,76.76,65.25,65.25,65.25,32.35,37.61,37.61,SKIPPED,SKIPPED,33.01,33.01,0
4520285,521,29580,,,,,,,STRAPPING:UNNA BOOT,63.16,25.26,0,63.16,53.69,SKIPPED,63.16,63.16,53.69,53.69,53.69,26.62,30.95,30.95,0,18.95,27.16,27.16,0
4520289,521,20551,,,,,,,INJ SING TENDON/INSERT,93.52,37.41,0,93.52,79.49,SKIPPED,93.52,93.52,79.49,79.49,79.49,39.41,45.82,45.82,SKIPPED,SKIPPED,40.21,40.21,0
4520290,761,11042,,,,,,,DEB SUBQ TISSUE 20SQ CM <,134.92,53.97,56.86,134.92,114.68,SKIPPED,134.92,134.92,114.68,114.68,114.68,56.86,66.11,66.11,SKIPPED,SKIPPED,58.02,58.02,114.68
4520291,521,11043,,,,,,,DEB MUSC/FASCIA 20 OR <,338.74,135.5,0,338.74,287.93,SKIPPED,338.74,338.74,287.93,287.93,287.93,142.75,165.98,165.98,SKIPPED,SKIPPED,145.66,145.66,0
4520292,521,11044,,,,,,,DEB BONE 20 SQ CM <,502.02,200.81,0,502.02,426.72,SKIPPED,502.02,502.02,426.72,426.72,426.72,211.55,245.99,245.99,SKIPPED,SKIPPED,215.87,215.87,0
4520293,521,11045,,,,,,,DEB SUBQ TISSUE ADD-20 SQ,57.62,23.05,0,48.98,48.98,SKIPPED,0,0,48.98,48.98,48.98,24.28,28.23,28.23,0,17.29,24.78,24.78,0
4520296,975,28285,,,,,,,CORRECTION HAMMERTOE PROF,824.36,329.74,0,824.36,700.71,SKIPPED,824.36,824.36,700.71,700.71,700.71,421.32,403.94,403.94,SKIPPED,SKIPPED,429.92,429.92,0
4520297,521,28293,,,,,,,COR HALLUX VALGUS(BUNION),1771.4,708.56,0,1505.69,1505.69,SKIPPED,1346.26,1346.26,1505.69,1505.69,1505.69,746.47,867.99,867.99,0,531.42,761.7,761.7,0
4520298,975,20694,,,,,,,"RMVE BONE FIX, UNDER ANES",935.39,374.16,0,935.39,795.08,SKIPPED,935.39,935.39,795.08,795.08,795.08,371.44,458.34,458.34,SKIPPED,SKIPPED,379.02,379.02,0
4520300,521,28122,,,,,,,PART RMVE FOOT BONE,960.32,384.13,0,960.32,816.27,SKIPPED,960.32,960.32,816.27,816.27,816.27,404.68,470.56,470.56,SKIPPED,SKIPPED,412.94,412.94,0
4520301,975,29897,,,,,,,"ARTHROSCOPY. ANLKE, LIMIT",1201.7,480.68,0,1201.7,1021.44,SKIPPED,1201.7,1201.7,1021.44,1021.44,1021.44,540.21,588.83,588.83,SKIPPED,SKIPPED,551.23,551.23,0
4520302,521,28485,,,,,,,TREAT METATARSAL FX,1177.12,470.85,0,1177.12,1000.55,SKIPPED,1177.12,1177.12,1000.55,1000.55,1000.55,496.04,576.79,576.79,SKIPPED,SKIPPED,506.16,506.16,0
4520303,975,28110,,,,,,,PART RMVE OF METATARSAL PROF,696.18,278.47,0,696.18,591.75,SKIPPED,696.18,696.18,591.75,591.75,591.75,319.41,341.13,341.13,SKIPPED,SKIPPED,325.93,325.93,0
4520304,521,29898,,,,,,,"ARTHROSCOPY ANKLE, EXTEN",1223.16,489.26,0,1223.16,1039.69,SKIPPED,1223.16,1223.16,1039.69,1039.69,1039.69,515.44,599.35,599.35,SKIPPED,SKIPPED,525.96,525.96,0
4520305,975,28505,,,,,,,TREAT BIG TOE FX,1459.44,583.78,0,1459.44,1240.52,SKIPPED,1459.44,1459.44,1240.52,1240.52,1240.52,547.72,715.13,715.13,SKIPPED,SKIPPED,558.9,558.9,0
4520308,521,28445,,,,,,,OPEN TREATMENT TALUS FX,2290.36,916.14,0,2290.36,1946.81,SKIPPED,2290.36,2290.36,1946.81,1946.81,1946.81,965.15,1122.28,1122.28,SKIPPED,SKIPPED,984.85,984.85,0
4520309,975,27610,,,,,,,ARTHROTOMY ANKLE,1549.61,619.84,0,1549.61,1317.17,SKIPPED,1549.61,1549.61,1317.17,1317.17,1317.17,709.42,759.31,759.31,SKIPPED,SKIPPED,723.9,723.9,0
4520312,975,28820,,,,,,,AMPUTATION TOE PROF,1270.67,508.27,0,1270.67,1080.07,SKIPPED,1270.67,1270.67,1080.07,1080.07,1080.07,195.63,622.63,622.63,SKIPPED,SKIPPED,199.62,199.62,0
4520313,521,28124,,,,,,,PARTIAL EXC PHALANX BONE,720.96,288.38,0,720.96,612.82,SKIPPED,720.96,720.96,612.82,612.82,612.82,303.81,353.27,353.27,SKIPPED,SKIPPED,310.01,310.01,0
4520314,975,28090,,,,,,,EXC OF FOOT LESION PROF,1108.07,443.23,0,1108.07,941.86,SKIPPED,1108.07,1108.07,941.86,941.86,941.86,337.51,542.95,542.95,SKIPPED,SKIPPED,344.4,344.4,0
4520315,975,28041,,,,,,,EXC FOOT TUMOR 1.5+,1096.66,438.66,0,1096.66,932.16,SKIPPED,1096.66,1096.66,932.16,932.16,932.16,493.72,537.36,537.36,SKIPPED,SKIPPED,503.8,503.8,0
4520316,521,11623,,,,,,,EXC MALIGN LESION 2.1-3.0,461.24,184.5,0,461.24,392.05,SKIPPED,461.24,461.24,392.05,392.05,392.05,194.36,226.01,226.01,SKIPPED,SKIPPED,198.33,198.33,0
4520318,521,64782,,,,,,,EXC OF NEUROMA HAND/FOOT,990.56,396.22,0,990.56,841.98,SKIPPED,990.56,990.56,841.98,841.98,841.98,417.42,485.37,485.37,SKIPPED,SKIPPED,425.94,425.94,0
4520319,975,28465,,,,,,,OPEN TRTMNT OF TARSAL FX,1184.31,473.72,0,1184.31,1006.66,SKIPPED,1184.31,1184.31,1006.66,1006.66,1006.66,700.64,580.31,580.31,SKIPPED,SKIPPED,714.94,714.94,0
4520320,521,28292,,,,,,,HALLUX VALGUS CORRECTION,1062.14,424.86,0,1062.14,902.82,SKIPPED,1062.14,1062.14,902.82,902.82,902.82,447.59,520.45,520.45,SKIPPED,SKIPPED,456.72,456.72,0
4520321,975,28299,,,,,,,BUNION CORR DBL OSTEOTOMY,1968.67,787.47,0,1968.67,1673.37,SKIPPED,1968.67,1968.67,1673.37,1673.37,1673.37,645.91,964.65,964.65,SKIPPED,SKIPPED,659.09,659.09,0
4520322,521,28297,,,,,,,BUNION CORR LAPIDUS TYPE,1309.48,523.79,0,1309.48,1113.06,SKIPPED,1309.48,1309.48,1113.06,1113.06,1113.06,551.82,641.65,641.65,SKIPPED,SKIPPED,563.08,563.08,0
4520323,975,28238,,,,,,,RECONST TIBIAL TENDON PROF,1622.16,648.86,0,1622.16,1378.84,SKIPPED,1622.16,1622.16,1378.84,1378.84,1378.84,537.67,794.86,794.86,SKIPPED,SKIPPED,548.64,548.64,0
4520324,975,28308,,,,,,,METATARSAL OSTEOTOMY PROF,1323.76,529.5,0,1323.76,1125.2,SKIPPED,1323.76,1323.76,1125.2,1125.2,1125.2,422.58,648.64,648.64,SKIPPED,SKIPPED,431.2,431.2,0
4520325,521,64774,,,,,,,EXCISION OF NEUROMA,891.54,356.62,0,891.54,757.81,SKIPPED,891.54,891.54,757.81,757.81,757.81,375.69,436.85,436.85,SKIPPED,SKIPPED,383.36,383.36,0
4520326,521,28062,,,,,,,FASCIECTOMY,890.38,356.15,0,890.38,756.82,SKIPPED,890.38,890.38,756.82,756.82,756.82,375.2,436.29,436.29,SKIPPED,SKIPPED,382.86,382.86,0
4520327,975,28119,,,,,,,OSTECTOMY CALCANEUS,865.66,346.26,0,865.66,735.81,SKIPPED,865.66,865.66,735.81,735.81,735.81,400.04,424.17,424.17,SKIPPED,SKIPPED,408.2,408.2,0
4520328,983,28043,,,,,,,EXC FOOT/TOE TUM SC <1.5 CM,573.94,229.58,0,573.94,487.85,SKIPPED,573.94,573.94,487.85,487.85,487.85,285.49,281.23,281.23,SKIPPED,SKIPPED,291.32,291.32,0
4520330,521,11105,,,,,,,PUNCH BX EA ADD'L,169.1,67.64,0,143.74,143.74,SKIPPED,0,0,143.74,143.74,143.74,71.26,82.86,82.86,0,50.73,72.71,72.71,0
4520331,975,28290,,,,,,,CORRECTION HALLUX VALGUS,1259.7,503.88,0,1070.74,1070.74,SKIPPED,957.37,957.37,1070.74,1070.74,1070.74,438.97,617.25,617.25,0,377.91,447.93,447.93,0
4520332,975,28322,,,,,,,REPAIR OF METATARSAL,1704.61,681.84,0,1704.61,1448.92,SKIPPED,1704.61,1704.61,1448.92,1448.92,1448.92,630.98,835.26,835.26,SKIPPED,SKIPPED,643.86,643.86,0
4520334,521,28118,,,,,,,REMOVAL OF HEEL BONE,901.86,360.74,0,901.86,766.58,SKIPPED,901.86,901.86,766.58,766.58,766.58,380.04,441.91,441.91,SKIPPED,SKIPPED,387.8,387.8,0
4520335,521,28092,,,,,,,REMOVAL OF TOE LESIONS,585.6,234.24,0,585.6,497.76,SKIPPED,585.6,585.6,497.76,497.76,497.76,246.77,286.94,286.94,SKIPPED,SKIPPED,251.81,251.81,0
4520336,521,11423,,,,,,,EXC H-F-NK-SP B9+MARG 2.1,337.76,135.1,0,337.76,287.1,SKIPPED,337.76,337.76,287.1,287.1,287.1,142.34,165.5,165.5,SKIPPED,SKIPPED,145.24,145.24,0
4520337,975,28805,,,,,,,AMPUTATION THRU METATARSA,1755.14,702.06,0,1755.14,1491.87,SKIPPED,1755.14,1755.14,1491.87,1491.87,1491.87,778.31,860.02,860.02,0,526.54,794.19,794.19,0
4520338,521,29891,,,,,,,ANKLE ARTHROSCOPY/SURGERY,1456.72,582.69,0,1456.72,1238.21,SKIPPED,1456.72,1456.72,1238.21,1238.21,1238.21,613.86,713.79,713.79,SKIPPED,SKIPPED,626.39,626.39,0
4520340,521,28104,,,,,,,REMOVAL OF FOOT LESION,771.02,308.41,0,771.02,655.37,SKIPPED,771.02,771.02,655.37,655.37,655.37,324.91,377.8,377.8,SKIPPED,SKIPPED,331.54,331.54,0
4520341,521,28107,,,,,,,REMOVE/GRAFT FOOT LESION,762.16,304.86,0,762.16,647.84,SKIPPED,762.16,762.16,647.84,647.84,647.84,321.18,373.46,373.46,SKIPPED,SKIPPED,327.73,327.73,0
4520343,521,58300,,,,,,,INSERT INTRAUTERINE DEVIC,243.6,97.44,0,243.6,207.06,SKIPPED,243.6,243.6,207.06,207.06,207.06,102.66,119.36,119.36,0,73.08,104.75,104.75,0
4520344,521,J7298,,,,,,,LEVONORGESTREL IU CONTRAC,1419.6,567.84,0,1206.66,1206.66,SKIPPED,858.33,858.33,1206.66,1206.66,1206.66,598.22,695.6,695.6,0,425.88,610.43,610.43,0
4520345,521,11406,,,,,,,EXC TR-EXT B9+MARG > 4.0,533.94,213.58,0,533.94,453.85,SKIPPED,533.94,533.94,453.85,453.85,453.85,225,261.63,261.63,SKIPPED,SKIPPED,229.59,229.59,0
4520348,521,11426,,,,,,,EXC H-F-NK-SP B9+MARG > 4,596.76,238.7,0,596.76,507.25,SKIPPED,596.76,596.76,507.25,507.25,507.25,251.48,292.41,292.41,SKIPPED,SKIPPED,256.61,256.61,0
4520351,521,11982,,,,,,,REMOVE IMPLANT DEVICE,217.18,86.87,0,217.18,184.6,SKIPPED,217.18,217.18,184.6,184.6,184.6,91.52,106.42,106.42,SKIPPED,SKIPPED,93.39,93.39,0
4520352,521,90698,,,,,,,DTAP-HIB-IP VACCINE IM,189,75.6,0,160.65,160.65,SKIPPED,105.3,105.3,160.65,160.65,160.65,79.64,92.61,92.61,0,56.7,81.27,81.27,0
4520353,521,G0438,,,,,,,PPPS INITIAL VISIT,369.38,147.75,0,313.97,313.97,SKIPPED,280.73,280.73,313.97,313.97,313.97,155.65,181,181,0,110.81,158.83,158.83,0
4520354,521,G0439,,,,,,,PPPS SUBSEQ VISIT,250.42,100.17,0,212.86,212.86,SKIPPED,190.32,190.32,212.86,212.86,212.86,105.53,122.71,122.71,0,75.13,107.68,107.68,0
4520356,521,57160,,,,,,,INSERT PESSARY,101.36,40.54,0,101.36,86.16,SKIPPED,101.36,101.36,86.16,86.16,86.16,42.71,49.67,49.67,0,30.41,43.58,43.58,0
4520357,521,58301,,,,,,,REMOVE INTRAUTERINE DEVIC,146.18,58.47,0,146.18,124.25,SKIPPED,146.18,146.18,124.25,124.25,124.25,61.6,71.63,71.63,0,43.85,62.86,62.86,0
4520358,521,12011,,,,,,,REPAIR SUPERFICIAL WOUND,120.24,48.1,0,120.24,102.2,SKIPPED,120.24,120.24,102.2,102.2,102.2,50.67,58.92,58.92,0,36.07,51.7,51.7,0
4520360,521,28825,,,,,,,PARTIAL AMPUTATION OF TOE,896.7,358.68,0,896.7,762.2,SKIPPED,896.7,896.7,762.2,762.2,762.2,377.87,439.38,439.38,SKIPPED,SKIPPED,385.58,385.58,0
4520367,521,28192,,,,,,,REMOVAL FOOT FOREIGN BODY,682.44,272.98,0,682.44,580.07,SKIPPED,682.44,682.44,580.07,580.07,580.07,287.58,334.4,334.4,SKIPPED,SKIPPED,293.45,293.45,0
4520372,521,20220,,,,,,,BONE BIOPSY TROCAR/NEEDLE,157.68,63.07,0,157.68,134.03,SKIPPED,157.68,157.68,134.03,134.03,134.03,66.44,77.26,77.26,SKIPPED,SKIPPED,67.8,67.8,0
4520373,521,28645,,,,,,,REPAIR TOE DISLOCATION,1052.42,420.97,0,1052.42,894.56,SKIPPED,1052.42,1052.42,894.56,894.56,894.56,443.49,515.69,515.69,SKIPPED,SKIPPED,452.54,452.54,0
4520374,521,28039,,,,,,,EXC FOOT/TOE TUM SC > 1.5,756.82,302.73,0,756.82,643.3,SKIPPED,756.82,756.82,643.3,643.3,643.3,318.92,370.84,370.84,SKIPPED,SKIPPED,325.43,325.43,0
4520375,521,11055,,,,,,,TRIM SKIN LESION,35.42,14.17,0,35.42,30.11,SKIPPED,35.42,35.42,30.11,30.11,30.11,14.93,17.36,17.36,0,10.63,15.23,15.23,0
4520376,521,98925,,,,,,,OMT 1-2 REGIONS,47.06,18.82,0,47.06,40,SKIPPED,47.06,47.06,40,40,40,19.84,23.06,23.06,0,14.12,20.24,20.24,0
4520377,521,98926,,,,,,,OMT 3-4 REGIONS,71.4,28.56,0,71.4,60.69,SKIPPED,71.4,71.4,60.69,60.69,60.69,30.09,34.99,34.99,0,21.42,30.7,30.7,0
4520378,521,11606,,,,,,,EXC TR-EXT MLG+MARG > 4 C,696.3,278.52,0,696.3,591.86,SKIPPED,696.3,696.3,591.86,591.86,591.86,293.42,341.19,341.19,SKIPPED,SKIPPED,299.41,299.41,0
4520379,521,12032,,,,,,,INTMD WND REPAIR S/TR/EXT,422.08,168.83,0,422.08,358.77,SKIPPED,422.08,422.08,358.77,358.77,358.77,177.86,206.82,206.82,SKIPPED,SKIPPED,181.49,181.49,0
4520381,975,28525,,,,,,,TREAT TOE FRACTURE,1129.77,451.91,0,1129.77,960.3,SKIPPED,1129.77,1129.77,960.3,960.3,960.3,445.19,553.59,553.59,SKIPPED,SKIPPED,454.28,454.28,0
4520382,521,28005,,,,,,,TREAT FOOT BONE LESION,1256.68,502.67,0,1256.68,1068.18,SKIPPED,1256.68,1256.68,1068.18,1068.18,1068.18,529.56,615.77,615.77,SKIPPED,SKIPPED,540.37,540.37,0
4520383,975,20680,,,,,,,REMOVAL OF SUPPORT IMPLANT PROF,1343.04,537.22,0,1343.04,1141.58,SKIPPED,1343.04,1343.04,1141.58,1141.58,1141.58,456.9,658.09,658.09,SKIPPED,SKIPPED,466.22,466.22,0
4520384,521,11421,,,,,,,EXC H-F-NK-SP B9+MARG 0.6,237.36,94.94,0,237.36,201.76,SKIPPED,237.36,237.36,201.76,201.76,201.76,100.02,116.31,116.31,SKIPPED,SKIPPED,102.06,102.06,0
4520385,521,,,,,,,,EXC TR-EXT B9+MARG 3.1-4,343.4,137.36,0,291.89,291.89,SKIPPED,260.98,260.98,291.89,291.89,291.89,144.71,168.27,168.27,0,103.02,147.66,147.66,0
4520386,521,13160,,,,,,,LATE CLOSURE OF WOUND,1730.56,692.22,0,1730.56,1470.98,SKIPPED,1730.56,1730.56,1470.98,1470.98,1470.98,729.26,847.97,847.97,SKIPPED,SKIPPED,744.14,744.14,0
4520387,521,28446,,,,,,,OSTEOCHONDRAL TALUS AUTOG,2655.22,1062.09,0,2655.22,2256.94,SKIPPED,2655.22,2655.22,2256.94,2256.94,2256.94,1118.91,1301.06,1301.06,SKIPPED,SKIPPED,1141.74,1141.74,0
4520388,975,27676,,,,,,,REPAIR LOWER LEG TENDONS,1447.78,579.11,0,1447.78,1230.61,SKIPPED,1447.78,1447.78,1230.61,1230.61,1230.61,666.34,709.41,709.41,SKIPPED,SKIPPED,679.94,679.94,0
4520389,521,28208,,,,,,,REPAIR OF FOOT TENDON,685.72,274.29,0,685.72,582.86,SKIPPED,685.72,685.72,582.86,582.86,582.86,288.96,336,336,SKIPPED,SKIPPED,294.86,294.86,0
4520390,521,28740,,,,,,,FUSION OF FOOT BONES,1354.5,541.8,0,1354.5,1151.32,SKIPPED,1354.5,1354.5,1151.32,1151.32,1151.32,570.79,663.7,663.7,SKIPPED,SKIPPED,582.44,582.44,0
4520391,521,20225,,,,,,,BONE BIOPSY TROCAR/NEEDLE,235.1,94.04,0,235.1,199.84,SKIPPED,235.1,235.1,199.84,199.84,199.84,99.07,115.2,115.2,SKIPPED,SKIPPED,101.09,101.09,0
4520392,521,28120,,,,,,,PART REMOVAL OF ANKLE/HEEL,1081.32,432.53,0,1081.32,919.12,SKIPPED,1081.32,1081.32,919.12,919.12,919.12,455.67,529.85,529.85,SKIPPED,SKIPPED,464.97,464.97,0
4520394,521,J1580,,,,,,,GARAMYCIN GENTAMICIN INJ,16.8,6.72,0,14.28,14.28,SKIPPED,0.82,0.82,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,0
4520395,521,J2360,,,,,,,ORPHENADRINE INJECTION,16.8,6.72,0,14.28,14.28,SKIPPED,9.66,9.66,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,0
4520397,521,90670,,,,,,,PNEUMOCOCCAL VACC 13 VA;,290.9,116.36,0,247.26,247.26,SKIPPED,173.56,173.56,247.26,247.26,247.26,122.59,142.54,142.54,0,87.27,125.09,125.09,0
4520398,521,J7620,,,,,,,ALBUTEROL IPRATROP NON-CO,16.8,6.72,0,14.28,14.28,SKIPPED,0.63,0.63,14.28,14.28,14.28,7.08,8.23,8.23,0,5.04,7.22,7.22,0
4520401,975,28200,,,,,,,REPAIR OF FOOT TENDON,1164.96,465.98,0,1164.96,990.22,SKIPPED,1164.96,1164.96,990.22,990.22,990.22,359.64,570.83,570.83,SKIPPED,SKIPPED,366.98,366.98,0
4520403,975,28112,,,,,,,PART REMOVAL OF METATARSA,750.96,300.38,0,750.96,638.32,SKIPPED,750.96,750.96,638.32,638.32,638.32,343.26,367.97,367.97,SKIPPED,SKIPPED,350.27,350.27,0
4520406,975,27650,,,,,,,REPAIR ACHILLES TENDON,1737.15,694.86,0,1737.15,1476.58,SKIPPED,1737.15,1737.15,1476.58,1476.58,1476.58,723.48,851.2,851.2,SKIPPED,SKIPPED,738.25,738.25,0
4520407,520,90633,,,,,,,TV HEP A STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520408,520,90647,,,,,,,TV HIB STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520409,520,90648,,,,,,,TV HIB VAC STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520410,520,90649,,,,,,,TV HPV STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520412,520,90670,,,,,,,TV PCV7 PCV13 STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520413,520,90680,,,,,,,TV ROTAVIRUS-STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520416,520,90698,,,,,,,TV DTAP-IPV-HIB/STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520417,520,90700,,,,,,,TV DAPTACEL-STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520418,520,90702,,,,,,,TV DT-STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520419,520,90707,,,,,,,TV M-M-R/STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520420,520,90710,,,,,,,TV MMRV-STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520421,520,90713,,,,,,,TV IPV VAC STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520422,520,90714,,,,,,,TV TENIVAC/STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520423,521,90715,,,,,,,TV ADACEL(STATE),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0
4520424,520,90716,,,,,,,TV VARICELLA(STATE),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520425,520,90723,,,,,,,TV DTAP-HEP B-IPV(STATE),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520426,520,90732,,,,,,,TV PPSV23 STATE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520427,510,90734,,,,,,,TV MENINGOCOCCAL(STATE),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
4520428,520,90744,,,,,,,TV HEP B(STATE),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0.01
4520430,972,72040,,,,,,,SPINE CERIVCAL 2 VIEW PRO,78.72,31.49,0,78.72,66.91,SKIPPED,78.72,78.72,66.91,66.91,66.91,12.16,78.72,78.72,0,39.88,12.41,12.41,0
4520431,972,72070,,,,,,,SPINE THORACIC 2 VIEW PRO,74.09,29.64,0,74.09,62.98,SKIPPED,74.09,74.09,62.98,62.98,62.98,11.02,74.09,74.09,0,73.48,11.24,11.24,0
4520432,972,72100,,,,,,,SPINE LUMBAR 2 3 VIEW PRO,79.87,31.95,0,79.87,67.89,SKIPPED,79.87,79.87,67.89,67.89,67.89,12.16,79.87,79.87,0,73.48,12.41,12.41,0
4520433,972,73630,,,,,,,FOOT 3 VIEW PRO,69.46,27.78,0,69.46,59.04,SKIPPED,69.46,69.46,59.04,59.04,59.04,9.09,69.46,69.46,0,39.88,9.28,9.28,0
4520436,972,73590,,,,,,,LEG 2 VIEW PRO,61.35,24.54,0,61.35,52.15,SKIPPED,61.35,61.35,52.15,52.15,52.15,8.7,61.35,61.35,0,39.88,8.88,8.88,0
4520439,972,72220,,,,,,,SACRUM/COCCYX PRO,63.67,25.47,0,63.67,54.12,SKIPPED,63.67,63.67,54.12,54.12,54.12,9.47,63.67,63.67,0,39.88,9.66,9.66,0
4520440,972,73080,,,,,,,ELBOW MIN 3 VIEW PRO,74.09,29.64,0,74.09,62.98,SKIPPED,74.09,74.09,62.98,62.98,62.98,9.47,74.09,74.09,0,39.88,9.66,9.66,0
4520442,972,73090,,,,,,,FOREARM 2 VIEW PRO,62.52,25.01,0,62.52,53.14,SKIPPED,62.52,62.52,53.14,53.14,53.14,8.7,62.52,62.52,0,39.88,8.88,8.88,0
4520443,972,74000,,,,,,,ABDOMEN 1 VIEW PRO,53.26,21.3,0,45.27,45.27,SKIPPED,40.48,40.48,45.27,45.27,45.27,10.23,26.1,26.1,0,15.98,10.44,10.44,0
4520446,972,72170,,,,,,,PELVIS 1 VIEW PRO,63.67,25.47,0,63.67,54.12,SKIPPED,63.67,63.67,54.12,54.12,54.12,9.47,63.67,63.67,0,63.67,9.66,9.66,0
4520447,972,74022,,,,,,,ACUTE ABD CHEST PRO,107.66,43.06,0,107.66,91.51,SKIPPED,107.66,107.66,91.51,91.51,91.51,17.18,107.66,107.66,0,73.48,17.53,17.53,0
4520448,972,72081,,,,,,,SCOLIOSIS STUDY PRO,99.17,39.67,0,99.17,84.29,SKIPPED,99.17,99.17,84.29,84.29,84.29,14.09,99.17,99.17,0,39.88,14.38,14.38,0
4520449,972,72110,,,,,,,SPINE LUMBAR COMPLETE PRO,107.66,43.06,0,107.66,91.51,SKIPPED,107.66,107.66,91.51,91.51,91.51,14.09,107.66,107.66,0,73.48,14.38,14.38,0
4520450,972,70210,,,,,,,SINUSES LESS THAN 3 PRO,68.3,27.32,0,68.3,58.06,SKIPPED,68.3,68.3,58.06,58.06,58.06,9.47,68.3,68.3,0,39.88,9.66,9.66,0
4520451,972,73130,,,,,,,HAND 3 VIEW PRO,71.78,28.71,0,71.78,61.01,SKIPPED,71.78,71.78,61.01,61.01,61.01,9.47,71.78,71.78,0,39.88,9.66,9.66,0
4520452,983,99347,,,,,,,HOME VISIT EST PATIENT,119.18,47.67,0,101.3,101.3,SKIPPED,90.58,90.58,101.3,101.3,101.3,59.88,58.4,58.4,0,35.75,61.1,61.1,0
4520453,983,99348,,,,,,,HOME VISIT EST PATIENT,182,72.8,0,154.7,154.7,SKIPPED,138.32,138.32,154.7,154.7,154.7,90.83,89.18,89.18,0,54.6,92.68,92.68,0
4520454,983,99349,,,,,,,HOME VISIT EST PATIENT,278.16,111.26,0,236.44,236.44,SKIPPED,211.4,211.4,236.44,236.44,236.44,139.88,136.3,136.3,0,83.45,142.73,142.73,0
4520455,983,99350,,,,,,,HOME VISIT EST PATIENT,386.76,154.7,0,328.75,328.75,SKIPPED,293.94,293.94,328.75,328.75,328.75,193.51,189.51,189.51,0,116.03,197.46,197.46,0
4520456,972,70220,,,,,,,SINUSES MIN 3 VIEW PRO,71.78,28.71,0,71.78,61.01,SKIPPED,71.78,71.78,61.01,61.01,61.01,11.79,71.78,71.78,0,39.88,12.03,12.03,0
4520457,972,71100,,,,,,,RIBS UNILAT 2 VIEW PRO,71.78,28.71,0,71.78,61.01,SKIPPED,71.78,71.78,61.01,61.01,61.01,12.16,71.78,71.78,0,39.88,12.41,12.41,0
4520458,972,73620,,,,,,,FOOT 2 VIEW PRO,61.35,24.54,0,61.35,52.15,SKIPPED,61.35,61.35,52.15,52.15,52.15,8.33,61.35,61.35,0,39.88,8.5,8.5,0
4520459,972,73620,,,,,,,FINGER 2 VIEW PRO,61.35,24.54,0,61.35,52.15,SKIPPED,61.35,61.35,52.15,52.15,52.15,8.33,61.35,61.35,0,39.88,8.5,8.5,0
4520461,972,73120,,,,,,,HAND 2 VIEW PRO,61.35,24.54,0,61.35,52.15,SKIPPED,61.35,61.35,52.15,52.15,52.15,9.07,61.35,61.35,0,61.35,9.26,9.26,0
4520462,521,65210,,,,,,,REMOVE FOREIGN BODY EYE,114.96,45.98,0,114.96,97.72,SKIPPED,114.96,114.96,97.72,97.72,97.72,48.44,56.33,56.33,0,34.49,49.43,49.43,0
452047,972,74022,,,,,,,ACUTE ABD W/PA CHEST PRO,107.66,43.06,0,107.66,91.51,SKIPPED,107.66,107.66,91.51,91.51,91.51,17.18,107.66,107.66,0,73.48,17.53,17.53,0
4520470,302,,,,,,,,PTH PEPTIDE,89.37,35.75,0,75.96,75.96,SKIPPED,67.92,67.92,75.96,75.96,75.96,37.66,43.79,43.79,0,26.81,38.43,38.43,75.96
4520471,302,,,,,,,,IMMUNOGLOBULIN LIGHT CHAI,75.37,30.15,0,64.06,64.06,SKIPPED,57.28,57.28,64.06,64.06,64.06,31.76,36.93,36.93,0,22.61,32.41,32.41,64.06
4520472,302,,,,,,,,IMMUNOGLOBULIA FEE LIGHT,536.1,214.44,0,455.68,455.68,SKIPPED,407.44,407.44,455.68,455.68,455.68,225.91,262.69,262.69,0,160.83,230.52,230.52,455.68
4520473,302,,,,,,,,IMMUNOGLOBULIA FEE LIGHT,257.81,103.12,0,219.14,219.14,SKIPPED,195.94,195.94,219.14,219.14,219.14,108.64,126.33,126.33,0,77.34,110.86,110.86,219.14
4520474,301,,,,,,,,MEASLES AB 1gG,29.66,11.86,0,25.21,25.21,SKIPPED,22.54,22.54,25.21,25.21,25.21,12.5,14.53,14.53,0,8.9,12.75,12.75,25.21
4520631,521,29125,,,,,,,WRIST SPLINT,85.76,34.3,0,85.76,72.9,SKIPPED,85.76,85.76,72.9,72.9,72.9,36.14,42.02,42.02,0,25.73,36.88,36.88,0
4520632,521,29130,,,,,,,FINGER SPLINT,62.9,25.16,0,62.9,53.46,SKIPPED,62.9,62.9,53.46,53.46,53.46,26.51,30.82,30.82,0,18.87,27.05,27.05,0
4520633,521,29405,,,,,,,APPLY SHORT LEG CAST,129.46,51.78,0,129.46,110.04,SKIPPED,129.46,129.46,110.04,110.04,110.04,54.56,63.44,63.44,SKIPPED,SKIPPED,55.67,55.67,0
4520635,521,29515,,,,,,,APPLY LOWER LEG SPLINT,108.08,43.23,0,108.08,91.87,SKIPPED,108.08,108.08,91.87,91.87,91.87,45.54,52.96,52.96,0,32.42,46.47,46.47,0
4520636,521,29580,,,,,,,STRAPPING/UNNA BOOT,63.16,25.26,0,63.16,53.69,SKIPPED,63.16,63.16,53.69,53.69,53.69,26.62,30.95,30.95,0,18.95,27.16,27.16,0
4520640,521,30901,,,,,,,CONTROL OF NOS,123.1,49.24,0,123.1,104.64,SKIPPED,123.1,123.1,104.64,104.64,104.64,51.87,60.32,60.32,0,36.93,52.93,52.93,0
4520641,521,90636,,,,,,,TV HEPA HEP B TV,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0
4520642,521,28899,,,,,,,FOOT/TOES SURGERY PROCEDURE,73.5,29.4,0,73.5,62.48,SKIPPED,73.5,73.5,62.48,62.48,62.48,30.98,36.02,36.02,0,22.05,31.61,31.61,0
4520643,521,94640,,,,,,,NEBULIZER TX W/MEDS,39,15.6,0,39,33.15,SKIPPED,39,39,33.15,33.15,33.15,16.43,19.11,19.11,0,11.7,16.77,16.77,0
4520644,975,28755,,,,,,,FUSION BIG TOE JOINT PROF,957.35,382.94,0,957.35,813.75,SKIPPED,957.35,957.35,813.75,813.75,813.75,367.56,469.1,469.1,SKIPPED,SKIPPED,375.06,375.06,0
4520645,975,28080,,,,,,,REMOVAL FOOT LESION PROF,1054.99,422,0,1054.99,896.74,SKIPPED,1054.99,1054.99,896.74,896.74,896.74,413.03,516.95,516.95,SKIPPED,SKIPPED,421.46,421.46,0
4520646,975,28297,,,,,,,CORR BUNION LAPIDUS TYPE - PROF,1699.12,679.65,0,1699.12,1444.25,SKIPPED,1699.12,1699.12,1444.25,1444.25,1444.25,662.5,832.57,832.57,SKIPPED,SKIPPED,676.02,676.02,0
4520647,975,29891,,,,,,,ANKLE ARTHROSCOPY PROF,1975.3,790.12,0,1975.3,1679,SKIPPED,1975.3,1975.3,1679,1679,1679,734.63,967.9,967.9,SKIPPED,SKIPPED,749.62,749.62,0
4520648,975,28485,,,,,,,TREAT METATARSAL FRACTURE PROF,1513.04,605.22,0,1513.04,1286.08,SKIPPED,1513.04,1513.04,1286.08,1286.08,1286.08,619.32,741.39,741.39,SKIPPED,SKIPPED,631.96,631.96,0
4520650,975,28285,,,,,,,REPAIR OF HAMMERTOE PROF,1090.33,436.13,0,1090.33,926.78,SKIPPED,1090.33,1090.33,926.78,926.78,926.78,421.32,534.26,534.26,SKIPPED,SKIPPED,429.92,429.92,0
4520651,983,11643,,,,,,,EXC FEENL MAL 2.1-3,499.92,199.97,0,499.92,424.93,SKIPPED,499.92,499.92,424.93,424.93,424.93,247.1,244.96,244.96,SKIPPED,SKIPPED,252.14,252.14,0
4520652,983,11603,,,,,,,EXC TR EXT MAL 2.1-3,425.7,170.28,0,425.7,361.84,SKIPPED,425.7,425.7,361.84,361.84,361.84,209.87,208.59,208.59,SKIPPED,SKIPPED,214.15,214.15,0
4520653,983,11444,,,,,,,EXC FACE MM B9 3.1-4,490.3,196.12,0,490.3,416.76,SKIPPED,490.3,490.3,416.76,416.76,416.76,246.31,240.25,240.25,SKIPPED,SKIPPED,251.34,251.34,0
4520654,983,11642,,,,,,,EXC FEENL MAL 1.1-2,398.62,159.45,0,398.62,338.83,SKIPPED,398.62,398.62,338.83,338.83,338.83,197.74,195.32,195.32,SKIPPED,SKIPPED,201.78,201.78,0
4520655,983,11644,,,,,,,EXC FEENL MAL 3.1-4,619.86,247.94,0,619.86,526.88,SKIPPED,619.86,619.86,526.88,526.88,526.88,306.59,303.73,303.73,SKIPPED,SKIPPED,312.85,312.85,0
4520656,983,11443,,,,,,,EXC FACE MN B9 2.1-3,383.68,153.47,0,383.68,326.13,SKIPPED,383.68,383.68,326.13,326.13,326.13,194.65,188,188,SKIPPED,SKIPPED,198.62,198.62,0
4520657,983,11442,,,,,,,EXC FACE M N B9 1.1-2,312.54,125.02,0,312.54,265.66,SKIPPED,312.54,312.54,265.66,265.66,265.66,159.42,153.14,153.14,SKIPPED,SKIPPED,162.67,162.67,0
4520658,975,28292,,,,,,,CORR OF BUNION PROF,1744.94,697.98,0,1744.94,1483.2,SKIPPED,1744.94,1744.94,1483.2,1483.2,1483.2,528.79,855.02,855.02,SKIPPED,SKIPPED,539.58,539.58,0
4520659,975,11042,,,,,,,DEB SUBQ TISSUE 20 SQ CM/< PROF,178.82,71.53,0,178.82,152,SKIPPED,178.82,178.82,152,152,152,65.59,87.62,87.62,SKIPPED,SKIPPED,66.93,66.93,0
4520664,521,11900,,,,,,,INTRALESION INJECT 7 LESIONS PROF,68.14,27.26,0,68.14,57.92,SKIPPED,68.14,68.14,57.92,57.92,57.92,28.71,33.39,33.39,0,20.44,29.3,29.3,0
4520665,975,11750,,,,,,,REMOVAL OF NAIL BED PROF,243.74,97.5,0,243.74,207.18,SKIPPED,243.74,243.74,207.18,207.18,207.18,111.66,119.43,119.43,SKIPPED,SKIPPED,113.94,113.94,0
4520666,975,20240,,,,,,,BONE BIOPSY EXCISIONAL PROF,365.93,146.37,0,365.93,311.04,SKIPPED,365.93,365.93,311.04,311.04,311.04,154.67,179.31,179.31,SKIPPED,SKIPPED,157.83,157.83,0
4520667,983,20553,,,,,,,TRIG POINT 3 MUSCLE,94.26,37.7,0,94.26,80.12,SKIPPED,94.26,94.26,80.12,80.12,80.12,46.8,46.19,46.19,SKIPPED,SKIPPED,47.76,47.76,0
4520668,983,29105,,,,,,,ARM SPLINT LONG,128.22,51.29,0,128.22,108.99,SKIPPED,128.22,128.22,108.99,108.99,108.99,44.83,62.83,62.83,0,38.47,45.74,45.74,0
4520669,983,29065,,,,,,,ARM LONG CAST,147.18,58.87,0,147.18,125.1,SKIPPED,147.18,147.18,125.1,125.1,125.1,73.78,72.12,72.12,SKIPPED,SKIPPED,75.29,75.29,0
4520670,983,29126,,,,,,,ARM SPLINT SHORT STATIC,105.7,42.28,0,105.7,89.84,SKIPPED,105.7,105.7,89.84,89.84,89.84,53.39,51.79,51.79,0,31.71,54.48,54.48,0
4520671,983,29085,,,,,,,APPLY HAND/WRIST CAST(GAUNTLET),145.82,58.33,0,145.82,123.95,SKIPPED,145.82,145.82,123.95,123.95,123.95,72.81,71.45,71.45,SKIPPED,SKIPPED,74.3,74.3,0
4520673,983,29505,,,,,,,LEG SPLINT LONG,109.34,43.74,0,109.34,92.94,SKIPPED,109.34,109.34,92.94,92.94,92.94,55.5,53.58,53.58,0,32.8,56.63,56.63,0
4520675,521,17360,,,,,,,CHEMICAL PEEL,212.1,84.84,0,212.1,180.28,SKIPPED,212.1,212.1,180.28,180.28,180.28,89.38,103.93,103.93,0,63.63,91.2,91.2,0
4520676,983,64450,,,,,,,NERVE BLOCK>PERIPHERAL,98.78,39.51,0,98.78,83.96,SKIPPED,98.78,98.78,83.96,83.96,83.96,46.2,48.4,48.4,0,29.63,47.14,47.14,0
4520677,983,26720,,,,,,,TRT PROXIMAL PHALANX FX,393.66,157.46,0,393.66,334.61,SKIPPED,393.66,393.66,334.61,334.61,334.61,208.98,192.89,192.89,SKIPPED,SKIPPED,213.24,213.24,0
4520678,983,23500,,,,,,,TRT CLAVICLE FX,474.42,189.77,0,474.42,403.26,SKIPPED,474.42,474.42,403.26,403.26,403.26,252.19,232.47,232.47,SKIPPED,SKIPPED,257.34,257.34,0
4520679,983,26740,,,,,,,TRT VOLAR PLATE FX,461.32,184.53,0,461.32,392.12,SKIPPED,461.32,461.32,392.12,392.12,392.12,244.93,226.05,226.05,0,138.4,249.93,249.93,0
4520680,983,26600,,,,,,,TRT METACARPAL FX,591.4,236.56,0,531.76,502.69,SKIPPED,531.76,531.76,502.69,502.69,502.69,318.39,289.79,289.79,SKIPPED,SKIPPED,324.89,324.89,0
4520681,983,28470,,,,,,,TRT METATARSAL FX,438.28,175.31,0,438.28,372.54,SKIPPED,438.28,438.28,372.54,372.54,372.54,227.32,214.76,214.76,SKIPPED,SKIPPED,231.96,231.96,0
4520682,983,27788,,,,,,,TRT ANKLE FX(LATERAL MALLEOLUS),823.84,329.54,0,823.84,700.26,SKIPPED,823.84,823.84,700.26,700.26,700.26,425.69,403.68,403.68,SKIPPED,SKIPPED,434.38,434.38,0
4520683,983,23600,,,,,,,TRT PROXIMAL HUMERUS FX,657.04,262.82,0,558.48,558.48,SKIPPED,531.76,531.76,558.48,558.48,558.48,350.79,321.95,321.95,SKIPPED,SKIPPED,357.95,357.95,0
4520684,983,27760,,,,,,,TRT CLTX MEDIAL ANKLE FX,651.02,260.41,0,651.02,553.37,SKIPPED,651.02,651.02,553.37,553.37,553.37,341.54,319,319,SKIPPED,SKIPPED,348.51,348.51,0
4520685,983,25600,,,,,,,TRT DISTAL RADIUS FX,663.16,265.26,0,563.69,563.69,SKIPPED,531.76,531.76,563.69,563.69,563.69,360.06,324.95,324.95,SKIPPED,SKIPPED,367.41,367.41,0
4520686,983,28430,,,,,,,TRT ANKLE FX(TALUS),449.22,179.69,0,449.22,381.84,SKIPPED,449.22,449.22,381.84,381.84,381.84,233.48,220.12,220.12,SKIPPED,SKIPPED,238.25,238.25,0
4520687,983,27780,,,,,,,TRT PROXIMAL FIBULA FX,596.28,238.51,0,596.28,506.84,SKIPPED,596.28,596.28,506.84,506.84,506.84,316.81,292.18,292.18,SKIPPED,SKIPPED,323.28,323.28,0
4520688,983,26750,,,,,,,TRT DISTAL PHALANX FX,393.96,157.58,0,393.96,334.87,SKIPPED,393.96,393.96,334.87,334.87,334.87,209.43,193.04,193.04,0,118.19,213.7,213.7,0
4520689,983,27808,,,,,,,TRT BIMALLEOLAR ANKLE FX,641.18,256.47,0,641.18,545,SKIPPED,641.18,641.18,545,545,545,340.11,314.18,314.18,SKIPPED,SKIPPED,347.05,347.05,0
4520690,983,28515,,,,,,,TRT PHALANX FX(OTHER THAN GREAT TOE),306.86,122.74,0,306.86,260.83,SKIPPED,306.86,306.86,260.83,260.83,260.83,157.31,150.36,150.36,SKIPPED,SKIPPED,160.52,160.52,0
4520691,983,27193,,,,,,,TRT PELVIC RING FX,513.8,205.52,0,533.05,436.73,SKIPPED,390.49,390.49,436.73,436.73,436.73,522.39,251.76,251.76,0,154.14,533.05,533.05,0
4520692,983,24650,,,,,,,TRT RADIAL HEAD/NECK FX,512.94,205.18,0,512.94,436,SKIPPED,512.94,512.94,436,436,436,272.34,251.34,251.34,SKIPPED,SKIPPED,277.9,277.9,0
4520693,510,11624,,,,,,,EX S/N/H/F/G MAT+MRG 3.1-4,520.4,208.16,0,520.4,442.34,SKIPPED,520.4,520.4,442.34,442.34,0,219.29,255,255,SKIPPED,SKIPPED,223.77,223.77,442.34
4520695,983,20206,,,,,,,NEEDLE BX MUSCLE-PERCUTANEOUS,129.14,51.66,0,129.14,109.77,SKIPPED,129.14,129.14,109.77,109.77,109.77,62.64,63.28,63.28,SKIPPED,SKIPPED,63.92,63.92,0
4520696,983,96110,,,,,,,DEVELOPMENTAL TEST LIM,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0
4520701,983,99495,,,,,,,TRANS CARE MGMT 14 DAY DISCH,239.04,95.62,0,239.04,203.18,SKIPPED,239.04,239.04,203.18,203.18,203.18,157.81,117.13,117.13,0,71.71,161.03,161.03,0
4520702,983,11646,,,,,,,EXC F/E/E/N/L MAL+MRG>4CM,858.66,343.46,0,858.66,729.86,SKIPPED,858.66,858.66,729.86,729.86,729.86,424.08,420.74,420.74,SKIPPED,SKIPPED,432.73,432.73,0
4520704,983,27750,,,,,,,TRT TIBIAL SHAFT FX.,680.2,272.08,0,680.2,578.17,SKIPPED,680.2,680.2,578.17,578.17,578.17,357.65,333.3,333.3,SKIPPED,SKIPPED,364.95,364.95,0
4520705,983,28400,,,,,,,CLOSED TRT CALCANEUS FX W/O MANIP.,488.4,195.36,0,488.4,415.14,SKIPPED,488.4,488.4,415.14,415.14,415.14,253.83,239.32,239.32,SKIPPED,SKIPPED,259.01,259.01,0
4520706,983,16020,,,,,,,DRESS/DEBRID P-THICK BURN,118.2,47.28,0,118.2,100.47,SKIPPED,118.2,118.2,100.47,100.47,100.47,59.25,57.92,57.92,0,35.46,60.46,60.46,0
4520707,983,16035,,,,,,,INCISION OF BURN SCAB,426.58,170.63,0,426.58,362.59,SKIPPED,426.58,426.58,362.59,362.59,362.59,208.9,209.02,209.02,SKIPPED,SKIPPED,213.16,213.16,0
4520708,983,10040,,,,,,,ACNE SURGERY,154.24,61.7,0,154.24,131.1,SKIPPED,154.24,154.24,131.1,131.1,131.1,56.92,75.58,75.58,0,46.27,58.08,58.08,0
4520709,510,11404,,,,,,,EXC TR-EXT B9+MARG,177.5,71,0,177.5,150.88,SKIPPED,177.5,177.5,150.88,150.88,0,74.8,86.98,86.98,SKIPPED,SKIPPED,76.33,76.33,150.88
4520710,983,11981,,,,,,,"INSERTION,NONBIODEGRADABLE DRUG IMPLANT",181.4,72.56,0,181.4,154.19,SKIPPED,181.4,181.4,154.19,154.19,154.19,68.46,88.89,88.89,SKIPPED,SKIPPED,69.86,69.86,0
4520711,983,11983,,,,,,,REMOVAL WITH REINSERTION DRUG IMPLANT,387.88,155.15,0,387.88,329.7,SKIPPED,387.88,387.88,329.7,329.7,329.7,112.18,190.06,190.06,SKIPPED,SKIPPED,114.47,114.47,0
4520712,983,J7307,,,,,,,ETONOGESTREL IMPLANT SYSTEM W/ SUPPLIES,357,142.8,0,357,303.45,SKIPPED,357,357,303.45,303.45,303.45,0,174.93,174.93,0,107.1,0,0,0
4520713,983,27530,,,,,,,TRT KNEE FX,599.8,239.92,0,599.8,509.83,SKIPPED,599.8,599.8,509.83,509.83,509.83,321.63,293.9,293.9,SKIPPED,SKIPPED,328.19,328.19,0
4520714,983,11424,,,,,,,EXC H-F-NK-SP B9-MARG 3.1-4,388.24,155.3,0,388.24,330,SKIPPED,388.24,388.24,330,330,330,193.33,190.24,190.24,SKIPPED,SKIPPED,197.28,197.28,0
4520716,983,99441,,,,,,,PHONE E/M PHYS QHP 5-10MIN,89.3,35.72,0,75.9,75.9,SKIPPED,61.37,61.37,75.9,75.9,75.9,39.24,43.76,43.76,0,26.79,40.04,40.04,0
4520717,983,23620,,,,,,,TRT HUMERAS FX,547.28,218.91,0,531.76,465.19,SKIPPED,531.76,531.76,465.19,465.19,465.19,289.11,268.17,268.17,SKIPPED,SKIPPED,295.01,295.01,0
4520718,983,11626,,,,,,,EXC S/N/H/F/G MAL MRG>4CM,638.48,255.39,0,638.48,542.71,SKIPPED,638.48,638.48,542.71,542.71,542.71,317.04,312.86,312.86,SKIPPED,SKIPPED,323.51,323.51,0
4520719,900,90791,,,,,,,PSYCH DIAGNOSTIC EVAL,276.06,110.42,0,234.65,234.65,SKIPPED,209.81,209.81,234.65,234.65,234.65,116.34,135.27,135.27,0,82.82,118.71,118.71,234.65
4520720,900,90792,,,,,,,PSYCH DIAGNOSTIC EVAL W/ MEDICAL SERVICE,310.06,124.02,0,263.55,263.55,SKIPPED,235.65,235.65,263.55,263.55,263.55,130.66,151.93,151.93,0,93.02,133.33,133.33,263.55
4520721,914,90834,,,,,,,PSYCH INDIVIDUAL SESSION-45 MIN,183.1,73.24,0,155.64,155.64,SKIPPED,139.16,139.16,155.64,155.64,155.64,77.16,89.72,89.72,0,54.93,78.73,78.73,0
4520722,914,90837,,,,,,,PSYCH INDIVIDUAL SESSION-60 MIN,275.34,110.14,0,234.04,234.04,SKIPPED,209.26,209.26,234.04,234.04,234.04,116.03,134.92,134.92,0,82.6,118.4,118.4,0
4520723,916,90847,,,,,,,PSYCH FAMILY SESSION,231.06,92.42,0,196.4,196.4,SKIPPED,175.61,175.61,196.4,196.4,196.4,97.37,113.22,113.22,0,69.32,99.36,99.36,0
4520724,918,96101,,,,,,,PSYCH TESTING BY PSYCH,173.56,69.42,0,147.53,147.53,SKIPPED,131.91,131.91,147.53,147.53,147.53,73.14,85.04,85.04,0,52.07,74.63,74.63,147.53
4520725,916,90846,,,,,,,PSYCH FAMILY SESSION W/O PATIENT,221.72,88.69,0,188.46,188.46,SKIPPED,168.51,168.51,188.46,188.46,188.46,93.43,108.64,108.64,0,66.52,95.34,95.34,0
4520726,914,90832,,,,,,,PSYCH INDIVIDUAL THERAPY-30 MIN,137.36,54.94,0,116.76,116.76,SKIPPED,104.39,104.39,116.76,116.76,116.76,57.88,67.31,67.31,0,41.21,59.06,59.06,0
4520729,914,90785,,,,,,,INTERACTIVE COMPLEXITY,30.26,12.1,0,25.72,25.72,SKIPPED,23,23,25.72,25.72,25.72,12.75,14.83,14.83,0,9.08,13.01,13.01,0
4520730,983,41010,,,,,,,INCISION OF TONGUE FOLD,232.34,92.94,0,232.34,197.49,SKIPPED,232.34,232.34,197.49,197.49,197.49,120.91,113.85,113.85,SKIPPED,SKIPPED,123.38,123.38,0
4520731,983,99496,,,,,,,TRANSCARE MGMT 7 DAY DISCH,346.86,138.74,0,346.86,294.83,SKIPPED,346.86,346.86,294.83,294.83,294.83,213.99,169.96,169.96,0,104.06,218.36,218.36,0
4520732,983,46083,,,,,,,INCISE EXT HEMORRHOID,231.64,92.66,0,231.64,196.89,SKIPPED,231.64,231.64,196.89,196.89,196.89,120.43,113.5,113.5,0,69.49,122.89,122.89,0
4520733,983,11719,,,,,,,TRIM NAILS,16.96,6.78,0,16.96,14.42,SKIPPED,16.96,16.96,14.42,14.42,14.42,8.35,8.31,8.31,0,5.09,8.52,8.52,0
4520734,983,11755,,,,,,,BX NAIL UNIT,168.34,67.34,0,168.34,143.09,SKIPPED,168.34,168.34,143.09,143.09,143.09,66.67,82.49,82.49,SKIPPED,SKIPPED,68.03,68.03,0
4520735,983,51701,,,,,,,IN & OUT CATH,56.38,22.55,0,56.38,47.92,SKIPPED,56.38,56.38,47.92,47.92,47.92,28.03,27.63,27.63,0,16.91,28.6,28.6,0
4520736,983,11622,,,,,,,EX MG LZ SP NK H/F 1,371.48,148.59,0,371.48,315.76,SKIPPED,371.48,371.48,315.76,315.76,315.76,183.95,182.03,182.03,SKIPPED,SKIPPED,187.7,187.7,0
4520737,983,99490,,,,,,,CHRONIC CARE MGMT SRVC.,69.7,27.88,0,69.7,59.24,SKIPPED,69.7,69.7,59.24,59.24,59.24,56.24,34.15,34.15,0,20.91,57.39,57.39,0
4520738,983,10080,,,,,,,DRAINAGE OF PILONIDAL CYST,220.86,88.34,0,220.86,187.73,SKIPPED,220.86,220.86,187.73,187.73,187.73,114.34,108.22,108.22,0,66.26,116.67,116.67,0
4520739,983,29540,,,,,,,STRAPPING OF ANKLE/FOOT,39.96,15.98,0,39.96,33.97,SKIPPED,39.96,39.96,33.97,33.97,33.97,19.47,19.58,19.58,0,11.99,19.87,19.87,0
4520741,983,11000,,,,,,,DEBRID.INFECTED SKIN-UP TO 10% BODY SURF,62.86,25.14,0,62.86,53.43,SKIPPED,62.86,62.86,53.43,53.43,53.43,30.5,30.8,30.8,0,18.86,31.12,31.12,0
4520742,983,99406,,,,,,,BEHAV CHNG SMOKING 3-10MIN,26.78,10.71,0,26.78,22.76,SKIPPED,26.78,26.78,22.76,22.76,22.76,13.16,13.12,13.12,0,8.03,13.43,13.43,0
4520743,983,99407,,,,,,,BEHAV CHNG SMOKING >10 MIN,55.84,22.34,0,55.84,47.46,SKIPPED,55.84,55.84,47.46,47.46,47.46,27.86,27.36,27.36,0,16.75,28.43,28.43,0
4520744,983,40812,,,,,,,EXCISE/RPR MOUTH LESION,427.86,171.14,0,427.86,363.68,SKIPPED,427.86,427.86,363.68,363.68,363.68,204.28,209.65,209.65,0,128.36,208.45,208.45,0
4520745,983,62322,,,,,,,INJ SPINE LUMBAR/SACRAL,189.72,75.89,0,189.72,161.26,SKIPPED,189.72,189.72,161.26,161.26,161.26,88.61,92.96,92.96,0,56.92,90.42,90.42,0
4520746,983,69200,,,,,,,REMOVAL OF FOREIGN BODY FROM EAR,102.24,40.9,0,102.24,86.9,SKIPPED,102.24,102.24,86.9,86.9,86.9,51.53,50.1,50.1,0,30.67,52.58,52.58,0
4520747,983,99354,,,,,,,PROLONG E&M/PSYCTX SERV O/P,264.14,105.66,0,264.14,224.52,SKIPPED,264.14,264.14,224.52,224.52,224.52,130.88,129.43,129.43,0,79.24,133.55,133.55,0
4520748,983,41899,,,,,,,DENTOALVEOLAR STRUCTURE,231.5,92.6,0,231.5,196.78,SKIPPED,231.5,231.5,196.78,196.78,196.78,0,113.44,113.44,0,69.45,0,0,0
4520749,983,67938,,,,,,,RMV FOREIGN BODY-EYELID,251.44,100.58,0,251.44,213.72,SKIPPED,251.44,251.44,213.72,213.72,213.72,127.75,123.21,123.21,SKIPPED,SKIPPED,130.36,130.36,0
4520750,983,41115,,,,,,,EXCISION OF TONGUE FOLD,312.76,125.1,0,312.76,265.85,SKIPPED,312.76,312.76,265.85,265.85,265.85,160.8,153.25,153.25,SKIPPED,SKIPPED,164.08,164.08,0
4520751,983,65205,,,,,,,REMOVAL FOREIGN BODY FROM EYE,95.98,38.39,0,95.98,81.58,SKIPPED,95.98,95.98,81.58,81.58,81.58,31.94,47.03,47.03,0,28.79,32.59,32.59,0
4520752,983,11201,,,,,,,REMOVE SKIN TAGS ADD-ON(ADTL.10),37.12,14.85,0,31.55,31.55,SKIPPED,0,0,31.55,31.55,31.55,17.81,18.19,18.19,0,11.14,18.17,18.17,0
4520753,983,11056,,,,,,,TRIM SKIN LESION(2-4),50.04,20.02,0,50.04,42.53,SKIPPED,50.04,50.04,42.53,42.53,42.53,24.51,24.52,24.52,0,15.01,25.01,25.01,0
4520754,983,11057,,,,,,,TRIM SKIN LESION(>4),66.08,26.43,0,66.08,56.17,SKIPPED,66.08,66.08,56.17,56.17,56.17,31.7,32.38,32.38,0,19.82,32.35,32.35,0
4520755,983,28450,,,,,,,TRT MIDFOOT FX,411.22,164.49,0,411.22,349.54,SKIPPED,411.22,411.22,349.54,349.54,349.54,211.82,201.5,201.5,SKIPPED,SKIPPED,216.14,216.14,0
4520756,983,27220,,,,,,,TRT HIP SOCKET FX,1133.18,453.27,0,1020.78,963.2,SKIPPED,1020.78,1020.78,963.2,963.2,963.2,452.47,555.26,555.26,SKIPPED,SKIPPED,461.7,461.7,0
4520757,983,27520,,,,,,,TRT KNEECAP FX,630.66,252.26,0,630.66,536.06,SKIPPED,630.66,630.66,536.06,536.06,536.06,334.1,309.02,309.02,SKIPPED,SKIPPED,340.92,340.92,0
4520758,983,27267,,,,,,,CLTX THIGH FX,931.68,372.67,0,931.68,791.93,SKIPPED,931.68,931.68,791.93,791.93,791.93,484.79,456.52,456.52,SKIPPED,SKIPPED,494.68,494.68,0
4520759,983,20670,,,,,,,RMV SUPPORT IMPLANT(SUPERFICIAL),316.34,126.54,0,316.34,268.89,SKIPPED,316.34,316.34,268.89,268.89,268.89,157.54,155.01,155.01,SKIPPED,SKIPPED,160.75,160.75,0
4520760,983,40820,,,,,,,TRT MOUTH LESION,370.88,148.35,0,370.88,315.25,SKIPPED,370.88,370.88,315.25,315.25,315.25,186.85,181.73,181.73,SKIPPED,SKIPPED,190.66,190.66,0
4520761,983,87220,,,,,,,TISSUE EXAM FOR FUNGI,12.2,4.88,0,12.2,10.37,SKIPPED,12.2,12.2,10.37,10.37,10.37,0,3.59,3.59,0,3.99,0,0,0
4520762,983,11752,,,,,,,RMV NAIL BED/TIP,655.2,262.08,0,556.92,556.92,SKIPPED,497.95,497.95,556.92,556.92,556.92,288.89,321.05,321.05,0,196.56,294.79,294.79,0
4520763,983,25622,,,,,,,TRT WRIST BONE FX,595.54,238.22,0,531.76,506.21,SKIPPED,531.76,531.76,506.21,506.21,506.21,315.54,291.81,291.81,SKIPPED,SKIPPED,321.98,321.98,0
4520764,983,25530,,,,,,,TRT FX OF ULNA,507.44,202.98,0,507.44,431.32,SKIPPED,507.44,507.44,431.32,431.32,431.32,269,248.65,248.65,SKIPPED,SKIPPED,274.49,274.49,0
4520765,983,10021,,,,,,,FNA PROCEDURE W/O IMAGE,151.12,60.45,0,151.12,128.45,SKIPPED,151.12,151.12,128.45,128.45,128.45,59.66,74.05,74.05,0,45.34,60.88,60.88,0
4520766,983,16000,,,,,,,INITIAL TREATMENT OF BURNS,101.24,40.5,0,101.24,86.05,SKIPPED,101.24,101.24,86.05,86.05,86.05,48.99,49.61,49.61,0,30.37,49.99,49.99,0
4520767,983,64405,,,,,,,OCCIPITAL NERVE BLOCK PROF,137.38,54.95,0,137.38,116.77,SKIPPED,137.38,137.38,116.77,116.77,116.77,56.71,67.32,67.32,0,41.21,57.87,57.87,0
4520768,983,64425,,,,,,,ILLIOINGUINAL NERVE BLOCK PROF,205.12,82.05,0,205.12,174.35,SKIPPED,205.12,205.12,174.35,174.35,174.35,60.27,100.51,100.51,0,61.54,61.5,61.5,0
4520769,983,20526,,,,,,,CARPEL TUNNEL INJ PROF,125.26,50.1,0,125.26,106.47,SKIPPED,125.26,125.26,106.47,106.47,106.47,61.99,61.38,61.38,SKIPPED,SKIPPED,63.26,63.26,0
4520770,983,30801,,,,,,,ABLATE INF TURBINATE SUPERF,286.46,114.58,0,286.46,243.49,SKIPPED,286.46,286.46,243.49,243.49,243.49,171.25,140.37,140.37,SKIPPED,SKIPPED,174.74,174.74,0
4520771,983,20611,,,,,,,DRAIN/INJ JOINT/BURSA W/US,133.54,53.42,0,133.54,113.51,SKIPPED,133.54,133.54,113.51,113.51,113.51,64.71,65.43,65.43,0,40.06,66.03,66.03,0
4520772,983,12020,,,,,,,CLOSURE OF SPLIT WOUND,407.72,163.09,0,407.72,346.56,SKIPPED,407.72,407.72,346.56,346.56,346.56,204.35,199.78,199.78,SKIPPED,SKIPPED,208.52,208.52,0
4520773,916,90833,,,,,,,PSYCH PT/FAM W/ E&M-30 MIN,143.04,57.22,0,121.58,121.58,SKIPPED,108.71,108.71,121.58,121.58,121.58,60.28,70.09,70.09,0,42.91,61.51,61.51,0
4520774,916,90836,,,,,,,PSYCH PT/FAM W/ E&M-45 MIN,180.28,72.11,0,153.24,153.24,SKIPPED,137.01,137.01,153.24,153.24,153.24,75.97,88.34,88.34,0,54.08,77.52,77.52,0
4520775,916,90838,,,,,,,PSYCH PT/FAM W/ E&M-60 MIN,238.22,95.29,0,202.49,202.49,SKIPPED,181.05,181.05,202.49,202.49,202.49,100.38,116.73,116.73,0,71.47,102.43,102.43,0
4520776,983,99497,,,,,,,ADVNCD CARE PLAN 30 MIN,171.48,68.59,0,171.48,145.76,SKIPPED,171.48,171.48,145.76,145.76,145.76,84.99,84.03,84.03,0,51.44,86.72,86.72,0
4520777,983,99498,,,,,,,ADVNCD CARE PLAN ADTL 30 MIN,160.78,64.31,0,160.78,136.66,SKIPPED,160.78,160.78,136.66,136.66,136.66,80.12,78.78,78.78,0,48.23,81.75,81.75,0
4520778,983,51702,,,,,,,INSERT TEMP BLADDER CATH,57.08,22.83,0,57.08,48.52,SKIPPED,57.08,57.08,48.52,48.52,48.52,27.8,27.97,27.97,0,17.12,28.37,28.37,0
4520779,983,28190,,,,,,,RMV FOREIGN BODY (FOOT),292.58,117.03,0,292.58,248.69,SKIPPED,292.58,292.58,248.69,248.69,248.69,145.52,143.36,143.36,0,87.77,148.49,148.49,0
4520780,983,45108,,,,,,,RMV ANORECTAL LESION,799.84,319.94,0,799.84,679.86,SKIPPED,799.84,799.84,679.86,679.86,679.86,407.1,391.92,391.92,SKIPPED,SKIPPED,415.41,415.41,0
4520781,983,21014,,,,,,,EXC FACE TUM DEEP 2 CM/>,1129.08,451.63,0,1129.08,959.72,SKIPPED,1129.08,1129.08,959.72,959.72,959.72,569.09,553.25,553.25,SKIPPED,SKIPPED,580.7,580.7,0
4520782,983,90839,,,,,,,PSYCH CRISIS INTL. 60 MIN,287.02,114.81,0,243.97,243.97,SKIPPED,218.14,218.14,243.97,243.97,243.97,141.19,140.64,140.64,0,86.11,144.07,144.07,0
4520783,983,27786,,,,,,,TRT DIST FIB CLSD W/,611.2,244.48,0,611.2,519.52,SKIPPED,611.2,611.2,519.52,519.52,519.52,320.5,299.49,299.49,SKIPPED,SKIPPED,327.04,327.04,0
4520784,983,28505,,,,,,,TRT BIG TOE FX,1087.32,434.93,0,1087.32,924.22,SKIPPED,1087.32,1087.32,924.22,924.22,924.22,547.72,532.79,532.79,SKIPPED,SKIPPED,558.9,558.9,0
4520785,983,20950,,,,,,,FLUID PRESSURE MUSCLE,196.14,78.46,0,196.14,166.72,SKIPPED,196.14,196.14,166.72,166.72,166.72,95.21,96.11,96.11,0,58.84,97.15,97.15,0
4520786,983,25630,,,,,,,TRT WRIST BONE FX,601.46,240.58,0,531.76,511.24,SKIPPED,531.76,531.76,511.24,511.24,511.24,315.53,294.72,294.72,SKIPPED,SKIPPED,321.97,321.97,0
4520787,983,24500,,,,,,,TRT HUMERUS FX,698.1,279.24,0,698.1,593.38,SKIPPED,698.1,698.1,593.38,593.38,593.38,370.62,342.07,342.07,SKIPPED,SKIPPED,378.18,378.18,0
4520788,983,25560,,,,,,,TREAT FRACTURE RADIUS & ULNA,538.32,215.33,0,531.76,457.57,SKIPPED,531.76,531.76,457.57,457.57,457.57,287.32,263.78,263.78,SKIPPED,SKIPPED,293.18,293.18,0
4520789,983,27086,,,,,,,RMV HIP FOREIGN BODY,361.38,144.55,0,361.38,307.17,SKIPPED,361.38,361.38,307.17,307.17,307.17,183.82,177.08,177.08,SKIPPED,SKIPPED,187.57,187.57,0
452079,983,55000,,,,,,,DRAINAGE OF HYDROCELE,186.58,74.63,0,186.58,158.59,SKIPPED,186.58,186.58,158.59,158.59,158.59,91.76,91.42,91.42,0,55.97,93.63,93.63,0
4520790,983,96160,,,,,,,HEALTH RISK ASSESSMENT TEST,0.01,0,0,3.04,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,2.98,0,0,0,0,3.04,3.04,0
4520791,983,20606,,,,,,,DRAIN/INJ JOINT/BURSA W/US,116.42,46.57,0,116.42,98.96,SKIPPED,116.42,116.42,98.96,98.96,98.96,56.78,57.05,57.05,0,34.93,57.94,57.94,0
4520792,983,97597,,,,,,,RMV DEVITAL TISS 20 CM/<,52.44,20.98,0,52.44,44.57,SKIPPED,52.44,52.44,44.57,44.57,44.57,39.82,25.7,25.7,0,15.73,40.63,40.63,0
4520793,983,67800,,,,,,,RMV EYELID LESION,223.42,89.37,0,223.42,189.91,SKIPPED,223.42,223.42,189.91,189.91,189.91,111.13,109.48,109.48,SKIPPED,SKIPPED,113.4,113.4,0
4520794,983,97598,,,,,,,RMV DEVITAL TISS ADTL 20 CM<,24.68,9.87,0,27.99,20.98,SKIPPED,24.68,24.68,20.98,20.98,20.98,27.43,12.09,12.09,0,7.4,27.99,27.99,0
4520795,983,67700,,,,,,,DRAIN EYELID ABSCES,251.3,100.52,0,251.3,213.6,SKIPPED,251.3,251.3,213.6,213.6,213.6,126.01,123.14,123.14,0,75.39,128.58,128.58,0
4520796,983,55000,,,,,,,DRAINAGE OF HYDROCELE,186.58,74.63,0,186.58,158.59,SKIPPED,186.58,186.58,158.59,158.59,158.59,91.76,91.42,91.42,0,55.97,93.63,93.63,0
4520797,983,30300,,,,,,,REMOVE NASAL FOREIGN BODY,225.1,90.04,0,225.1,191.34,SKIPPED,225.1,225.1,191.34,191.34,191.34,137.7,110.3,110.3,0,67.53,140.51,140.51,0
4520798,983,64400,,,,,,,N BLOCK INJ TRIGEMINAL,155.46,62.18,0,155.46,132.14,SKIPPED,155.46,155.46,132.14,132.14,132.14,53.92,76.18,76.18,0,46.64,55.02,55.02,0
4520799,983,25650,,,,,,,TRT WRIST BONE FX,641.4,256.56,0,545.19,545.19,SKIPPED,531.76,531.76,545.19,545.19,545.19,339.51,314.29,314.29,SKIPPED,SKIPPED,346.44,346.44,0
4520800,983,25605,,,,,,,TREAT FRACTURE RADIUS/ULNA,1093.94,437.58,0,1093.94,929.85,SKIPPED,1093.94,1093.94,929.85,929.85,929.85,563.95,536.03,536.03,SKIPPED,SKIPPED,575.46,575.46,0
4520801,983,20604,,,,,,,DRAIN/INJ JOINT/BURSA W/ US,101.36,40.54,0,101.36,86.16,SKIPPED,101.36,101.36,86.16,86.16,86.16,50.4,49.67,49.67,0,30.41,51.43,51.43,0
4520802,983,27197,,,,,,,CLOSED TX PELVIC RING FX,258.78,103.51,0,258.78,219.96,SKIPPED,258.78,258.78,219.96,219.96,219.96,146.81,126.8,126.8,0,77.63,149.81,149.81,0
4520803,983,12051,,,,,,,INTMD RPR FACE/MM 2.5 CM OR LESS,371.94,148.78,0,371.94,316.15,SKIPPED,371.94,371.94,316.15,316.15,316.15,183.9,182.25,182.25,SKIPPED,SKIPPED,187.65,187.65,0
4520804,977,97110,,,,,,,EXERCISE 16-30 MIN,66.18,26.47,0,66.18,56.25,SKIPPED,66.18,66.18,56.25,56.25,56.25,32.91,32.43,32.43,0,19.85,33.58,33.58,0
4520805,983,99355,,,,,,,PROLONG E&M/PSYCTX SERV OP ADD 30 MIN,198.4,79.36,0,198.4,168.64,SKIPPED,198.4,198.4,168.64,168.64,168.64,92.77,97.22,97.22,0,59.52,94.66,94.66,0
4520806,983,99024,,,,,,,POST OP PERIOD FOLLOW UP,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0
4520807,983,99456A,,,,,,,Disability Eval: Psycho-Social Survey,153.16,61.26,0,130.19,130.19,SKIPPED,116.4,116.4,130.19,130.19,130.19,0,75.05,75.05,0,45.95,0,0,0
4520808,983,99456B,,,,,,,Disability Eval: Psych w/ IQ & Mental St,317.38,126.95,0,269.77,269.77,SKIPPED,241.21,241.21,269.77,269.77,269.77,0,155.52,155.52,0,95.21,0,0,0
4520809,983,36590,,,,,,,REMOVE TUNNELED CV CATH,415.52,166.21,0,415.52,353.19,SKIPPED,415.52,415.52,353.19,353.19,353.19,206.44,203.6,203.6,SKIPPED,SKIPPED,210.65,210.65,0
4520810,983,46600,,,,,,,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN,89.48,35.79,0,89.48,76.06,SKIPPED,89.48,89.48,76.06,76.06,76.06,44.35,43.85,43.85,0,26.84,45.26,45.26,0
4520811,983,11012,,,,,,,DBRDMT FX&/DISLC SUBQ T/M/F BONE,924.58,369.83,0,924.58,785.89,SKIPPED,924.58,924.58,785.89,785.89,785.89,448.7,453.04,453.04,SKIPPED,SKIPPED,457.86,457.86,0
4520812,983,26765,,,,,,,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,1077,430.8,0,1077,915.45,SKIPPED,1077,1077,915.45,915.45,915.45,552.46,527.73,527.73,SKIPPED,SKIPPED,563.73,563.73,0
4520813,983,25065,,,,,,,BX FOREARM SOFT TISSUES,351.28,140.51,0,351.28,298.59,SKIPPED,351.28,351.28,298.59,298.59,298.59,173.84,172.13,172.13,SKIPPED,SKIPPED,177.39,177.39,0
4520814,983,96374,,,,,,,THER/PROPH/DIAG INJ IV PUSH,97.32,38.93,0,97.32,82.72,SKIPPED,97.32,97.32,82.72,82.72,82.72,43.23,47.69,47.69,0,29.2,44.11,44.11,0
4520815,983,38505,,,,,,,NEEDLE BX LYMPH NODES,154.86,61.94,0,154.86,131.63,SKIPPED,154.86,154.86,131.63,131.63,131.63,93.88,75.88,75.88,SKIPPED,SKIPPED,95.8,95.8,0
4520816,983,64421,,,,,,,MULTI NERVE BLOCK INJ RIB AREA,201.42,80.57,0,201.42,171.21,SKIPPED,201.42,201.42,171.21,171.21,171.21,27.34,98.7,98.7,SKIPPED,SKIPPED,27.9,27.9,0
4520817,983,99456C,,,,,,,Psych Exam-Full Battery w/IQ & MSE,461.07,184.43,0,391.91,391.91,SKIPPED,350.41,350.41,391.91,391.91,391.91,0,225.92,225.92,0,138.32,0,0,0
4520818,510,,,,,,,,DDS NO SHOW CHARGE,67.5,27,0,57.38,57.38,SKIPPED,51.3,51.3,57.38,57.38,0,28.45,33.08,33.08,0,20.25,29.03,29.03,57.38
4520819,983,11446,,,,,,,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M,703.94,281.58,0,703.94,598.35,SKIPPED,703.94,703.94,598.35,598.35,598.35,348.62,344.93,344.93,SKIPPED,SKIPPED,355.73,355.73,0
4520820,983,28510,,,,,,,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MA,258.06,103.22,0,258.06,219.35,SKIPPED,258.06,258.06,219.35,219.35,219.35,131.42,126.45,126.45,0,77.42,134.1,134.1,0
4520821,983,28490,,,,,,,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,268.92,107.57,0,268.92,228.58,SKIPPED,268.92,268.92,228.58,228.58,228.58,137.03,131.77,131.77,SKIPPED,SKIPPED,139.83,139.83,0
4520822,983,99379,,,,,,,SUPERVISION NH PT 15-29 MIN PT NOT PRSNT,68,27.2,0,68,57.8,SKIPPED,68,68,57.8,57.8,57.8,0,33.32,33.32,0,20.4,0,0,0
4520823,983,99380,,,,,,,SUPERVISION NH PT >30 MIN PT NOT PRSNT,68,27.2,0,68,57.8,SKIPPED,68,68,57.8,57.8,57.8,0,33.32,33.32,0,20.4,0,0,0
4520824,983,26432,,,,,,,RPR FINGER TENDON,1053.6,421.44,0,1053.6,895.56,SKIPPED,1053.6,1053.6,895.56,895.56,895.56,612.95,516.26,516.26,SKIPPED,SKIPPED,625.46,625.46,0
4520825,983,12005,,,,,,,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-,207.28,82.91,0,207.28,176.19,SKIPPED,207.28,207.28,176.19,176.19,176.19,102.48,101.57,101.57,SKIPPED,SKIPPED,104.57,104.57,0
4520826,983,12041,,,,,,,RPR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM,326.38,130.55,0,326.38,277.42,SKIPPED,326.38,326.38,277.42,277.42,277.42,156.88,159.93,159.93,SKIPPED,SKIPPED,160.08,160.08,0
4520827,983,27508,,,,,,,TRT THIGH FX,1061.4,424.56,0,1020.78,902.19,SKIPPED,1020.78,1020.78,902.19,902.19,902.19,548.88,520.09,520.09,SKIPPED,SKIPPED,560.08,560.08,0
4520830,983,25660,,,,,,,TRT WRIST DISLOCATION,888.78,355.51,0,888.78,755.46,SKIPPED,888.78,888.78,755.46,755.46,755.46,495.32,435.5,435.5,SKIPPED,SKIPPED,505.43,505.43,0
4520831,983,19100,,,,,,,BX BREAT W/O IMAGE,151.98,60.79,0,151.98,129.18,SKIPPED,151.98,151.98,129.18,129.18,129.18,74.47,74.47,74.47,SKIPPED,SKIPPED,75.99,75.99,0
4520832,983,28270,,,,,,,RELEASE FOOT CONTRACTURE,729.96,291.98,0,729.96,620.47,SKIPPED,729.96,729.96,620.47,620.47,620.47,366.43,357.68,357.68,SKIPPED,SKIPPED,373.91,373.91,0
4520833,983,28153,,,,,,,PARTIAL REMOVAL OF TOE,577.08,230.83,0,577.08,490.52,SKIPPED,577.08,577.08,490.52,490.52,490.52,290.72,282.77,282.77,SKIPPED,SKIPPED,296.65,296.65,0
4520834,983,65220,,,,,,,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,91.84,36.74,0,91.84,78.06,SKIPPED,91.84,91.84,78.06,78.06,78.06,44.64,45,45,0,27.55,45.55,45.55,0
4520835,983,28124,,,,,,,PARTIAL EXCISION OF TOE,720.96,288.38,0,720.96,612.82,SKIPPED,720.96,720.96,612.82,612.82,612.82,366.3,353.27,353.27,SKIPPED,SKIPPED,373.78,373.78,0
4520836,983,26641,,,,,,,TREAT THUMB DISLOCATION,745.52,298.21,0,633.69,633.69,SKIPPED,531.76,531.76,633.69,633.69,633.69,423.51,365.3,365.3,SKIPPED,SKIPPED,432.15,432.15,0
4520837,983,26775,,,,,,,CLTX IPHAL JT DISLC W/MANJ REQ ANES,739.88,295.95,0,628.9,628.9,SKIPPED,587.1,587.1,628.9,628.9,628.9,391.09,362.54,362.54,SKIPPED,SKIPPED,399.07,399.07,0
4520838,983,27246,,,,,,,CLTX GREATER TROCHANTERIC FX W/O MANJ,831.4,332.56,0,831.4,706.69,SKIPPED,831.4,831.4,706.69,706.69,706.69,424.87,407.39,407.39,SKIPPED,SKIPPED,433.54,433.54,0
4520839,983,26770,,,,,,,CLTX IPHAL JT DISLC W/MANJ W/O ANES,546.84,218.74,0,546.84,464.81,SKIPPED,546.84,546.84,464.81,464.81,464.81,287.97,267.95,267.95,0,164.05,293.85,293.85,0
4520840,983,90880,,,,,,,HYPNOSIS (CASH ONLY),201.62,80.65,0,171.38,171.38,SKIPPED,153.23,153.23,171.38,171.38,171.38,100.13,98.79,98.79,0,60.49,102.17,102.17,0
4520841,983,69210,,,,,,,Removal of impacted cerumen with instrum,71.56,28.62,0,71.56,60.83,SKIPPED,71.56,71.56,60.83,60.83,60.83,35.9,35.06,35.06,0,21.47,36.63,36.63,0
4520842,983,90863,,,,,,,PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY,52,20.8,0,44.2,44.2,SKIPPED,39.52,39.52,44.2,44.2,44.2,0,25.48,25.48,0,15.6,0,0,0
4520843,983,64445,,,,,,,N BLOCK INJ SCIATIC SNG,159.74,63.9,0,159.74,135.78,SKIPPED,159.74,159.74,135.78,135.78,135.78,58.78,78.27,78.27,0,47.92,59.98,59.98,0
4520844,983,11771,,,,,,,RMV PILONIDAL CYST,939.5,375.8,0,939.5,798.58,SKIPPED,939.5,939.5,798.58,798.58,798.58,489.52,460.36,460.36,SKIPPED,SKIPPED,499.51,499.51,0
4520845,983,99339,,,,,,,"DOMICILIARY, REST HOME",151.88,60.75,0,129.1,129.1,SKIPPED,115.43,115.43,129.1,129.1,129.1,0,74.42,74.42,0,45.56,0,0,0
4520846,983,46030,,,,,,,REMOVAL ANAL SETON OTHER MARKER,195.52,78.21,0,195.52,166.19,SKIPPED,195.52,195.52,166.19,166.19,166.19,94.7,95.8,95.8,SKIPPED,SKIPPED,96.63,96.63,0
4520847,983,24075,,,,,,,EXCISION ELBOW TUMOR,712.54,285.02,0,712.54,605.66,SKIPPED,712.54,712.54,605.66,605.66,605.66,360.55,349.14,349.14,SKIPPED,SKIPPED,367.91,367.91,0
4520848,983,12042,,,,,,,INTMD RPR N-HF/GENIT2.6-7.5,434.74,173.9,0,434.74,369.53,SKIPPED,434.74,434.74,369.53,369.53,369.53,212.94,213.02,213.02,SKIPPED,SKIPPED,217.29,217.29,0
4520849,983,56420,,,,,,,INCISION/DRAIN OF BARTHOLIN GLAND,195.36,78.14,0,195.36,166.06,SKIPPED,195.36,195.36,166.06,166.06,166.06,122.94,95.73,95.73,SKIPPED,SKIPPED,125.45,125.45,0
4520850,983,19020,,,,,,,INCISION/DRAIN BREAST LESION,660.68,264.27,0,660.68,561.58,SKIPPED,660.68,660.68,561.58,561.58,561.58,340.6,323.73,323.73,SKIPPED,SKIPPED,347.55,347.55,0
4520851,983,19101,,,,,,,OPEN BX OF BREAST,477.6,191.04,0,477.6,405.96,SKIPPED,477.6,477.6,405.96,405.96,405.96,243.33,234.02,234.02,SKIPPED,SKIPPED,248.3,248.3,0
4520852,983,27618,,,,,,,EXC TUMOR SOFT TISSUE OF LEG/ANKLE>3CM,666.74,266.7,0,666.74,566.73,SKIPPED,666.74,666.74,566.73,566.73,566.73,334.75,326.7,326.7,SKIPPED,SKIPPED,341.58,341.58,0
4520853,983,28108,,,,,,,EXC/CURTG CST/B9 TUM PHALANGES FOOT,629.24,251.7,0,629.24,534.85,SKIPPED,629.24,629.24,534.85,534.85,534.85,316.48,308.33,308.33,SKIPPED,SKIPPED,322.94,322.94,0
4520854,983,28232,,,,,,,"TENOTOMY, OPEN, TENDON FLEXOR",528.88,211.55,0,528.88,449.55,SKIPPED,528.88,528.88,449.55,449.55,449.55,264.48,259.15,259.15,SKIPPED,SKIPPED,269.88,269.88,0
4520855,983,57456,,,,,,,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,221.88,88.75,0,221.88,188.6,SKIPPED,221.88,221.88,188.6,188.6,188.6,110.04,108.72,108.72,SKIPPED,SKIPPED,112.29,112.29,0
4520856,983,27767,,,,,,,CLOSED TREATMENT PST MALLEOLUS FRACTURE,605.26,242.1,0,531.76,514.47,SKIPPED,531.76,531.76,514.47,514.47,514.47,321.81,296.58,296.58,SKIPPED,SKIPPED,328.38,328.38,0
4520857,983,24530,,,,,,,TRT HUMERUS FX,737.8,295.12,0,737.8,627.13,SKIPPED,737.8,737.8,627.13,627.13,627.13,389.24,361.52,361.52,SKIPPED,SKIPPED,397.18,397.18,0
4520858,983,25500,,,,,,,closed treatment of radial shaft fractur,536.04,214.42,0,531.76,455.63,SKIPPED,531.76,531.76,455.63,455.63,455.63,285.61,262.66,262.66,SKIPPED,SKIPPED,291.44,291.44,0
4520859,983,49180,,,,,,,NEEDLE BX ABDOMEN,189.02,75.61,0,189.02,160.67,SKIPPED,189.02,189.02,160.67,160.67,160.67,90.77,92.62,92.62,SKIPPED,SKIPPED,92.62,92.62,0
4520860,983,21011,,,,,,,EXC TUMOR OF FACE,556.76,222.7,0,556.76,473.25,SKIPPED,556.76,556.76,473.25,473.25,473.25,282.74,272.81,272.81,0,167.03,288.51,288.51,0
4520861,983,67820,,,,,,,REVISE EYELASHES,91.36,36.54,0,91.36,77.66,SKIPPED,91.36,91.36,77.66,77.66,77.66,24.11,44.77,44.77,0,27.41,24.6,24.6,0
4520862,983,11770,,,,,,,REMOVE PILONIDAL CYST SIMPLE,398.5,159.4,0,398.5,338.72,SKIPPED,398.5,398.5,338.72,338.72,338.72,201.96,195.26,195.26,SKIPPED,SKIPPED,206.08,206.08,0
4520863,510,90473,,,,,,,IMMUNE ADMN ORAL/NASAL,45,18,0,45,38.25,SKIPPED,45,45,38.25,38.25,0,18.96,22.05,22.05,0,13.5,19.35,19.35,38.25
4520864,510,90474,,,,,,,IMMUNE ADMN ORAL/NASAL ADDL.,26,10.4,0,26,22.1,SKIPPED,26,26,22.1,22.1,0,10.96,12.74,12.74,0,7.8,11.18,11.18,22.1
4520865,983,46900,,,,,,,DESTRUCTION LESION ANUS-SIMPLE,297,118.8,0,297,252.45,SKIPPED,297,297,252.45,252.45,252.45,149.83,145.53,145.53,0,89.1,152.89,152.89,0
4520866,983,46910,,,,,,,DESTRUCTION LESION ANUS-ELECT.,291.5,116.6,0,291.5,247.78,SKIPPED,291.5,291.5,247.78,247.78,247.78,147.85,142.84,142.84,0,87.45,150.87,150.87,0
4520867,983,46922,,,,,,,EXCISION OF ANAL LESION(S),293.78,117.51,0,293.78,249.71,SKIPPED,293.78,293.78,249.71,249.71,249.71,150.03,143.95,143.95,SKIPPED,SKIPPED,153.09,153.09,0
4520868,983,49422,,,,,,,Removal of tunneled intraperitoneal cath,825.9,330.36,0,825.9,702.02,SKIPPED,825.9,825.9,702.02,702.02,702.02,238.12,404.69,404.69,SKIPPED,SKIPPED,242.98,242.98,0
4520869,983,37609,,,,,,,"Ligation or biopsy, temporal artery",448.54,179.42,0,448.54,381.26,SKIPPED,448.54,448.54,381.26,381.26,381.26,221.43,219.78,219.78,SKIPPED,SKIPPED,225.95,225.95,0
4520870,983,24640,,,,,,,Closed treatment of child nursemaid elbo,169,67.6,0,169,143.65,SKIPPED,169,169,143.65,143.65,143.65,89.54,82.81,82.81,SKIPPED,SKIPPED,91.37,91.37,0
4520871,983,22310,,,,,,,CLOSED TX VERT FX W/O MANI REQ CAST/BRAC,612,244.8,0,612,520.2,SKIPPED,612,612,520.2,520.2,520.2,324.47,299.88,299.88,SKIPPED,SKIPPED,331.09,331.09,0
4520872,983,11102,,,,,,,TANGENTIAL BX SKIN SINGLE LES,79.1,31.64,0,79.1,67.24,SKIPPED,79.1,79.1,67.24,67.24,67.24,41.11,38.76,38.76,0,23.73,41.95,41.95,0
4520873,983,11103,,,,,,,TANGNTL BX SKIN EA SEP/ADDL,45.8,18.32,0,38.93,38.93,SKIPPED,0,0,38.93,38.93,38.93,23.92,22.44,22.44,0,13.74,24.41,24.41,0
4520874,983,65222,,,,,,,"Removal of foreign body, external eye; c",113.46,45.38,0,113.46,96.44,SKIPPED,113.46,113.46,96.44,96.44,96.44,55.13,55.6,55.6,0,34.04,56.26,56.26,0
4520875,983,23570,,,,,,,Closed treatment of scapular fracture,511.26,204.5,0,511.26,434.57,SKIPPED,511.26,511.26,434.57,434.57,434.57,268.77,250.52,250.52,SKIPPED,SKIPPED,274.26,274.26,0
4520876,983,12031,,,,,,,Repair-Intermediate 2.5 cm or less scal,331.8,132.72,0,331.8,282.03,SKIPPED,331.8,331.8,282.03,282.03,282.03,164.52,162.58,162.58,SKIPPED,SKIPPED,167.88,167.88,0
4520877,983,17999,,,,,,,"UNLISTED PROC.SKIN, MUCOUS MEMBRANE,SUBQ",1008,403.2,0,856.8,856.8,SKIPPED,802.51,802.51,856.8,856.8,856.8,0,493.92,493.92,0,302.4,0,0,0
4520878,983,46221,,,,,,,LIGATION OF HEMORRHOID,412.56,165.02,0,412.56,350.68,SKIPPED,412.56,412.56,350.68,350.68,350.68,214.5,202.15,202.15,SKIPPED,SKIPPED,218.88,218.88,0
4520879,983,69110,,,,,,,REMOVE EXTERNAL EAR PARTIAL,691.34,276.54,0,691.34,587.64,SKIPPED,691.34,691.34,587.64,587.64,587.64,363.09,338.76,338.76,SKIPPED,SKIPPED,370.5,370.5,0
4520880,983,99489,,,,,,,CMPLX CHRON CARE ADDL 30 MIN,56.7,22.68,0,57.01,48.2,SKIPPED,56.7,56.7,48.2,48.2,48.2,55.87,27.78,27.78,0,17.01,57.01,57.01,0
4520881,983,99487,,,,,,,CMPLX CHRON CARE W/O PT VSIT,113.42,45.37,0,113.42,96.41,SKIPPED,113.42,113.42,96.41,96.41,96.41,101.41,55.58,55.58,0,34.03,103.48,103.48,0
4520882,983,20520,,,,,,,RMV FOREIGN BODY-SIMPLE,317.72,127.09,0,317.72,270.06,SKIPPED,317.72,317.72,270.06,270.06,270.06,161.46,155.68,155.68,0,95.32,164.75,164.75,0
4520883,983,12014,,,,,,,Repair of superficial wounds face 5.1cm,163.1,65.24,0,163.1,138.64,SKIPPED,163.1,163.1,138.64,138.64,138.64,80.59,79.92,79.92,0,48.93,82.23,82.23,0
4520884,983,29445,,,,,,,APPLICATION RIDGE TOTAL ONTACT LEG CAST,224.84,89.94,0,224.84,191.11,SKIPPED,224.84,224.84,191.11,191.11,191.11,108.62,110.17,110.17,SKIPPED,SKIPPED,110.84,110.84,0
4520885,983,40810,,,,,,,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH,250.02,100.01,0,250.02,212.52,SKIPPED,250.02,250.02,212.52,212.52,212.52,134.39,122.51,122.51,0,75.01,137.13,137.13,0
4520886,983,17280,,,,,,,Destruct. malig.lesion face (0.5 cm or <,178.04,71.22,0,178.04,151.33,SKIPPED,178.04,178.04,151.33,151.33,151.33,93.67,87.24,87.24,0,53.41,95.58,95.58,0
4520887,983,17281,,,,,,,Destruction malignant lesion face (0.6 t,244.58,97.83,0,244.58,207.89,SKIPPED,244.58,244.58,207.89,207.89,207.89,128.25,119.84,119.84,SKIPPED,SKIPPED,130.87,130.87,0
4520888,983,17282,,,,,,,Destruction malignant lesion face (1.1 t,283.46,113.38,0,283.46,240.94,SKIPPED,283.46,283.46,240.94,240.94,240.94,148.12,138.9,138.9,SKIPPED,SKIPPED,151.14,151.14,0
4520889,983,17283,,,,,,,Destruction malignant lesion face (2.1 t,354.86,141.94,0,354.86,301.63,SKIPPED,354.86,354.86,301.63,301.63,301.63,184.73,173.88,173.88,SKIPPED,SKIPPED,188.5,188.5,0
4520890,983,17284,,,,,,,Destruction malignant lesion face (3.1 t,413.32,165.33,0,413.32,351.32,SKIPPED,413.32,413.32,351.32,351.32,351.32,216.28,202.53,202.53,SKIPPED,SKIPPED,220.69,220.69,0
4520891,983,17286,,,,,,,Destruction malignant lesion face (Over,556.48,222.59,0,556.48,473.01,SKIPPED,556.48,556.48,473.01,473.01,473.01,292.54,272.68,272.68,SKIPPED,SKIPPED,298.51,298.51,0
4520892,983,49460,,,,,,,Mechanical removal of obstructive materi,97.24,38.9,0,97.24,82.65,SKIPPED,97.24,97.24,82.65,82.65,82.65,52.98,47.65,47.65,SKIPPED,SKIPPED,54.06,54.06,0
4520893,983,24620,,,,,,,CLOSED TX ELBOW FX W/ MANIP,1092.7,437.08,0,1092.7,928.8,SKIPPED,1092.7,1092.7,928.8,928.8,928.8,619.75,535.42,535.42,SKIPPED,SKIPPED,632.4,632.4,0
4520894,983,96160,,,,,,,PT-FOCUSED HLTH RISK ASSMT,6,2.4,0,6,5.1,SKIPPED,6,6,5.1,5.1,5.1,2.98,2.94,2.94,0,1.8,3.04,3.04,0
4520895,983,96161,,,,,,,CAREGIVER HLTH RISK ASSMT SCORE,6,2.4,0,6,5.1,SKIPPED,6,6,5.1,5.1,5.1,2.98,2.94,2.94,0,1.8,3.04,3.04,0
4520896,983,11106,,,,,,,INCISIONAL BIOPSY SKIN SINGLE LESION,117.72,47.09,0,117.72,100.06,SKIPPED,117.72,117.72,100.06,100.06,100.06,62,57.68,57.68,0,35.32,63.27,63.27,0
4520897,983,24670,,,,,,,CLOSED TX ULNAR FRACTURE PROXIMAL END W/,521.5,208.6,0,521.5,443.28,SKIPPED,521.5,521.5,443.28,443.28,443.28,297.48,255.54,255.54,SKIPPED,SKIPPED,303.55,303.55,0
4520898,983,43762,,,,,,,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTR,75.84,30.34,0,75.84,64.46,SKIPPED,75.84,75.84,64.46,64.46,64.46,40.18,37.16,37.16,0,22.75,41,41,0
4520899,983,28288,,,,,,,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,862.84,345.14,0,862.84,733.41,SKIPPED,862.84,862.84,733.41,733.41,733.41,476.51,422.79,422.79,SKIPPED,SKIPPED,486.23,486.23,0
4520900,983,64520,,,,,,,INJECTION ANES LMBR/THRC PARAVERTBRL SYM,165.44,66.18,0,165.44,140.62,SKIPPED,165.44,165.44,140.62,140.62,140.62,92.63,81.07,81.07,SKIPPED,SKIPPED,94.52,94.52,0
4520901,983,64447,,,,,,,INJECTION AA&/STRD FEMORAL NERVE,107.12,42.85,0,107.12,91.05,SKIPPED,107.12,107.12,91.05,91.05,91.05,57.99,52.49,52.49,0,32.14,59.17,59.17,0
4520902,983,19120,,,,,,,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/>,817.1,326.84,0,817.1,694.54,SKIPPED,817.1,817.1,694.54,694.54,694.54,452.67,400.38,400.38,SKIPPED,SKIPPED,461.91,461.91,0
4520903,636,C1762,,,,,,,NUCEL 2CC,3735,1494,0,3174.75,3174.75,SKIPPED,2838.6,2838.6,3174.75,3174.75,3174.75,1573.93,1830.15,1830.15,0,1120.5,1606.05,1606.05,3174.75
4520904,983,G2012,,,,,,,CMC VIRTUAL CHECK-IN,28.62,11.45,0,28.62,24.33,SKIPPED,28.62,28.62,24.33,24.33,24.33,13.93,14.02,14.02,0,8.59,14.21,14.21,0
4520905,983,G0071,,,,,,,MCMC VIRTUAL CHECK-IN,27.38,10.95,0,27.38,23.27,SKIPPED,27.38,27.38,23.27,23.27,23.27,0,13.42,13.42,0,8.21,0,0,0
4520906,983,64615,,,,,,,CHEMODENERVATION,238.98,95.59,0,238.98,203.13,SKIPPED,238.98,238.98,203.13,203.13,203.13,130.14,117.1,117.1,0,71.69,132.8,132.8,0
4520907,983,51700,,,,,,,IRRIGATION OF BLADDER,62.14,24.86,0,62.14,52.82,SKIPPED,62.14,62.14,52.82,52.82,52.82,33.27,30.45,30.45,0,18.64,33.95,33.95,0
4520908,983,24576,,,,,,,Closed treatment humeral condyle fx with,607.92,243.17,0,607.92,516.73,SKIPPED,607.92,607.92,516.73,516.73,516.73,347.92,297.88,297.88,SKIPPED,SKIPPED,355.02,355.02,0
4520909,983,13100,,,,,,,CMPLX RPR TRUNK 1.1-2.5 CM,402.12,160.85,0,402.12,341.8,SKIPPED,402.12,402.12,341.8,341.8,341.8,218.09,197.04,197.04,SKIPPED,SKIPPED,222.54,222.54,0
4520910,983,90840,,,,,,,PSYTX CRISIS EA ADDL 30 MIN,125.62,50.25,0,106.78,106.78,SKIPPED,95.47,95.47,106.78,106.78,106.78,70.32,61.55,61.55,0,37.69,71.75,71.75,0
4520911,983,64418,,,,,,,INJ AA&/STRD SUPRASCULAR NERVE,119.78,47.91,0,119.78,101.81,SKIPPED,119.78,119.78,101.81,101.81,101.81,61.65,58.69,58.69,0,35.93,62.91,62.91,0
4520912,983,28272,,,,,,,CAPSULOTOMY IPHAL JOINT EACH,504.8,201.92,0,504.8,429.08,SKIPPED,504.8,504.8,429.08,429.08,429.08,276.02,247.35,247.35,SKIPPED,SKIPPED,281.65,281.65,0
4520913,983,11107,,,,,,,INCISIONAL BX(ADD ON),63.34,25.34,0,53.84,53.84,SKIPPED,0,0,53.84,53.84,53.84,33.83,31.04,31.04,0,19,34.52,34.52,0
4520914,771,0011A,,,,,,,ADMIN 1ST DOSE COVID-19 VACCINE MODERNA,33.88,13.55,0,28.8,28.8,SKIPPED,25.75,25.75,28.8,28.8,28.8,14.28,16.6,16.6,0,10.16,14.57,14.57,0
4520915,771,0012A,,,,,,,ADMIN 2ND DOSE COVID-19 VACCINE MODERNA,56.78,22.71,0,48.26,48.26,SKIPPED,43.15,43.15,48.26,48.26,48.26,23.93,27.82,27.82,0,17.03,24.42,24.42,0
4520916,510,64420,,,,,,,N BLOCK INJ INTERCOST SNG,1415.23,566.09,0,1415.23,1202.95,SKIPPED,1415.23,1415.23,1202.95,1202.95,0,596.38,693.46,693.46,SKIPPED,SKIPPED,608.55,608.55,1202.95
4520917,983,28240,,,,,,,RELEASE OF BIG TOE,574.9,229.96,0,574.9,488.66,SKIPPED,574.9,574.9,488.66,488.66,488.66,322.85,281.7,281.7,SKIPPED,SKIPPED,329.44,329.44,0
4520918,771,0001A,,,,,,,ADMIN 1ST DOSE COVID-19 VACCINE PFIZER,33.88,13.55,0,28.8,28.8,SKIPPED,25.75,25.75,28.8,28.8,28.8,14.28,16.6,16.6,0,10.16,14.57,14.57,0
4520919,771,0002A,,,,,,,ADMIN 2ND DOSE COVID-19 VACCINE PFIZER,56.78,22.71,0,48.26,48.26,SKIPPED,43.15,43.15,48.26,48.26,48.26,23.93,27.82,27.82,0,17.03,24.42,24.42,0
4520920,983,99417,,,,,,,PROLONGED E/M EACH 15 MIN,50,20,0,42.5,42.5,SKIPPED,38,38,42.5,42.5,42.5,0,24.5,24.5,0,15,0,0,0
4520921,983,99356,,,,,,,"PROLONGED SERVICE INP/OBS, FIRST HOUR",165,66,0,165,140.25,SKIPPED,165,165,140.25,140.25,140.25,98.63,80.85,80.85,0,49.5,100.64,100.64,0
4520922,983,99357,,,,,,,"PROLONGED SERVICE INP/OBS, EACH ADDTL 30",85,34,0,101.02,72.25,SKIPPED,85,85,72.25,72.25,72.25,99,41.65,41.65,0,25.5,101.02,101.02,0
4520923,771,0031A,,,,,,,ADMIN COVID-19 JOHNSON & JOHNSON VACCINE,33.88,13.55,0,28.8,28.8,SKIPPED,25.75,25.75,28.8,28.8,28.8,14.28,16.6,16.6,0,10.16,14.57,14.57,0
4520924,983,99439,,,,,,,CHRON CARE MANAGEMENT EA ADDL 20 MIN,54.64,21.86,0,46.44,46.44,SKIPPED,41.53,41.53,46.44,46.44,46.44,39.61,26.77,26.77,0,16.39,40.42,40.42,0
4520925,771,0003A,,,,,,,ADMIN 3RD DOSE COVID-19 VACCINE PFIZER,56.78,22.71,0,48.26,48.26,SKIPPED,43.15,43.15,48.26,48.26,48.26,23.93,27.82,27.82,0,17.03,24.42,24.42,0
4520926,771,0013A,,,,,,,ADMIN 3RD DOSE COVID-19 VACCINE MODERNA,56.78,22.71,0,48.26,48.26,SKIPPED,43.15,43.15,48.26,48.26,48.26,23.93,27.82,27.82,0,17.03,24.42,24.42,0
4520927,983,G0101,,,,,,,CA SCREEN;PELVIC/BREAST EXAM,53.18,21.27,0,53.18,45.2,SKIPPED,53.18,53.18,45.2,45.2,45.2,30.17,26.06,26.06,0,15.95,30.79,30.79,0
4520928,771,0071A,,,,,,,ADMIN 1ST DOSE PEDI COVID VACCINE,33.88,13.55,0,28.8,28.8,SKIPPED,25.75,25.75,28.8,28.8,28.8,14.28,16.6,16.6,0,10.16,14.57,14.57,0
4520929,983,Q0091,,,,,,,SCREENING PAP SMEAR,36.48,14.59,0,36.48,31.01,SKIPPED,36.48,36.48,31.01,31.01,31.01,20.56,17.88,17.88,0,10.94,20.98,20.98,0
4520930,983,27824,,,,,,,CLOSED TRT DISTAL TIBIA W/O MANIPULATION,599.44,239.78,0,599.44,509.52,SKIPPED,599.44,599.44,509.52,509.52,509.52,337.79,293.73,293.73,SKIPPED,SKIPPED,344.68,344.68,0
4520931,983,99358,,,,,,,PROLONGED SERVICE NON FACE TO FACE ONLY,214.46,85.78,0,214.46,182.29,SKIPPED,214.46,214.46,182.29,182.29,182.29,120.84,105.09,105.09,0,64.34,123.31,123.31,0
4520932,983,99359,,,,,,,PROLONGED SERVICE NON FACE/FACE 15 ADDTL,107.23,42.89,0,107.23,91.15,SKIPPED,107.23,107.23,91.15,91.15,91.15,58.56,52.54,52.54,0,32.17,59.75,59.75,0
4520933,771,0004A,,,,,,,ADMIN 4TH DOSE COVID-19 VACCINE PFIZER,56.78,22.71,0,48.26,48.26,SKIPPED,43.15,43.15,48.26,48.26,48.26,23.93,27.82,27.82,0,17.03,24.42,24.42,0
4520934,771,0064A,,,,,,,ADMIN 4TH DOSE COVID-19 VACCINE MODERNA,56.78,22.71,0,48.26,48.26,SKIPPED,43.15,43.15,48.26,48.26,48.26,23.93,27.82,27.82,0,17.03,24.42,24.42,0
4520935,771,0074A,,,,,,,ADMIN BOOTER(PEDI) COVID-19 VACC. PFIZER,56.98,22.79,0,48.43,48.43,SKIPPED,43.3,43.3,48.43,48.43,48.43,24.01,27.92,27.92,0,17.09,24.5,24.5,0
4520936,972,10005,,,,,,,FNA W/IMAGE,1498.35,599.34,0,1273.6,1273.6,SKIPPED,338.91,338.91,1273.6,1273.6,1273.6,80.93,734.19,734.19,0,449.5,82.58,82.58,0
4520937,983,37785,,,,,,,INCISION AND REMOVAL OF VARICOSE VEIN,488.2,195.28,0,488.2,414.97,SKIPPED,488.2,488.2,414.97,414.97,414.97,275.11,239.22,239.22,SKIPPED,SKIPPED,280.72,280.72,0
4520938,983,27337,,,,,,,EXC THIGH/KNEE LES SC 3 CM/>,810.78,324.31,0,810.78,689.16,SKIPPED,810.78,810.78,689.16,689.16,689.16,456.88,397.28,397.28,SKIPPED,SKIPPED,466.2,466.2,0
45299442,983,99442,,,,,,,PHONE E/M PHYS/QHP 11-20 MIN,105,42,0,105,89.25,SKIPPED,105,105,89.25,89.25,89.25,73.24,51.45,51.45,0,31.5,74.73,74.73,0
45299443,983,99443,,,,,,,PHONE E/M PHYS/QHP 21-30 MIN,120.8,48.32,0,120.8,102.68,SKIPPED,120.8,120.8,102.68,102.68,102.68,108.16,59.19,59.19,0,36.24,110.37,110.37,0
4590001,540,A0425,,,,,,,GROUND MILEAGE,20.11,8.04,0,17.09,17.09,SKIPPED,15.28,15.28,17.09,17.09,17.09,7.86,9.85,9.85,0,6.03,8.02,8.02,17.09
4590002,542,A0426,,,,,,,ALS NON EMERGENCY,814.37,325.75,0,692.21,692.21,SKIPPED,618.92,618.92,692.21,692.21,692.21,283.8,399.04,399.04,0,244.31,289.59,289.59,692.21
4590003,542,A0427,,,,,,,ALS EMERGENCY,1222.44,488.98,0,1039.07,1039.07,SKIPPED,929.05,929.05,1039.07,1039.07,1039.07,449.35,599,599,0,366.73,458.52,458.52,1039.07
4590004,542,A0428,,,,,,,BLS NON EMERGENCY,651.7,260.68,0,553.94,553.94,SKIPPED,495.29,495.29,553.94,553.94,553.94,236.5,319.33,319.33,0,195.51,241.33,241.33,553.94
4590005,542,A0429,,,,,,,BLS EMERGENCY,977.33,390.93,0,830.73,830.73,SKIPPED,742.77,742.77,830.73,830.73,830.73,378.4,478.89,478.89,0,293.2,386.12,386.12,830.73
4590006,542,A0433,,,,,,,ALS 2,1385.25,554.1,0,1177.46,1177.46,SKIPPED,1052.79,1052.79,1177.46,1177.46,1177.46,650.38,678.77,678.77,0,415.58,663.65,663.65,1177.46
4590007,542,A0434,,,,,,,SPECIALTY CARE TRANSPORT,1628.88,651.55,0,1384.55,1384.55,SKIPPED,1237.95,1237.95,1384.55,1384.55,1384.55,768.62,798.15,798.15,0,488.66,784.31,784.31,1384.55
4590008,542,A0425,,,,,,,FOOTBALL STANDBY,311.06,124.42,0,264.4,264.4,SKIPPED,236.41,236.41,264.4,264.4,264.4,24.7,152.42,152.42,0,93.32,25.2,25.2,264.4
4590009,542,,,,,,,,WHEELCHAIR VAN TRANSPORT,62.04,24.82,0,52.73,52.73,SKIPPED,47.15,47.15,52.73,52.73,52.73,26.15,30.4,30.4,0,18.61,26.68,26.68,52.73
4590010,542,A0998,,,,,,,EMT STANDBY,122.62,49.05,0,104.23,104.23,SKIPPED,93.19,93.19,104.23,104.23,104.23,51.68,60.08,60.08,0,36.79,52.73,52.73,104.23
4590011,542,A0998,,,,,,,PARAMEDIC STANDBY,203.16,81.26,0,172.69,172.69,SKIPPED,154.4,154.4,172.69,172.69,172.69,85.61,99.55,99.55,0,60.95,87.36,87.36,172.69
4590012,542,A0998,,,,,,,AMBULANCE STANDBY,325.77,130.31,0,276.9,276.9,SKIPPED,247.59,247.59,276.9,276.9,276.9,137.28,159.63,159.63,0,97.73,140.08,140.08,276.9
4590013,549,,,,,,,,CPR TRAINING,38.86,15.54,0,33.03,33.03,SKIPPED,29.53,29.53,33.03,33.03,33.03,16.38,19.04,19.04,0,11.66,16.71,16.71,33.03
4590015,542,,,,,,,,PRISON AMBULANCE NO TRANSPORT,351.77,140.71,0,299,299,SKIPPED,267.35,267.35,299,299,299,148.23,172.37,172.37,0,105.53,151.26,151.26,299
4590016,540,A0420,,,,,,,AMBULANCE WAIT TIME/30 MIN INCREMENTS,76.58,30.63,0,65.09,65.09,SKIPPED,58.2,58.2,65.09,65.09,65.09,32.27,37.52,37.52,0,22.97,32.93,32.93,65.09
4590017,540,A0398,,,,,,,DISPOSABLE SUPPLIES,44.68,17.87,0,37.98,37.98,SKIPPED,33.96,33.96,37.98,37.98,37.98,18.83,21.89,21.89,0,13.4,19.21,19.21,37.98
4590018,540,A0998,,,,,,,AMBULANCE RESPONSE/TREATMENT,651.7,260.68,0,553.94,553.94,SKIPPED,495.29,495.29,553.94,553.94,553.94,274.63,319.33,319.33,0,195.51,280.23,280.23,553.94
4590019,300,82962,,,,,,,BLOOD GLUCOSE CHECK,38.39,15.36,0,32.63,32.63,SKIPPED,12.46,12.46,32.63,32.63,32.63,16.18,18.81,18.81,0,11.52,16.51,16.51,32.63
4593023,540,,,,,,,,NECK IMMOBILIZATION,29.19,11.68,0,24.81,24.81,SKIPPED,22.18,22.18,24.81,24.81,24.81,12.3,14.3,14.3,0,8.76,12.55,12.55,24.81
4593031,540,,,,,,,,SPINE IMMOBILIZATION,21.84,8.74,0,18.56,18.56,SKIPPED,16.6,16.6,18.56,18.56,18.56,9.2,10.7,10.7,0,6.55,9.39,9.39,18.56
4613000,110,,,,,,,,ROOM & BOARD 1BR/1PE,2704.5,1081.8,0,4322,2298.82,SKIPPED,1676.79,1676.79,2298.82,0,2298.82,4235.56,0,0,0,0,4322,4322,0
4614000,110,,,,,,,,ROOM & BOARD 1BR/2PE,3221.1,1288.44,0,4322,2737.94,SKIPPED,1997.08,1997.08,2737.94,0,2737.94,4235.56,0,0,0,0,4322,4322,0
4615000,110,,,,,,,,ROOM & BOARD 2BR/1PE,3464.2,1385.68,0,4322,2944.57,SKIPPED,2147.8,2147.8,2944.57,0,2944.57,4235.56,0,0,0,0,4322,4322,0
4616000,110,,,,,,,,ROOM & BOARD 2BR/2PE,3980.78,1592.31,0,4322,3383.66,SKIPPED,2468.08,2468.08,3383.66,0,3383.66,4235.56,0,0,0,0,4322,4322,0
4617000,110,,,,,,,,ROOM & BOARD STUDIO,2321.62,928.65,0,4322,1973.38,SKIPPED,1439.4,1439.4,1973.38,0,1973.38,4235.56,0,0,0,0,4322,4322,0
4650001,120,,,,,,,,MEADOWS SEMI PRIVATE R&B,170.17,68.07,0,4322,144.64,SKIPPED,105.51,105.51,144.64,0,144.64,4235.56,0,0,0,0,4322,4322,0
4650002,120,,,,,,,,MEADOWS PRIVATE R&B,188.4,75.36,0,4322,160.14,SKIPPED,116.81,116.81,160.14,0,160.14,4235.56,0,0,0,0,4322,4322,0
4650003,120,,,,,,,,MEADOWS DELUXE R&B,194.48,77.79,0,4322,165.31,SKIPPED,120.58,120.58,165.31,0,165.31,4235.56,0,0,0,0,4322,4322,0
4650004,120,,,,,,,,MEADOWS BED HOLD,97.24,38.9,0,4322,82.65,SKIPPED,60.29,60.29,82.65,0,82.65,4235.56,0,0,0,0,4322,4322,0
4650006,120,,,,,,,,MEADOWS MEDICARE R&B,303.88,121.55,0,4322,258.3,SKIPPED,188.41,188.41,258.3,0,258.3,4235.56,0,0,0,0,4322,4322,0
4650500,120,,,,,,,,RAD,227.89,91.16,0,4322,193.71,SKIPPED,141.29,141.29,193.71,0,193.71,4235.56,0,0,0,0,4322,4322,0
4650501,120,,,,,,,,RAC,202.02,80.81,0,4322,171.72,SKIPPED,125.25,125.25,171.72,0,171.72,4235.56,0,0,0,0,4322,4322,0
4650502,120,,,,,,,,RAB,190.1,76.04,0,4322,161.58,SKIPPED,117.86,117.86,161.58,0,161.58,4235.56,0,0,0,0,4322,4322,0
4650503,120,,,,,,,,RAA,167.94,67.18,0,4322,142.75,SKIPPED,104.12,104.12,142.75,0,142.75,4235.56,0,0,0,0,4322,4322,0
4650505,120,,,,,,,,SE2,246.66,98.66,0,4322,209.66,SKIPPED,152.93,152.93,209.66,0,209.66,4235.56,0,0,0,0,4322,4322,0
4650508,120,,,,,,,,SSB,186.41,74.56,0,4322,158.45,SKIPPED,115.57,115.57,158.45,0,158.45,4235.56,0,0,0,0,4322,4322,0
4650509,120,,,,,,,,SSA,186.01,74.4,0,4322,158.11,SKIPPED,115.33,115.33,158.11,0,158.11,4235.56,0,0,0,0,4322,4322,0
4650510,120,,,,,,,,CC2,161.9,64.76,0,4322,137.62,SKIPPED,100.38,100.38,137.62,0,137.62,4235.56,0,0,0,0,4322,4322,0
4650511,120,,,,,,,,CC1,153.69,61.48,0,4322,130.64,SKIPPED,95.29,95.29,130.64,0,130.64,4235.56,0,0,0,0,4322,4322,0
4650512,120,,,,,,,,CB2,149.04,59.62,0,4322,126.68,SKIPPED,92.4,92.4,126.68,0,126.68,4235.56,0,0,0,0,4322,4322,0
4650513,120,,,,,,,,CB1,142.59,57.04,0,4322,121.2,SKIPPED,88.41,88.41,121.2,0,121.2,4235.56,0,0,0,0,4322,4322,0
4650514,120,,,,,,,,CA2,135.67,54.27,0,4322,115.32,SKIPPED,84.12,84.12,115.32,0,115.32,4235.56,0,0,0,0,4322,4322,0
4650515,120,,,,,,,,CA1,127.9,51.16,0,4322,108.72,SKIPPED,79.3,79.3,108.72,0,108.72,4235.56,0,0,0,0,4322,4322,0
4650517,120,,,,,,,,IB1,127.09,50.84,0,4322,108.03,SKIPPED,78.8,78.8,108.03,0,108.03,4235.56,0,0,0,0,4322,4322,0
4650519,120,,,,,,,,IA1,110.89,44.36,0,4322,94.26,SKIPPED,68.75,68.75,94.26,0,94.26,4235.56,0,0,0,0,4322,4322,0
4650523,120,,,,,,,,BA1,104.22,41.69,0,4322,88.59,SKIPPED,64.62,64.62,88.59,0,88.59,4235.56,0,0,0,0,4322,4322,0
4650525,120,,,,,,,,PE1,135.83,54.33,0,4322,115.46,SKIPPED,84.21,84.21,115.46,0,115.46,4235.56,0,0,0,0,4322,4322,0
4650526,120,,,,,,,,PD2,137.64,55.06,0,4322,116.99,SKIPPED,85.34,85.34,116.99,0,116.99,4235.56,0,0,0,0,4322,4322,0
4650527,120,,,,,,,,PD1,129.89,51.96,0,4322,110.41,SKIPPED,80.53,80.53,110.41,0,110.41,4235.56,0,0,0,0,4322,4322,0
4650528,120,,,,,,,,PC2,126.61,50.64,0,4322,107.62,SKIPPED,78.5,78.5,107.62,0,107.62,4235.56,0,0,0,0,4322,4322,0
4650529,120,,,,,,,,PC1,121.65,48.66,0,4322,103.4,SKIPPED,75.42,75.42,103.4,0,103.4,4235.56,0,0,0,0,4322,4322,0
4650531,120,,,,,,,,PB1,113.17,45.27,0,4322,96.19,SKIPPED,70.17,70.17,96.19,0,96.19,4235.56,0,0,0,0,4322,4322,0
4650533,120,,,,,,,,PA1,100.84,40.34,0,4322,85.71,SKIPPED,62.52,62.52,85.71,0,85.71,4235.56,0,0,0,0,4322,4322,0
4666908,301,83615,,,,,,,LDH,92.38,36.95,0,78.52,78.52,SKIPPED,28.31,28.31,78.52,78.52,78.52,38.93,5.07,5.07,0,5.64,39.72,39.72,78.52
4780100,982,99334,,,,,,,NURS HOME EST PT MINOR,129.88,51.95,0,110.4,110.4,SKIPPED,98.71,98.71,110.4,110.4,110.4,66.04,63.64,63.64,0,38.96,67.39,67.39,0
4780200,982,99335,,,,,,,NURS HOME EST PT MODERATE,204.88,81.95,0,174.15,174.15,SKIPPED,155.71,155.71,174.15,174.15,174.15,104,100.39,100.39,0,61.46,106.12,106.12,0
4780300,982,99336,,,,,,,NURS HOME EST PT COMPLEX,292.68,117.07,0,248.78,248.78,SKIPPED,222.44,222.44,248.78,248.78,248.78,147.18,143.41,143.41,0,87.8,150.18,150.18,0
4780500,982,99325,,,,,,,NURS HOME NEW PT MODERATE,173.76,69.5,0,147.7,147.7,SKIPPED,132.06,132.06,147.7,147.7,147.7,86.28,85.14,85.14,0,52.13,88.04,88.04,0
4780600,982,99326,,,,,,,NURS HOME NEW PT COMPLEX,301.64,120.66,0,256.39,256.39,SKIPPED,229.25,229.25,256.39,256.39,256.39,150.01,147.8,147.8,0,90.49,153.07,153.07,0
4841402,521,73521,,,,,,,HIP JOINT BILATERAL,177.5,71,0,177.5,150.88,SKIPPED,177.5,177.5,150.88,150.88,150.88,74.8,137.3,137.3,0,73.48,76.33,76.33,0
50G2025,521,G2025,,,,,,,MEDICARE RHC TELEHEALTH NH SUBS,150,60,0,127.5,127.5,SKIPPED,114,114,127.5,127.5,127.5,63.21,73.5,73.5,0,45,64.5,64.5,0
5110021,510,10021,,,,,,,FNA PROCEDURE W/O IMAGE,422.1,168.84,0,358.78,358.78,SKIPPED,347.13,347.13,358.78,358.78,0,177.87,206.83,206.83,0,126.63,181.5,181.5,358.78
5110040,510,10040,,,,,,,ACNE SURGERY,210,84,0,210,178.5,SKIPPED,210,210,178.5,178.5,0,88.49,102.9,102.9,0,63,90.3,90.3,178.5
5110060,521,10060,,,,,,,DRAIN SKIN ABSCESS,252,100.8,0,252,214.2,SKIPPED,252,252,214.2,214.2,214.2,106.19,123.48,123.48,0,75.6,108.36,108.36,0
5110061,521,10061,,,,,,,ABSCESS I&D COMP OR MULTI,252,100.8,0,252,214.2,SKIPPED,252,252,214.2,214.2,214.2,106.19,123.48,123.48,SKIPPED,SKIPPED,108.36,108.36,0
5110080,510,10080,,,,,,,DRAINAGE OF PILONIDAL CYST,437.9,175.16,0,437.9,372.22,SKIPPED,437.9,437.9,372.22,372.22,0,184.53,214.57,214.57,0,131.37,188.3,188.3,372.22
5110120,521,10120,,,,,,,REMOVAL FOREIGN BODY,433.7,173.48,0,433.7,368.64,SKIPPED,433.7,433.7,368.64,368.64,368.64,182.76,212.51,212.51,SKIPPED,SKIPPED,186.49,186.49,0
5110121,521,10121,,,,,,,INCISION & REMOVE FOREIGN BODY,1805,722,0,1805,1534.25,SKIPPED,1805,1805,1534.25,1534.25,1534.25,760.63,884.45,884.45,SKIPPED,SKIPPED,776.15,776.15,0
5110140,521,10140,,,,,,,"I&D HEMATOMA, SEROMA FLD",1329.3,531.72,0,1129.9,1129.9,SKIPPED,497.61,497.61,1129.9,1129.9,1129.9,560.17,651.36,651.36,SKIPPED,SKIPPED,571.6,571.6,0
5110160,521,10160,,,,,,,PUNC ASP OF CYST,433.7,173.48,0,393.3,368.64,SKIPPED,393.3,393.3,368.64,368.64,368.64,182.76,212.51,212.51,0,130.11,186.49,186.49,0
5111000,510,11000,,,,,,,DEBRID.INFECTED SKIN-UP TO 10% BODY SURF,992.3,396.92,0,843.46,843.46,SKIPPED,155.61,155.61,843.46,843.46,0,418.16,486.23,486.23,0,297.69,426.69,426.69,843.46
5111012,510,11012,,,,,,,DBRDMT FX&/DISLC SUBQ T/M/F BONE,2272,908.8,0,2272,1931.2,SKIPPED,2272,2272,1931.2,1931.2,0,957.42,1113.28,1113.28,SKIPPED,SKIPPED,976.96,976.96,1931.2
5111042,761,11042,,,,,,,DEB SUBQ TISSURE 20SQ CM<,433.7,173.48,182.76,433.7,368.64,SKIPPED,433.7,433.7,368.64,368.64,368.64,182.76,212.51,212.51,SKIPPED,SKIPPED,186.49,186.49,368.64
5111043,521,11043,,,,,,,DEB MUSC/FASCIA 20 OR<,433.7,173.48,0,433.7,368.64,SKIPPED,433.7,433.7,368.64,368.64,368.64,182.76,212.51,212.51,SKIPPED,SKIPPED,186.49,186.49,0
5111045,521,11045,,,,,,,DEB SUBQ TISSUE ADD-20 SQ,801.2,320.48,0,681.02,681.02,SKIPPED,0,0,681.02,681.02,681.02,337.63,392.59,392.59,0,240.36,344.52,344.52,0
5111055,521,11055,,,,,,,TRIM SKIN LESION,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5111056,510,11056,,,,,,,TRIM SKIN LESION(2-4),293,117.2,0,293,249.05,SKIPPED,293,293,249.05,249.05,0,123.47,143.57,143.57,0,87.9,125.99,125.99,249.05
5111057,510,11057,,,,,,,TRIM SKIN LESION(>4),293,117.2,0,249.05,249.05,SKIPPED,203.49,203.49,249.05,249.05,0,123.47,143.57,143.57,0,87.9,125.99,125.99,249.05
5111100,521,11104,,,,,,,BIOPSY SKIN LESION,232.1,92.84,0,232.1,197.28,SKIPPED,232.1,232.1,197.28,197.28,197.28,97.8,113.73,113.73,0,69.63,99.8,99.8,0
5111101,521,11105,,,,,,,PUNCH BX EA ADD'L,219.5,87.8,0,186.58,186.58,SKIPPED,0,0,186.58,186.58,186.58,92.5,107.56,107.56,0,65.85,94.39,94.39,0
5111102,510,11102,,,,,,,TANGENTIAL BX SKIN SINGLE LES,232.19,92.88,0,232.19,197.36,SKIPPED,232.19,232.19,197.36,197.36,0,97.84,113.77,113.77,0,69.66,99.84,99.84,197.36
5111103,510,11103,,,,,,,TANGNTL BX SKIN EA SEP/ADDL,196.54,78.62,0,167.06,167.06,SKIPPED,0,0,167.06,167.06,0,82.82,96.3,96.3,0,58.96,84.51,84.51,167.06
5111106,510,11106,,,,,,,INCISIONAL BIOPSY SKIN SINGLE LESION,952,380.8,0,809.2,809.2,SKIPPED,532.33,532.33,809.2,809.2,0,401.17,466.48,466.48,0,285.6,409.36,409.36,809.2
5111107,510,11107,,,,,,,INCISIONAL BX(ADD ON),503,201.2,0,427.55,427.55,SKIPPED,0,0,427.55,427.55,0,211.96,246.47,246.47,0,150.9,216.29,216.29,427.55
5111200,521,11200,,,,,,,ELECTROCAUTERY 15 OR LESS,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5111201,510,11201,,,,,,,REMOVE SKIN TAGS ADD-ON(ADTL.10),116.8,46.72,0,99.28,99.28,SKIPPED,0,0,99.28,99.28,0,49.22,57.23,57.23,0,35.04,50.22,50.22,99.28
5111300,521,11300,,,,,,,SHAVE BIOPSY,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5111301,521,11301,,,,,,,SHAVE SKIN LESION,138.72,55.49,0,138.72,117.91,SKIPPED,138.72,138.72,117.91,117.91,117.91,58.46,67.97,67.97,0,41.62,59.65,59.65,0
5111302,521,11302,,,,,,,SHAVE SKIN LESION,163.08,65.23,0,163.08,138.62,SKIPPED,163.08,163.08,138.62,138.62,138.62,68.72,79.91,79.91,0,48.92,70.12,70.12,0
5111303,521,11303,,,,,,,SHAVE SKIN LESION,232.1,92.84,0,232.1,197.28,SKIPPED,232.1,232.1,197.28,197.28,197.28,97.8,113.73,113.73,0,69.63,99.8,99.8,0
5111305,521,11305,,,,,,,SHAVE SKIN LESION,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5111306,521,11306,,,,,,,SHAVE SKIN LESION,146.1,58.44,0,146.1,124.18,SKIPPED,146.1,146.1,124.18,124.18,124.18,61.56,71.59,71.59,0,43.83,62.82,62.82,0
5111307,521,11307,,,,,,,SHAVE SKIN LESION,162.32,64.93,0,162.32,137.97,SKIPPED,162.32,162.32,137.97,137.97,137.97,68.4,79.54,79.54,SKIPPED,SKIPPED,69.8,69.8,0
5111310,521,11310,,,,,,,SHAVE SKIN LESION,138.7,55.48,0,138.7,117.9,SKIPPED,138.7,138.7,117.9,117.9,117.9,58.45,67.96,67.96,SKIPPED,SKIPPED,59.64,59.64,0
5111311,521,11311,,,,,,,SHAVE SKIN LESION,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,SKIPPED,SKIPPED,56.89,56.89,0
5111312,521,11312,,,,,,,SHAVE SKIN LESION,232.1,92.84,0,232.1,197.28,SKIPPED,232.1,232.1,197.28,197.28,197.28,97.8,113.73,113.73,SKIPPED,SKIPPED,99.8,99.8,0
5111313,521,11313,,,,,,,SHAVE SKIN LESION,232.1,92.84,0,232.1,197.28,SKIPPED,232.1,232.1,197.28,197.28,197.28,97.8,113.73,113.73,SKIPPED,SKIPPED,99.8,99.8,0
5111400,521,11400,,,,,,,"EXC BENIGN, TRUNK, ARMS",503,201.2,0,436.05,427.55,SKIPPED,436.05,436.05,427.55,427.55,427.55,211.96,246.47,246.47,SKIPPED,SKIPPED,216.29,216.29,0
5111401,521,11401,,,,,,,EXCISION ARM LESION,1142.4,456.96,0,971.04,971.04,SKIPPED,478.8,478.8,971.04,971.04,971.04,481.41,559.78,559.78,SKIPPED,SKIPPED,491.23,491.23,0
5111402,521,11402,,,,,,,EXCISION BENIGN LESION,1644.3,657.72,0,1397.66,1397.66,SKIPPED,526.68,526.68,1397.66,1397.66,1397.66,692.91,805.71,805.71,SKIPPED,SKIPPED,707.05,707.05,0
5111403,521,11403,,,,,,,EXCISON SKIN NEOPLASM,2860.2,1144.08,0,2431.17,2431.17,SKIPPED,572.85,572.85,2431.17,2431.17,2431.17,1205.29,1401.5,1401.5,SKIPPED,SKIPPED,1229.89,1229.89,0
5111404,521,11404,,,,,,,EXC TR-EXT B9+MARG,4003.7,1601.48,0,4003.7,3403.14,SKIPPED,4003.7,4003.7,3403.14,3403.14,3403.14,1687.16,1961.81,1961.81,SKIPPED,SKIPPED,1721.59,1721.59,0
5111406,521,11406,,,,,,,EXC TR EXT B9=MARG>4.0,4903.5,1961.4,0,4903.5,4167.98,SKIPPED,4903.5,4903.5,4167.98,4167.98,4167.98,2066.34,2402.72,2402.72,SKIPPED,SKIPPED,2108.51,2108.51,0
5111420,521,11420,,,,,,,#EX BN LZ SP NK H/F,1010.1,404.04,0,858.58,858.58,SKIPPED,401.85,401.85,858.58,858.58,858.58,425.65,494.95,494.95,SKIPPED,SKIPPED,434.34,434.34,0
5111421,521,11421,,,,,,,EXC H-F-NK-SP B9=MARG 0.6,1010.1,404.04,0,858.58,858.58,SKIPPED,480.51,480.51,858.58,858.58,858.58,425.65,494.95,494.95,SKIPPED,SKIPPED,434.34,434.34,0
5111422,521,11422,,,,,,,EXC BEN LESION 1.1-2CM,1010.1,404.04,0,858.58,858.58,SKIPPED,530.1,530.1,858.58,858.58,858.58,425.65,494.95,494.95,SKIPPED,SKIPPED,434.34,434.34,0
5111423,521,11423,,,,,,,EXC H-F-NK-SP B9-MARG 2.1,1805,722,0,1534.25,1534.25,SKIPPED,574.56,574.56,1534.25,1534.25,1534.25,760.63,884.45,884.45,SKIPPED,SKIPPED,776.15,776.15,0
5111424,510,11424,,,,,,,EXC H-F-NK-SP B9-MARG 3.1-4,2598.8,1039.52,0,2598.8,2208.98,SKIPPED,2598.8,2598.8,2208.98,2208.98,0,1095.13,1273.41,1273.41,SKIPPED,SKIPPED,1117.48,1117.48,2208.98
5111426,521,11426,,,,,,,EXC H-F-NK-SP B9-MARG>4,2734.2,1093.68,0,2734.2,2324.07,SKIPPED,2734.2,2734.2,2324.07,2324.07,2324.07,1152.2,1339.76,1339.76,SKIPPED,SKIPPED,1175.71,1175.71,0
5111440,521,11440,,,,,,,EXCISION OF LESION,503,201.2,0,459.99,427.55,SKIPPED,459.99,459.99,427.55,427.55,427.55,211.96,246.47,246.47,SKIPPED,SKIPPED,216.29,216.29,0
5111441,521,11441,,,,,,,REMOVAL OF SKIN LESION,503,201.2,0,503,427.55,SKIPPED,503,503,427.55,427.55,427.55,211.96,246.47,246.47,SKIPPED,SKIPPED,216.29,216.29,0
5111442,510,11442,,,,,,,EXC FACE MN B9 1.1-2,1653.8,661.52,0,1405.73,1405.73,SKIPPED,569.43,569.43,1405.73,1405.73,0,696.91,810.36,810.36,SKIPPED,SKIPPED,711.13,711.13,1405.73
5111443,510,11443,,,,,,,EXC FACE MN B9 2.1-3,1653.8,661.52,0,1405.73,1405.73,SKIPPED,629.28,629.28,1405.73,1405.73,0,696.91,810.36,810.36,SKIPPED,SKIPPED,711.13,711.13,1405.73
5111444,510,11444,,,,,,,EXC FACE MM B9 3.1-4,1834.6,733.84,0,1834.6,1559.41,SKIPPED,1834.6,1834.6,1559.41,1559.41,0,773.1,898.95,898.95,SKIPPED,SKIPPED,788.88,788.88,1559.41
5111446,510,11446,,,,,,,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M,3128.34,1251.34,0,3128.34,2659.09,SKIPPED,3128.34,3128.34,2659.09,2659.09,0,1318.29,1532.89,1532.89,SKIPPED,SKIPPED,1345.19,1345.19,2659.09
5111600,521,11600,,,,,,,EXCISION OF SQUMOUS CELL,1010.1,404.04,0,858.58,858.58,SKIPPED,624.15,624.15,858.58,858.58,858.58,425.65,494.95,494.95,SKIPPED,SKIPPED,434.34,434.34,0
5111601,521,11601,,,,,,,EX MALIG LESION 0.6-1.0,503,201.2,0,503,427.55,SKIPPED,503,503,427.55,427.55,427.55,211.96,246.47,246.47,SKIPPED,SKIPPED,216.29,216.29,0
5111602,521,11602,,,,,,,EX MALIG LESION 1.1-2.0 CM,503,201.2,0,503,427.55,SKIPPED,503,503,427.55,427.55,427.55,211.96,246.47,246.47,SKIPPED,SKIPPED,216.29,216.29,0
5111603,521,11603,,,,,,,EX MALIG LESION 2.1-3.0CM,1010.1,404.04,0,858.58,858.58,SKIPPED,829.35,829.35,858.58,858.58,858.58,425.65,494.95,494.95,SKIPPED,SKIPPED,434.34,434.34,0
5111604,521,11604,,,,,,,EX MALIG LESION 3.1-4.0CM,1010.1,404.04,0,1010.1,858.58,SKIPPED,1010.1,1010.1,858.58,858.58,858.58,425.65,494.95,494.95,SKIPPED,SKIPPED,434.34,434.34,0
5111606,521,11606,,,,,,,EXC TR-EXT MLG=MARG>4,1805,722,0,1805,1534.25,SKIPPED,1805,1805,1534.25,1534.25,1534.25,760.63,884.45,884.45,SKIPPED,SKIPPED,776.15,776.15,0
5111620,521,11620,,,,,,,EXC MAL LESION SCALP,1010.1,404.04,0,858.58,858.58,SKIPPED,627.57,627.57,858.58,858.58,858.58,425.65,494.95,494.95,SKIPPED,SKIPPED,434.34,434.34,0
5111621,521,11621,,,,,,,EX MAGL LESION SCPL HND FT,1010.1,404.04,0,858.58,858.58,SKIPPED,713.07,713.07,858.58,858.58,858.58,425.65,494.95,494.95,SKIPPED,SKIPPED,434.34,434.34,0
5111622,510,11622,,,,,,,EX MG LZ SP NK H/F 1,2381.2,952.48,0,2024.02,2024.02,SKIPPED,778.05,778.05,2024.02,2024.02,0,1003.44,1166.79,1166.79,SKIPPED,SKIPPED,1023.92,1023.92,2024.02
5111623,521,11623,,,,,,,EXC MALIGN LESION 2.0-3.0,1010.1,404.04,0,858.58,858.58,SKIPPED,853.29,853.29,858.58,858.58,858.58,425.65,494.95,494.95,SKIPPED,SKIPPED,434.34,434.34,0
5111624,510,11624,,,,,,,EX S/N/H/F/G MAT+MRG 3.1-4,2807,1122.8,0,2807,2385.95,SKIPPED,2807,2807,2385.95,2385.95,0,1182.87,1375.43,1375.43,SKIPPED,SKIPPED,1207.01,1207.01,2385.95
5111626,510,11626,,,,,,,EXC S/N/H/F/G MAL MRG>4CM,5445.3,2178.12,0,5445.3,4628.5,SKIPPED,5445.3,5445.3,4628.5,4628.5,0,2294.65,2668.2,2668.2,SKIPPED,SKIPPED,2341.48,2341.48,4628.5
5111640,521,11640,,,,,,,EXC MALIGNANT LESION F,1010.1,404.04,0,858.58,858.58,SKIPPED,651.51,651.51,858.58,858.58,858.58,425.65,494.95,494.95,SKIPPED,SKIPPED,434.34,434.34,0
5111641,521,11641,,,,,,,"EXC MALIGN LESION, FC, EA",1010.1,404.04,0,858.58,858.58,SKIPPED,733.59,733.59,858.58,858.58,858.58,425.65,494.95,494.95,SKIPPED,SKIPPED,434.34,434.34,0
5111642,510,11642,,,,,,,EXC FEENL MAL 1.1-2,1535.8,614.32,0,1305.43,1305.43,SKIPPED,807.12,807.12,1305.43,1305.43,0,647.18,752.54,752.54,SKIPPED,SKIPPED,660.39,660.39,1305.43
5111643,510,11643,,,,,,,EXC FEENL MAL 2.1-3,1958,783.2,0,1664.3,1664.3,SKIPPED,884.07,884.07,1664.3,1664.3,0,825.1,959.42,959.42,SKIPPED,SKIPPED,841.94,841.94,1664.3
5111644,510,11644,,,,,,,EXC FEENL MAL 3.1-4,2681.3,1072.52,0,2681.3,2279.1,SKIPPED,2681.3,2681.3,2279.1,2279.1,0,1129.9,1313.84,1313.84,SKIPPED,SKIPPED,1152.96,1152.96,2279.1
5111646,510,11646,,,,,,,EXC F/E/E/N/L MAL+MRG>4CM,3415.7,1366.28,0,3415.7,2903.34,SKIPPED,3415.7,3415.7,2903.34,2903.34,0,1439.38,1673.69,1673.69,SKIPPED,SKIPPED,1468.75,1468.75,2903.34
5111719,510,11719,,,,,,,TRIM NAILS,122.9,49.16,0,122.9,104.46,SKIPPED,122.9,122.9,104.46,104.46,0,51.79,60.22,60.22,0,36.87,52.85,52.85,104.46
5111720,521,11720,,,,,,,DEBRIDE NAIL 1-5,96.6,38.64,0,96.6,82.11,SKIPPED,96.6,96.6,82.11,82.11,82.11,40.71,47.33,47.33,0,28.98,41.54,41.54,0
5111721,521,11721,,,,,,,DEBRID OF NAIL 6 OR >,96.6,38.64,0,96.6,82.11,SKIPPED,96.6,96.6,82.11,82.11,82.11,40.71,47.33,47.33,0,28.98,41.54,41.54,0
5111730,521,11730,,,,,,,AVULSION OF NAIL,232.1,92.84,0,232.1,197.28,SKIPPED,232.1,232.1,197.28,197.28,197.28,97.8,113.73,113.73,0,69.63,99.8,99.8,0
5111732,521,11732,,,,,,,AVUL NAIL PLATE EA ADD,277.2,110.88,0,235.62,235.62,SKIPPED,0,0,235.62,235.62,235.62,116.82,135.83,135.83,0,83.16,119.2,119.2,0
5111740,521,11740,,,,,,,EVAC SUBUNGUAL HEMATOMA,96.6,38.64,0,96.6,82.11,SKIPPED,96.6,96.6,82.11,82.11,82.11,40.71,47.33,47.33,0,28.98,41.54,41.54,0
5111750,521,11750,,,,,,,EXC OF NAIL PLATE&MATRIX,503,201.2,0,456.57,427.55,SKIPPED,456.57,456.57,427.55,427.55,427.55,211.96,246.47,246.47,SKIPPED,SKIPPED,216.29,216.29,0
5111752,510,11752,,,,,,,RMV NAIL BED/TIP,3488.3,1395.32,0,2965.06,2965.06,SKIPPED,2651.11,2651.11,2965.06,2965.06,0,1469.97,1709.27,1709.27,0,1046.49,1499.97,1499.97,2965.06
5111755,510,11755,,,,,,,BX NAIL UNIT,977.6,391.04,0,830.96,830.96,SKIPPED,400.14,400.14,830.96,830.96,0,411.96,479.02,479.02,SKIPPED,SKIPPED,420.37,420.37,830.96
5111765,521,11765,,,,,,,ROMOVAL OF TOENAIL,154.18,61.67,0,154.18,131.05,SKIPPED,154.18,154.18,131.05,131.05,131.05,64.97,75.55,75.55,0,46.25,66.3,66.3,0
5111770,510,11770,,,,,,,REMOVE PILONIDAL CYST SIMPLE,5006,2002.4,0,5006,4255.1,SKIPPED,5006,5006,4255.1,4255.1,0,2109.53,2452.94,2452.94,SKIPPED,SKIPPED,2152.58,2152.58,4255.1
5111771,510,11771,,,,,,,RMV PILONIDAL CYST,5238,2095.2,0,5238,4452.3,SKIPPED,5238,5238,4452.3,4452.3,0,2207.29,2566.62,2566.62,SKIPPED,SKIPPED,2252.34,2252.34,4452.3
5111900,521,11900,,,,,,,INTRALESION INJECT 7 LESIONS,64.1,25.64,0,64.1,54.48,SKIPPED,64.1,64.1,54.48,54.48,54.48,27.01,31.41,31.41,0,19.23,27.56,27.56,0
5111976,521,11976,,,,,,,REMOVE OF CONTRACEPTIVE,503,201.2,0,427.55,427.55,SKIPPED,360.81,360.81,427.55,427.55,427.55,211.96,246.47,246.47,0,150.9,216.29,216.29,0
5111981,510,11981,,,,,,,"INSERTION,NONBIODEGRADABLE DRUG IMPLANT",1275.8,510.32,0,1084.43,1084.43,SKIPPED,498.94,498.94,1084.43,1084.43,0,537.62,625.14,625.14,SKIPPED,SKIPPED,548.59,548.59,1084.43
5111982,521,11982,,,,,,,REMOVE IMPLANT DEVICE,622.7,249.08,0,622.7,529.3,SKIPPED,622.7,622.7,529.3,529.3,529.3,262.4,305.12,305.12,SKIPPED,SKIPPED,267.76,267.76,0
5111983,510,11983,,,,,,,REMOVAL WITH REINSERTION DRUG IMPLANT,1068.9,427.56,0,1068.9,908.56,SKIPPED,1068.9,1068.9,908.56,908.56,0,450.44,523.76,523.76,SKIPPED,SKIPPED,459.63,459.63,908.56
5112001,521,12001,,,,,,,SUTUTING OF LACERATION,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5112002,521,12002,,,,,,,SUTURE LAC 2.6 7.6 CM,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5112004,521,12004,,,,,,,WOUND REPAIR 12 CM,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5112005,510,12005,,,,,,,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-,465,186,0,465,395.25,SKIPPED,465,465,395.25,395.25,0,195.95,227.85,227.85,SKIPPED,SKIPPED,199.95,199.95,395.25
5112011,521,12011,,,,,,,REPAIR SUPERFICAL WOUND,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5112013,521,12013,,,,,,,WOUND REPAIR FACE,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5112014,510,12014,,,,,,,Repair of superficial wounds face 5.1cm,472,188.8,0,472,401.2,SKIPPED,472,472,401.2,401.2,0,198.9,231.28,231.28,0,141.6,202.96,202.96,401.2
5112020,510,12020,,,,,,,CLOSURE OF SPLIT WOUND,1499.4,599.76,0,1499.4,1274.49,SKIPPED,1499.4,1499.4,1274.49,1274.49,0,631.85,734.71,734.71,SKIPPED,SKIPPED,644.74,644.74,1274.49
5112031,510,12031,,,,,,,Repair-Intermediate 2.5 cm or less scal,809,323.6,0,766.08,687.65,SKIPPED,766.08,766.08,687.65,687.65,0,340.91,396.41,396.41,SKIPPED,SKIPPED,347.87,347.87,687.65
5112032,521,12032,,,,,,,INTMD WND REPAIR S/TR/EXT,314,125.6,0,314,266.9,SKIPPED,314,314,266.9,266.9,266.9,132.32,153.86,153.86,SKIPPED,SKIPPED,135.02,135.02,0
5112041,510,12041,,,,,,,RPR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM,604,241.6,0,604,513.4,SKIPPED,604,604,513.4,513.4,0,254.53,295.96,295.96,SKIPPED,SKIPPED,259.72,259.72,513.4
5112042,510,12042,,,,,,,INTMD RPR N-HF/GENIT2.6-7.5,736,294.4,0,736,625.6,SKIPPED,736,736,625.6,625.6,0,310.15,360.64,360.64,SKIPPED,SKIPPED,316.48,316.48,625.6
5112051,510,12051,,,,,,,INTMD RPR FACE/MM 2.5 CM OR LESS,654,261.6,0,654,555.9,SKIPPED,654,654,555.9,555.9,0,275.6,320.46,320.46,SKIPPED,SKIPPED,281.22,281.22,555.9
5113100,510,13100,,,,,,,CMPLX RPR TRUNK 1.1-2.5 CM,1837.8,735.12,0,1837.8,1562.13,SKIPPED,1837.8,1837.8,1562.13,1562.13,0,774.44,900.52,900.52,SKIPPED,SKIPPED,790.25,790.25,1562.13
5113131,521,13131,,,,,,,COMPLEX FACE LACERATION,314,125.6,0,314,266.9,SKIPPED,314,314,266.9,266.9,266.9,132.32,153.86,153.86,SKIPPED,SKIPPED,135.02,135.02,0
5116000,510,16000,,,,,,,INITIAL TREATMENT OF BURNS,248.9,99.56,0,248.9,211.56,SKIPPED,248.9,248.9,211.56,211.56,0,104.89,121.96,121.96,0,74.67,107.03,107.03,211.56
5116020,510,16020,,,,,,,DRESS/DEBRID P-THICK BURN,481.2,192.48,0,481.2,409.02,SKIPPED,481.2,481.2,409.02,409.02,0,202.78,235.79,235.79,0,144.36,206.92,206.92,409.02
5116035,510,16035,,,,,,,INCISION OF BURN SCAB,445.2,178.08,0,445.2,378.42,SKIPPED,445.2,445.2,378.42,378.42,0,187.61,218.15,218.15,SKIPPED,SKIPPED,191.44,191.44,378.42
5117000,521,17000,,,,,,,DESTRUCT PREMALG LESION,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5117004,521,17004,,,,,,,DESTROY PREMAL LESIONS 15>,433.7,173.48,0,433.7,368.64,SKIPPED,433.7,433.7,368.64,368.64,368.64,182.76,212.51,212.51,SKIPPED,SKIPPED,186.49,186.49,0
5117110,521,17110,,,,,,,DESTRUCT BEN LESION 1-14,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5117111,521,17111,,,,,,,DESTRUCT BENIGN LES 15OR>,232.1,92.84,0,232.1,197.28,SKIPPED,232.1,232.1,197.28,197.28,197.28,97.8,113.73,113.73,0,69.63,99.8,99.8,0
5117250,521,17250,,,,,,,CHEMICAL CAUTERY TISSUE,232.1,92.84,0,232.1,197.28,SKIPPED,232.1,232.1,197.28,197.28,197.28,97.8,113.73,113.73,0,69.63,99.8,99.8,0
5117260,521,17260,,,,,,,DESTRUCTION LESION,232.1,92.84,0,232.1,197.28,SKIPPED,232.1,232.1,197.28,197.28,197.28,97.8,113.73,113.73,0,69.63,99.8,99.8,0
5117280,510,17280,,,,,,,Destruct. malig.lesion face (0.5 cm or <,243,97.2,0,243,206.55,SKIPPED,243,243,206.55,206.55,0,102.4,119.07,119.07,0,72.9,104.49,104.49,206.55
5117281,510,17281,,,,,,,Destruction malignant lesion face (0.6 t,342.85,137.14,0,342.85,291.42,SKIPPED,342.85,342.85,291.42,291.42,0,144.48,168,168,SKIPPED,SKIPPED,147.43,147.43,291.42
5117282,510,17282,,,,,,,Destruction malignant lesion face (1.1 t,363.95,145.58,0,363.95,309.36,SKIPPED,363.95,363.95,309.36,309.36,0,153.37,178.34,178.34,SKIPPED,SKIPPED,156.5,156.5,309.36
5117283,510,17283,,,,,,,Destruction malignant lesion face (2.1 t,363,145.2,0,363,308.55,SKIPPED,363,363,308.55,308.55,0,152.97,177.87,177.87,SKIPPED,SKIPPED,156.09,156.09,308.55
5117284,510,17284,,,,,,,Destruction malignant lesion face (3.1 t,458,183.2,0,458,389.3,SKIPPED,458,458,389.3,389.3,0,193,224.42,224.42,SKIPPED,SKIPPED,196.94,196.94,389.3
5117285,510,17286,,,,,,,Destruction malignant lesion face (Over,532.99,213.2,0,532.99,453.04,SKIPPED,532.99,532.99,453.04,453.04,0,224.61,261.17,261.17,SKIPPED,SKIPPED,229.19,229.19,453.04
5117307,510,J7307,,,,,,,ETONOGESTREL IMPLANT SYSTEM W/ SUPPLIES,1731.5,692.6,0,1471.78,1471.78,SKIPPED,847.9,847.9,1471.78,1471.78,0,729.66,848.44,848.44,0,519.45,744.55,744.55,1471.78
5117340,521,17340,,,,,,,CRYOTHERAPY,96.6,38.64,0,96.6,82.11,SKIPPED,96.6,96.6,82.11,82.11,82.11,40.71,47.33,47.33,0,28.98,41.54,41.54,0
5117360,521,17360,,,,,,,CHEMICAL PEEL,309.8,123.92,0,309.8,263.33,SKIPPED,309.8,309.8,263.33,263.33,263.33,130.55,151.8,151.8,0,92.94,133.21,133.21,0
5117999,510,17999,,,,,,,"UNLISTED PROC.SKIN, MUCOUS MEMBRANE,SUBQ",3003,1201.2,0,2552.55,2552.55,SKIPPED,802.51,802.51,2552.55,2552.55,0,1265.46,1471.47,1471.47,0,900.9,1291.29,1291.29,2552.55
5119020,510,19020,,,,,,,INCISION/DRAIN BREAST LESION,4044,1617.6,0,4044,3437.4,SKIPPED,4044,4044,3437.4,3437.4,0,1704.14,1981.56,1981.56,SKIPPED,SKIPPED,1738.92,1738.92,3437.4
5119100,510,19100,,,,,,,BX BREAST W/O IMAGE,1677,670.8,0,1677,1425.45,SKIPPED,1677,1677,1425.45,1425.45,0,706.69,821.73,821.73,SKIPPED,SKIPPED,721.11,721.11,1425.45
5119101,510,19101,,,,,,,OPEN BX OF BREAST,4503.42,1801.37,0,4503.42,3827.91,SKIPPED,4503.42,4503.42,3827.91,3827.91,0,1897.74,2206.68,2206.68,SKIPPED,SKIPPED,1936.47,1936.47,3827.91
5119120,510,19120,,,,,,,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/>,5982,2392.8,0,5982,5084.7,SKIPPED,5982,5982,5084.7,5084.7,0,2520.81,2931.18,2931.18,SKIPPED,SKIPPED,2572.26,2572.26,5084.7
5120206,510,20206,,,,,,,NEEDLE BX MUSCLE-PERCUTANEOUS,1724.1,689.64,0,1724.1,1465.48,SKIPPED,1724.1,1724.1,1465.48,1465.48,0,726.53,844.81,844.81,SKIPPED,SKIPPED,741.36,741.36,1465.48
5120520,510,20520,,,,,,,RMV FOREIGN BODY-SIMPLE,2346.62,938.65,0,1994.63,1994.63,SKIPPED,630.99,630.99,1994.63,1994.63,0,988.87,1149.84,1149.84,0,703.99,1009.05,1009.05,1994.63
5120526,510,20526,,,,,,,CARPEL TUNNEL INJ,374.9,149.96,0,318.66,318.66,SKIPPED,189.81,189.81,318.66,318.66,0,157.99,183.7,183.7,SKIPPED,SKIPPED,161.21,161.21,318.66
5120550,521,20550,,,,,,,JOINT INJECTION,424.2,169.68,0,360.57,360.57,SKIPPED,114.57,114.57,360.57,360.57,360.57,178.76,207.86,207.86,SKIPPED,SKIPPED,182.41,182.41,0
5120551,521,20551,,,,,,,INJ SING TENDON/INSERT,424.2,169.68,0,360.57,360.57,SKIPPED,153.9,153.9,360.57,360.57,360.57,178.76,207.86,207.86,SKIPPED,SKIPPED,182.41,182.41,0
5120552,510,20552,,,,,,,TRIG POINT 2 MUSCLE,513.8,205.52,0,436.73,436.73,SKIPPED,143.64,143.64,436.73,436.73,0,216.51,251.76,251.76,SKIPPED,SKIPPED,220.93,220.93,436.73
5120553,510,20553,,,,,,,TRIG POINT 3 MUSCLE,530.4,212.16,0,450.84,450.84,SKIPPED,167.58,167.58,450.84,450.84,0,223.51,259.9,259.9,SKIPPED,SKIPPED,228.07,228.07,450.84
5120600,521,20600,,,,,,,ARTHROCENTESIS/RT/LT INJ SM,214.2,85.68,0,182.07,182.07,SKIPPED,109.44,109.44,182.07,182.07,182.07,90.27,104.96,104.96,0,64.26,92.11,92.11,0
5120604,510,20604,,,,,,,DRAIN/INJ JOINT/BURSA W/ US,462,184.8,0,392.7,392.7,SKIPPED,181.26,181.26,392.7,392.7,0,194.69,226.38,226.38,0,138.6,198.66,198.66,392.7
5120605,521,20605,,,,,,,ARTHROCENTESIS/RT/LT INJ ME,424.2,169.68,0,360.57,360.57,SKIPPED,116.28,116.28,360.57,360.57,360.57,178.76,207.86,207.86,0,127.26,182.41,182.41,0
5120606,510,20606,,,,,,,DRAIN/INJ JOINT/BURSA W/US,233,93.2,0,198.36,198.05,SKIPPED,198.36,198.36,198.05,198.05,0,98.19,114.17,114.17,0,69.9,100.19,100.19,198.05
5120610,510,20610,,,,,,,ARTHROCENTIS/RT/LT INJ LG,640.6,256.24,0,544.51,544.51,SKIPPED,138.51,138.51,544.51,544.51,0,269.95,313.89,313.89,0,192.18,275.46,275.46,544.51
5120611,510,20611,,,,,,,DRAIN/INJ JOINT/BURSA W/US,367.5,147,0,312.38,312.38,SKIPPED,227.43,227.43,312.38,312.38,0,154.87,180.08,180.08,0,110.25,158.03,158.03,312.38
5120612,510,20612,,,,,,,RT/LT GANGILION INJECTION,303.2,121.28,0,257.72,257.72,SKIPPED,159.03,159.03,257.72,257.72,0,127.77,148.57,148.57,SKIPPED,SKIPPED,130.38,130.38,257.72
5120670,510,20670,,,,,,,RMV SUPPORT IMPLANT(SUPERFICIAL),4078.5,1631.4,0,4078.5,3466.72,SKIPPED,4078.5,4078.5,3466.72,3466.72,0,1718.68,1998.46,1998.46,SKIPPED,SKIPPED,1753.76,1753.76,3466.72
5120950,510,20950,,,,,,,FLUID PRESSURE MUSCLE,332.76,133.1,0,332.76,282.85,SKIPPED,332.76,332.76,282.85,282.85,0,140.23,163.05,163.05,0,99.83,143.09,143.09,282.85
5121011,510,21011,,,,,,,EXC TUMOR OF FACE,3145,1258,0,2673.25,2673.25,SKIPPED,1090.98,1090.98,2673.25,2673.25,0,1325.3,1541.05,1541.05,0,943.5,1352.35,1352.35,2673.25
5121014,510,21014,,,,,,,EXC FACE TUM DEEP 2 CM/>,3336,1334.4,0,3336,2835.6,SKIPPED,3336,3336,2835.6,2835.6,0,1405.79,1634.64,1634.64,SKIPPED,SKIPPED,1434.48,1434.48,2835.6
5122310,510,22310,,,,,,,CLOSED TX VERT FX W/O MANI REQ CAST/BRAC,600.91,240.36,0,600.91,510.77,SKIPPED,600.91,600.91,510.77,510.77,0,253.22,294.45,294.45,SKIPPED,SKIPPED,258.39,258.39,510.77
5123500,510,23500,,,,,,,TRT CLAVICLE FX,560.1,224.04,0,560.1,476.08,SKIPPED,560.1,560.1,476.08,476.08,0,236.02,274.45,274.45,SKIPPED,SKIPPED,240.84,240.84,476.08
5123570,510,23570,,,,,,,Closed treatment of scapular fracture,390.08,156.03,0,390.08,331.57,SKIPPED,390.08,390.08,331.57,331.57,0,164.38,191.14,191.14,SKIPPED,SKIPPED,167.73,167.73,331.57
5123600,510,23600,,,,,,,TRT PROXIMAL HUMERUS FX,651.6,260.64,0,553.86,553.86,SKIPPED,531.76,531.76,553.86,553.86,0,274.59,319.28,319.28,SKIPPED,SKIPPED,280.19,280.19,553.86
5123620,510,23620,,,,,,,TRT HUMERAS FX,551.3,220.52,0,531.76,468.6,SKIPPED,531.76,531.76,468.6,468.6,0,232.32,270.14,270.14,SKIPPED,SKIPPED,237.06,237.06,468.6
5124075,510,24075,,,,,,,EXCISION ELBOW TUMOR,4081.8,1632.72,0,4081.8,3469.53,SKIPPED,4081.8,4081.8,3469.53,3469.53,0,1720.07,2000.08,2000.08,SKIPPED,SKIPPED,1755.17,1755.17,3469.53
5124500,510,24500,,,,,,,TRT HUMERUS FX,415,166,0,415,352.75,SKIPPED,415,415,352.75,352.75,0,174.88,203.35,203.35,SKIPPED,SKIPPED,178.45,178.45,352.75
5124530,510,24530,,,,,,,TRT HUMERUS FX,479,191.6,0,479,407.15,SKIPPED,479,479,407.15,407.15,0,201.85,234.71,234.71,SKIPPED,SKIPPED,205.97,205.97,407.15
5124576,510,24576,,,,,,,Closed treatment humeral condyle fx with,536,214.4,0,536,455.6,SKIPPED,536,536,455.6,455.6,0,225.87,262.64,262.64,SKIPPED,SKIPPED,230.48,230.48,455.6
5124620,510,24620,,,,,,,CLOSED TX ELBOW FX W/ MANIP,1032,412.8,0,1032,877.2,SKIPPED,1032,1032,877.2,877.2,0,434.88,505.68,505.68,SKIPPED,SKIPPED,443.76,443.76,877.2
5124640,510,24640,,,,,,,Closed treatment of child nursemaid elbo,738,295.2,0,627.3,627.3,SKIPPED,258.21,258.21,627.3,627.3,0,310.99,361.62,361.62,SKIPPED,SKIPPED,317.34,317.34,627.3
5124650,510,24650,,,,,,,TRT RADIAL HEAD/NECK FX,563.4,225.36,0,531.76,478.89,SKIPPED,531.76,531.76,478.89,478.89,0,237.41,276.07,276.07,SKIPPED,SKIPPED,242.26,242.26,478.89
5124670,510,24670,,,,,,,CLOSED TX ULNAR FRACTURE PROXIMAL END W/,524,209.6,0,524,445.4,SKIPPED,524,524,445.4,445.4,0,220.81,256.76,256.76,SKIPPED,SKIPPED,225.32,225.32,445.4
5125065,510,25065,,,,,,,BX FOREARM SOFT TISSUES,3040,1216,0,2584,2584,SKIPPED,843.03,843.03,2584,2584,0,1281.06,1489.6,1489.6,SKIPPED,SKIPPED,1307.2,1307.2,2584
5125500,510,25500,,,,,,,closed treatment of radial shaft fractur,571.31,228.52,0,531.76,485.61,SKIPPED,531.76,531.76,485.61,485.61,0,240.75,279.94,279.94,SKIPPED,SKIPPED,245.66,245.66,485.61
5125530,510,25530,,,,,,,TRT FX OF ULNA,325.5,130.2,0,325.5,276.68,SKIPPED,325.5,325.5,276.68,276.68,0,137.17,159.5,159.5,SKIPPED,SKIPPED,139.97,139.97,276.68
5125560,510,25560,,,,,,,TREAT FRACTURE RADIUS & ULNA,429,171.6,0,429,364.65,SKIPPED,429,429,364.65,364.65,0,180.78,210.21,210.21,SKIPPED,SKIPPED,184.47,184.47,364.65
5125600,510,25600,,,,,,,TRT DISTAL RADIUS FX,669.3,267.72,0,568.9,568.9,SKIPPED,531.76,531.76,568.9,568.9,0,282.04,327.96,327.96,SKIPPED,SKIPPED,287.8,287.8,568.9
5125605,510,25605,,,,,,,TREAT FRACTURE RADIUS/ULNA,1679,671.6,0,1679,1427.15,SKIPPED,1679,1679,1427.15,1427.15,0,707.53,822.71,822.71,SKIPPED,SKIPPED,721.97,721.97,1427.15
5125622,510,25622,,,,,,,TRT WRIST BONE FX,437.9,175.16,0,437.9,372.22,SKIPPED,437.9,437.9,372.22,372.22,0,184.53,214.57,214.57,SKIPPED,SKIPPED,188.3,188.3,372.22
5125630,510,25630,,,,,,,TRT WRIST BONE FX,336,134.4,0,336,285.6,SKIPPED,336,336,285.6,285.6,0,141.59,164.64,164.64,SKIPPED,SKIPPED,144.48,144.48,285.6
5125650,510,25650,,,,,,,TRT WRIST BONE FX,520,208,0,520,442,SKIPPED,520,520,442,442,0,219.13,254.8,254.8,SKIPPED,SKIPPED,223.6,223.6,442
5125660,510,25660,,,,,,,TRT WRIST DISLOCATION,637,254.8,0,637,541.45,SKIPPED,637,637,541.45,541.45,0,268.43,312.13,312.13,SKIPPED,SKIPPED,273.91,273.91,541.45
5126432,510,26432,,,,,,,RPR FINGER TENDON,3182,1272.8,0,3182,2704.7,SKIPPED,3182,3182,2704.7,2704.7,0,1340.89,1559.18,1559.18,SKIPPED,SKIPPED,1368.26,1368.26,2704.7
5126600,510,26600,,,,,,,TRT METACARPAL FX,557.9,223.16,0,531.76,474.22,SKIPPED,531.76,531.76,474.22,474.22,0,235.1,273.37,273.37,SKIPPED,SKIPPED,239.9,239.9,474.22
5126641,510,26641,,,,,,,TREAT THUMB DISLOCATION,410,164,0,410,348.5,SKIPPED,410,410,348.5,348.5,0,172.77,200.9,200.9,SKIPPED,SKIPPED,176.3,176.3,348.5
5126720,510,26720,,,,,,,TRT PROXIMAL PHALANX FX,595.4,238.16,0,531.76,506.09,SKIPPED,531.76,531.76,506.09,506.09,0,250.9,291.75,291.75,SKIPPED,SKIPPED,256.02,256.02,506.09
5126740,510,26740,,,,,,,TRT VOLAR PLATE FX,491.7,196.68,0,491.7,417.94,SKIPPED,491.7,491.7,417.94,417.94,0,207.2,240.93,240.93,0,147.51,211.43,211.43,417.94
5126750,510,26750,,,,,,,TRT DISTAL PHALANX FX,545.8,218.32,0,531.76,463.93,SKIPPED,531.76,531.76,463.93,463.93,0,230,267.44,267.44,0,163.74,234.69,234.69,463.93
5126765,510,26765,,,,,,,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,3714,1485.6,0,3714,3156.9,SKIPPED,3714,3714,3156.9,3156.9,0,1565.08,1819.86,1819.86,SKIPPED,SKIPPED,1597.02,1597.02,3156.9
5126770,510,26770,,,,,,,CLTX IPHAL JT DISLC W/MANJ W/O ANES,482,192.8,0,482,409.7,SKIPPED,482,482,409.7,409.7,0,203.11,236.18,236.18,0,144.6,207.26,207.26,409.7
5126775,510,26775,,,,,,,CLTX IPHAL JT DISLC W/MANJ REQ ANES,788,315.2,0,669.8,669.8,SKIPPED,587.1,587.1,669.8,669.8,0,332.06,386.12,386.12,SKIPPED,SKIPPED,338.84,338.84,669.8
5127086,510,27086,,,,,,,RMV HIP FOREIGN BODY,3975,1590,0,3975,3378.75,SKIPPED,3975,3975,3378.75,3378.75,0,1675.06,1947.75,1947.75,SKIPPED,SKIPPED,1709.25,1709.25,3378.75
5127193,510,27193,,,,,,,TRT PELVIC RING FX,791.6,316.64,0,672.86,672.86,SKIPPED,601.62,601.62,672.86,672.86,0,333.58,387.88,387.88,0,237.48,340.39,340.39,672.86
5127197,510,27197,,,,,,,CLOSED TX PELVIC RING FX,399,159.6,0,399,339.15,SKIPPED,399,399,339.15,339.15,0,168.14,195.51,195.51,0,119.7,171.57,171.57,339.15
5127220,510,27220,,,,,,,TRT HIP SOCKET FX,555.5,222.2,0,555.5,472.18,SKIPPED,555.5,555.5,472.18,472.18,0,234.09,272.2,272.2,SKIPPED,SKIPPED,238.87,238.87,472.18
5127246,510,27246,,,,,,,CLTX GREATER TROCHANTERIC FX W/O MANJ,605,242,0,605,514.25,SKIPPED,605,605,514.25,514.25,0,254.95,296.45,296.45,SKIPPED,SKIPPED,260.15,260.15,514.25
5127267,510,27267,,,,,,,CLTX THIGH FX,626.9,250.76,0,626.9,532.86,SKIPPED,626.9,626.9,532.86,532.86,0,264.18,307.18,307.18,SKIPPED,SKIPPED,269.57,269.57,532.86
5127337,510,27337,,,,,,,EXC THIGH/KNEE LES SC 3 CM/>,5330,2132,0,5330,4530.5,SKIPPED,5330,5330,4530.5,4530.5,0,2246.06,2611.7,2611.7,SKIPPED,SKIPPED,2291.9,2291.9,4530.5
5127508,510,27508,,,,,,,TRT THIGH FX,462,184.8,0,462,392.7,SKIPPED,462,462,392.7,392.7,0,194.69,226.38,226.38,SKIPPED,SKIPPED,198.66,198.66,392.7
5127520,510,27520,,,,,,,TRT KNEECAP FX,390.6,156.24,0,390.6,332.01,SKIPPED,390.6,390.6,332.01,332.01,0,164.6,191.39,191.39,SKIPPED,SKIPPED,167.96,167.96,332.01
5127530,510,27530,,,,,,,TRT KNEE FX,709.8,283.92,0,709.8,603.33,SKIPPED,709.8,709.8,603.33,603.33,0,299.11,347.8,347.8,SKIPPED,SKIPPED,305.21,305.21,603.33
5127618,510,27618,,,,,,,EXC TUMOR SOFT TISSUE OF LEG/ANKLE>3CM,3650,1460,0,3650,3102.5,SKIPPED,3650,3650,3102.5,3102.5,0,1538.11,1788.5,1788.5,SKIPPED,SKIPPED,1569.5,1569.5,3102.5
5127750,510,27750,,,,,,,TRT TIBIAL SHAFT FX.,700.4,280.16,0,700.4,595.34,SKIPPED,700.4,700.4,595.34,595.34,0,295.15,343.2,343.2,SKIPPED,SKIPPED,301.17,301.17,595.34
5127760,510,27760,,,,,,,TRT CLTX MEDICAL ANKLE FX,685.8,274.32,0,685.8,582.93,SKIPPED,685.8,685.8,582.93,582.93,0,288.99,336.04,336.04,SKIPPED,SKIPPED,294.89,294.89,582.93
5127767,510,27767,,,,,,,CLOSED TREATMENT PST MALLEOLUS FRACTURE,380,152,0,380,323,SKIPPED,380,380,323,323,0,160.13,186.2,186.2,SKIPPED,SKIPPED,163.4,163.4,323
5127780,510,27780,,,,,,,TRT PROXIMAL FIBULA FX,629.6,251.84,0,629.6,535.16,SKIPPED,629.6,629.6,535.16,535.16,0,265.32,308.5,308.5,SKIPPED,SKIPPED,270.73,270.73,535.16
5127786,510,27786,,,,,,,TRT DIST FIB CLSD W/,443,177.2,0,443,376.55,SKIPPED,443,443,376.55,376.55,0,186.68,217.07,217.07,SKIPPED,SKIPPED,190.49,190.49,376.55
5127788,510,27788,,,,,,,TRT ANKLE FX(LATERAL MALLEOLUS),1221.6,488.64,0,1038.36,1038.36,SKIPPED,1020.78,1020.78,1038.36,1038.36,0,514.78,598.58,598.58,SKIPPED,SKIPPED,525.29,525.29,1038.36
5127808,510,27808,,,,,,,TRT BIMALLEOLAR ANKLE FX,628.4,251.36,0,628.4,534.14,SKIPPED,628.4,628.4,534.14,534.14,0,264.81,307.92,307.92,SKIPPED,SKIPPED,270.21,270.21,534.14
5127824,510,27824,,,,,,,CLOSED TRT DISTAL TIBIA W/O MANIPULATION,440,176,0,440,374,SKIPPED,440,440,374,374,0,185.42,215.6,215.6,SKIPPED,SKIPPED,189.2,189.2,374
5128043,510,28043,,,,,,,EXC FOOT/TOE TUM SC <1.5 CM,3322,1328.8,0,3322,2823.7,SKIPPED,3322,3322,2823.7,2823.7,0,1399.89,1627.78,1627.78,SKIPPED,SKIPPED,1428.46,1428.46,2823.7
5128108,510,28108,,,,,,,EXC/CURTG CST/B9 TUM PHALANGES FOOT,3599,1439.6,0,3599,3059.15,SKIPPED,3599,3599,3059.15,3059.15,0,1516.62,1763.51,1763.51,SKIPPED,SKIPPED,1547.57,1547.57,3059.15
5128124,510,28124,,,,,,,PARTIAL EXCISION OF TOE,3049,1219.6,0,2591.65,2591.65,SKIPPED,1439.82,1439.82,2591.65,2591.65,0,1284.85,1494.01,1494.01,SKIPPED,SKIPPED,1311.07,1311.07,2591.65
5128153,510,28153,,,,,,,PARTIAL REMOVAL OF TOE,2948,1179.2,0,2948,2505.8,SKIPPED,2948,2948,2505.8,2505.8,0,1242.29,1444.52,1444.52,SKIPPED,SKIPPED,1267.64,1267.64,2505.8
5128190,510,28190,,,,,,,RMV FOREIGN BODY (FOOT),1246,498.4,0,1059.1,1059.1,SKIPPED,902.88,902.88,1059.1,1059.1,0,525.06,610.54,610.54,0,373.8,535.78,535.78,1059.1
5128232,510,28232,,,,,,,"TENOTOMY, OPEN, TENDON FLEXOR",2148,859.2,0,1825.8,1825.8,SKIPPED,1263.69,1263.69,1825.8,1825.8,0,905.17,1052.52,1052.52,SKIPPED,SKIPPED,923.64,923.64,1825.8
5128240,510,28240,,,,,,,RELEASE OF BIG TOE,3030,1212,0,3030,2575.5,SKIPPED,3030,3030,2575.5,2575.5,0,1276.84,1484.7,1484.7,SKIPPED,SKIPPED,1302.9,1302.9,2575.5
5128270,510,28270,,,,,,,RELEASE FOOT CONTRACTURE,2300,920,0,2300,1955,SKIPPED,2300,2300,1955,1955,0,969.22,1127,1127,SKIPPED,SKIPPED,989,989,1955
5128272,510,28272,,,,,,,CAPSULOTOMY IPHAL JOINT EACH,3579.68,1431.87,0,3042.73,3042.73,SKIPPED,1227.78,1227.78,3042.73,3042.73,0,1508.47,1754.04,1754.04,SKIPPED,SKIPPED,1539.26,1539.26,3042.73
5128288,510,28288,,,,,,,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,3796.59,1518.64,0,3796.59,3227.1,SKIPPED,3796.59,3796.59,3227.1,3227.1,0,1599.88,1860.33,1860.33,SKIPPED,SKIPPED,1632.53,1632.53,3227.1
5128400,510,28400,,,,,,,CLOSED TRT CALCANEUS FX W/O MANIP.,566,226.4,0,566,481.1,SKIPPED,566,566,481.1,481.1,0,238.51,277.34,277.34,SKIPPED,SKIPPED,243.38,243.38,481.1
5128450,510,28450,,,,,,,TRT MIDFOOT FX,385.4,154.16,0,385.4,327.59,SKIPPED,385.4,385.4,327.59,327.59,0,162.41,188.85,188.85,SKIPPED,SKIPPED,165.72,165.72,327.59
5128470,510,28470,,,,,,,TRT METATARSAL FX,614.1,245.64,0,531.76,521.98,SKIPPED,531.76,531.76,521.98,521.98,0,258.78,300.91,300.91,SKIPPED,SKIPPED,264.06,264.06,521.98
5128485,510,28485,,,,,,,TREAT METATARSAL FRACTURE,6458,2583.2,0,6458,5489.3,SKIPPED,6458,6458,5489.3,5489.3,0,2721.4,3164.42,3164.42,SKIPPED,SKIPPED,2776.94,2776.94,5489.3
5128490,510,28490,,,,,,,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,301,120.4,0,301,255.85,SKIPPED,301,301,255.85,255.85,0,126.84,147.49,147.49,SKIPPED,SKIPPED,129.43,129.43,255.85
5128505,510,28505,,,,,,,TRT BIG TOE FX,4906,1962.4,0,4906,4170.1,SKIPPED,4906,4906,4170.1,4170.1,0,2067.39,2403.94,2403.94,SKIPPED,SKIPPED,2109.58,2109.58,4170.1
5128510,510,28510,,,,,,,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MA,305.33,122.13,0,305.33,259.53,SKIPPED,305.33,305.33,259.53,259.53,0,128.66,149.61,149.61,0,91.6,131.29,131.29,259.53
5128515,510,28515,,,,,,,TRT PHALANX FX(OTHER THAN GREAT TOE),745.3,298.12,0,633.5,633.5,SKIPPED,502.74,502.74,633.5,633.5,0,314.07,365.2,365.2,SKIPPED,SKIPPED,320.48,320.48,633.5
5128899,521,28899,,,,,,,FOOT/TOES SURGERY PROCEDURE,424.2,169.68,0,424.2,360.57,SKIPPED,424.2,424.2,360.57,360.57,360.57,178.76,207.86,207.86,0,127.26,182.41,182.41,0
5129075,521,29075,,,,,,,CAST APPLICATION,217.4,86.96,0,217.4,184.79,SKIPPED,217.4,217.4,184.79,184.79,184.79,91.61,106.53,106.53,SKIPPED,SKIPPED,93.48,93.48,0
5129085,510,29085,,,,,,,APPLY HAND/WRIST CAST(GAUNTLET),256.9,102.76,0,256.9,218.36,SKIPPED,256.9,256.9,218.36,218.36,0,108.26,125.88,125.88,SKIPPED,SKIPPED,110.47,110.47,218.36
5129105,510,29105,,,,,,,ARM SLING LONG,303.2,121.28,0,259.92,257.72,SKIPPED,259.92,259.92,257.72,257.72,0,127.77,148.57,148.57,0,90.96,130.38,130.38,257.72
5129125,521,29125,,,,,,,WRIST SPLINT,157.5,63,0,157.5,133.88,SKIPPED,157.5,157.5,133.88,133.88,133.88,66.38,77.18,77.18,0,47.25,67.73,67.73,0
5129126,510,29126,,,,,,,ARM SPLINT SHORT STATIC,315.3,126.12,0,315.3,268,SKIPPED,315.3,315.3,268,268,0,132.87,154.5,154.5,0,94.59,135.58,135.58,268
5129130,521,29130,,,,,,,FINGER SPLINT,88.2,35.28,0,88.2,74.97,SKIPPED,88.2,88.2,74.97,74.97,74.97,37.17,43.22,43.22,0,26.46,37.93,37.93,0
5129405,521,29405,,,,,,,APPLY SHORT LEG CAST,217.4,86.96,0,217.4,184.79,SKIPPED,217.4,217.4,184.79,184.79,184.79,91.61,106.53,106.53,SKIPPED,SKIPPED,93.48,93.48,0
5129445,510,29445,,,,,,,APPLICATION RIDGE TOTAL ONTACT LEG CAST,583,233.2,0,495.55,495.55,SKIPPED,300.96,300.96,495.55,495.55,0,245.68,285.67,285.67,SKIPPED,SKIPPED,250.69,250.69,495.55
5129505,510,29505,,,,,,,LEG SPLINT LONG,299.9,119.96,0,283.86,254.92,SKIPPED,283.86,283.86,254.92,254.92,0,126.38,146.95,146.95,0,89.97,128.96,128.96,254.92
5129515,521,29515,,,,,,,APPLY LOWER LEG SPLINT,440,176,0,374,374,SKIPPED,212.04,212.04,374,374,374,185.42,215.6,215.6,0,132,189.2,189.2,0
5129540,510,29540,,,,,,,STRAPPING OF ANKLE/FOOT,217.4,86.96,0,184.79,184.79,SKIPPED,56.43,56.43,184.79,184.79,0,91.61,106.53,106.53,0,65.22,93.48,93.48,184.79
5129580,521,29580,,,,,,,STRAPPING/UNNA BOOT,365.4,146.16,0,310.59,310.59,SKIPPED,193.23,193.23,310.59,310.59,310.59,153.98,179.05,179.05,0,109.62,157.12,157.12,0
5130300,510,30300,,,,,,,REMOVE NASAL FOREIGN BODY,219,87.6,0,219,186.15,SKIPPED,219,219,186.15,186.15,0,92.29,107.31,107.31,0,65.7,94.17,94.17,186.15
5130801,510,30801,,,,,,,ABLATE INF TURBINATE SUPERF,1371.3,548.52,0,1371.3,1165.6,SKIPPED,1371.3,1371.3,1165.6,1165.6,0,577.87,671.94,671.94,SKIPPED,SKIPPED,589.66,589.66,1165.6
5130901,521,30901,,,,,,,CONTROL OF NOS,166.02,66.41,0,166.02,141.12,SKIPPED,166.02,166.02,141.12,141.12,141.12,69.96,81.35,81.35,0,49.81,71.39,71.39,0
5136590,510,36590,,,,,,,REMOVE TUNNELED CV CATH,2800,1120,0,2800,2380,SKIPPED,2800,2800,2380,2380,0,1179.92,1372,1372,SKIPPED,SKIPPED,1204,1204,2380
5137609,510,37609,,,,,,,"Ligation or biopsy, temporal artery",5453.88,2181.55,0,5453.88,4635.8,SKIPPED,5453.88,5453.88,4635.8,4635.8,0,2298.27,2672.4,2672.4,SKIPPED,SKIPPED,2345.17,2345.17,4635.8
5137785,510,37785,,,,,,,INCISION AND REMOVAL OF VARICOSE VEIN,5400,2160,0,5400,4590,SKIPPED,5400,5400,4590,4590,0,2275.56,2646,2646,SKIPPED,SKIPPED,2322,2322,4590
5138505,510,38505,,,,,,,NEEDLE BX LYMPH NODES,1456,582.4,0,1456,1237.6,SKIPPED,1456,1456,1237.6,1237.6,0,613.56,713.44,713.44,SKIPPED,SKIPPED,626.08,626.08,1237.6
5140810,510,40810,,,,,,,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH,3046.5,1218.6,0,2589.52,2589.52,SKIPPED,745.56,745.56,2589.52,2589.52,0,1283.8,1492.78,1492.78,0,913.95,1310,1310,2589.52
5140812,510,40812,,,,,,,EXCISE/RPR MOUTH LESION,3366.3,1346.52,0,2861.36,2861.36,SKIPPED,949.05,949.05,2861.36,2861.36,0,1418.56,1649.49,1649.49,0,1009.89,1447.51,1447.51,2861.36
5140820,510,40820,,,,,,,TRT MOUTH LESION,2900.1,1160.04,0,2465.08,2465.08,SKIPPED,1034.55,1034.55,2465.08,2465.08,0,1222.1,1421.05,1421.05,SKIPPED,SKIPPED,1247.04,1247.04,2465.08
5141010,510,41010,,,,,,,INCISION OF TONGUE FOLD,1656.9,662.76,0,1656.9,1408.36,SKIPPED,1656.9,1656.9,1408.36,1408.36,0,698.22,811.88,811.88,SKIPPED,SKIPPED,712.47,712.47,1408.36
5141115,510,41115,,,,,,,EXCISION OF TONGUE FOLD,1847,738.8,0,1569.95,1569.95,SKIPPED,851.58,851.58,1569.95,1569.95,0,778.33,905.03,905.03,SKIPPED,SKIPPED,794.21,794.21,1569.95
5141899,510,41899,,,,,,,DENTOALVEOLAR STRUCTURE,1919.3,767.72,0,1631.4,1631.4,SKIPPED,847.88,847.88,1631.4,1631.4,0,808.79,940.46,940.46,0,575.79,825.3,825.3,1631.4
5143762,510,43762,,,,,,,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTR,809.97,323.99,0,809.97,688.47,SKIPPED,809.97,809.97,688.47,688.47,0,341.32,396.89,396.89,0,242.99,348.29,348.29,688.47
5145108,510,45108,,,,,,,RMV ANORECTAL LESION,3629,1451.6,0,3629,3084.65,SKIPPED,3629,3629,3084.65,3084.65,0,1529.26,1778.21,1778.21,SKIPPED,SKIPPED,1560.47,1560.47,3084.65
5146030,510,46030,,,,,,,REMOVAL ANAL SETON OTHER MARKER,2982,1192.8,0,2982,2534.7,SKIPPED,2982,2982,2534.7,2534.7,0,1256.61,1461.18,1461.18,SKIPPED,SKIPPED,1282.26,1282.26,2534.7
5146050,521,46050,,,,,,,I&D PERIANAL ABSCESS,743.4,297.36,0,743.4,631.89,SKIPPED,743.4,743.4,631.89,631.89,631.89,313.27,364.27,364.27,SKIPPED,SKIPPED,319.66,319.66,0
5146083,510,46083,,,,,,,INCISE EXT HEMORRHOID,775.6,310.24,0,659.26,659.26,SKIPPED,567.96,567.96,659.26,659.26,0,326.84,380.04,380.04,0,232.68,333.51,333.51,659.26
5146221,510,46221,,,,,,,LIGATION OF HEMORRHOID,1515,606,0,1287.75,1287.75,SKIPPED,855,855,1287.75,1287.75,0,638.42,742.35,742.35,SKIPPED,SKIPPED,651.45,651.45,1287.75
5146320,521,46320,,,,,,,ENUCLEART HEMORRHOID,2236.5,894.6,0,1901.02,1901.02,SKIPPED,577.98,577.98,1901.02,1901.02,1901.02,942.47,1095.88,1095.88,SKIPPED,SKIPPED,961.7,961.7,0
5146600,510,46600,,,,,,,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN,294.17,117.67,0,294.17,250.04,SKIPPED,294.17,294.17,250.04,250.04,0,123.96,144.14,144.14,0,88.25,126.49,126.49,250.04
5146900,510,46900,,,,,,,DESTRUCTION LESION ANUS-SIMPLE,507,202.8,0,507,430.95,SKIPPED,507,507,430.95,430.95,0,213.65,248.43,248.43,0,152.1,218.01,218.01,430.95
5146910,510,46910,,,,,,,DESTRUCTION LESION ANUS-ELECT.,3163,1265.2,0,2688.55,2688.55,SKIPPED,887.49,887.49,2688.55,2688.55,0,1332.89,1549.87,1549.87,0,948.9,1360.09,1360.09,2688.55
5146922,510,46922,,,,,,,EXCISION OF ANAL LESION(S),4202.82,1681.13,0,4202.82,3572.4,SKIPPED,4202.82,4202.82,3572.4,3572.4,0,1771.07,2059.38,2059.38,SKIPPED,SKIPPED,1807.21,1807.21,3572.4
5149180,510,49180,,,,,,,NEEDLE BX ABDOMEN,1695,678,0,1695,1440.75,SKIPPED,1695,1695,1440.75,1440.75,0,714.27,830.55,830.55,SKIPPED,SKIPPED,728.85,728.85,1440.75
5149422,510,49422,,,,,,,Removal of tunneled intraperitoneal cath,4802.5,1921,0,4802.5,4082.12,SKIPPED,4802.5,4802.5,4082.12,4082.12,0,2023.78,2353.22,2353.22,SKIPPED,SKIPPED,2065.08,2065.08,4082.12
5149460,510,49460,,,,,,,Mechanical removal of obstructive materi,1024.8,409.92,0,1024.8,871.08,SKIPPED,1024.8,1024.8,871.08,871.08,0,431.85,502.15,502.15,SKIPPED,SKIPPED,440.66,440.66,871.08
5151700,510,51700,,,,,,,IRRIGATION OF BLADDER,532.46,212.98,0,452.59,452.59,SKIPPED,247.95,247.95,452.59,452.59,0,224.38,260.91,260.91,0,159.74,228.96,228.96,452.59
5151701,510,51701,,,,,,,IN & OUT CATH,181,72.4,0,181,153.85,SKIPPED,181,181,153.85,153.85,0,76.27,88.69,88.69,0,54.3,77.83,77.83,153.85
5151702,510,51702,,,,,,,INSERT TEMP BLADDER CATH,218,87.2,0,218,185.3,SKIPPED,218,218,185.3,185.3,0,91.87,106.82,106.82,0,65.4,93.74,93.74,185.3
5155250,521,55250,,,,,,,VASECTOMY,4553.9,1821.56,0,4553.9,3870.82,SKIPPED,4553.9,4553.9,3870.82,3870.82,3870.82,1919.02,2231.41,2231.41,SKIPPED,SKIPPED,1958.18,1958.18,0
5156420,510,56420,,,,,,,INCISION/DRAIN OF BARTHOLIN GLAND,488,195.2,0,414.8,414.8,SKIPPED,316.35,316.35,414.8,414.8,0,205.64,239.12,239.12,SKIPPED,SKIPPED,209.84,209.84,414.8
5157160,521,57160,,,,,,,INSERT PESSARY,200.6,80.24,0,198.36,170.51,SKIPPED,198.36,198.36,170.51,170.51,170.51,84.53,98.29,98.29,0,60.18,86.26,86.26,0
5157456,510,57456,,,,,,,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,518,207.2,0,440.3,440.3,SKIPPED,295.83,295.83,440.3,440.3,0,218.29,253.82,253.82,SKIPPED,SKIPPED,222.74,222.74,440.3
5158100,521,58100,,,,,,,ENDOMETRIAL BIOPSY,298.2,119.28,0,253.47,253.47,SKIPPED,232.56,232.56,253.47,253.47,253.47,125.67,146.12,146.12,SKIPPED,SKIPPED,128.23,128.23,0
5158300,521,58300,,,,,,,INSERT INTRAUTERINE DEVICE,424.2,169.68,0,360.57,360.57,SKIPPED,262.53,262.53,360.57,360.57,360.57,178.76,207.86,207.86,0,127.26,182.41,182.41,0
5158301,521,58301,,,,,,,REMOVAL INTRAUTERINE DEVICE,298.2,119.28,0,253.47,253.47,SKIPPED,218.88,218.88,253.47,253.47,253.47,125.67,146.12,146.12,0,89.46,128.23,128.23,0
5162311,510,62322,,,,,,,INJ SPINE LUMBAR/SACRAL,1626.5,650.6,0,1626.5,1382.52,SKIPPED,1626.5,1626.5,1382.52,1382.52,0,685.41,796.98,796.98,0,487.95,699.4,699.4,1382.52
5164400,510,64400,,,,,,,N BLOCK INJ TRIGEMINAL,444,177.6,0,408.69,377.4,SKIPPED,408.69,408.69,377.4,377.4,0,187.1,217.56,217.56,0,133.2,190.92,190.92,377.4
5164405,510,64405,,,,,,,OCCIPITAL NERVE BLOCK,1260,504,0,1071,1071,SKIPPED,306.09,306.09,1071,1071,0,530.96,617.4,617.4,0,378,541.8,541.8,1071
5164418,510,64418,,,,,,,INJ AA&/STRD SUPRASCULAR NERVE,1312.5,525,0,1115.62,1115.62,SKIPPED,362.52,362.52,1115.62,1115.62,0,553.09,643.12,643.12,0,393.75,564.38,564.38,1115.62
5164421,510,64421,,,,,,,MULTI NERVE BLOCK INJ RIB AREA,1489,595.6,0,1489,1265.65,SKIPPED,1489,1489,1265.65,1265.65,0,627.46,729.61,729.61,SKIPPED,SKIPPED,640.27,640.27,1265.65
5164425,510,64425,,,,,,,ILLIOINGUINAL NERVE BLOCK,931.4,372.56,0,791.69,791.69,SKIPPED,324.9,324.9,791.69,791.69,0,392.49,456.39,456.39,0,279.42,400.5,400.5,791.69
5164445,510,64445,,,,,,,N BLOCK INJ SCIATIC SNG,1414,565.6,0,1201.9,1201.9,SKIPPED,389.88,389.88,1201.9,1201.9,0,595.86,692.86,692.86,0,424.2,608.02,608.02,1201.9
5164447,510,64447,,,,,,,INJECTION AA&/STRD FEMORAL NERVE,1801.87,720.75,0,1531.59,1531.59,SKIPPED,314.64,314.64,1531.59,1531.59,0,759.3,882.92,882.92,0,540.56,774.8,774.8,1531.59
5164450,521,64450,,,,,,,NERVE BLOCK>PERIPHERAL,1190.8,476.32,0,1012.18,1012.18,SKIPPED,249.66,249.66,1012.18,1012.18,1012.18,501.8,583.49,583.49,0,357.24,512.04,512.04,0
5164455,521,64455,,,,,,,MORTONS NEUROMA INJECT,318.2,127.28,0,270.47,270.47,SKIPPED,94.05,94.05,270.47,270.47,270.47,134.09,155.92,155.92,SKIPPED,SKIPPED,136.83,136.83,0
5164520,510,64520,,,,,,,INJECTION ANES LMBR/THRC PARAVERTBRL SYM,2133.72,853.49,0,2133.72,1813.66,SKIPPED,2133.72,2133.72,1813.66,1813.66,0,899.15,1045.52,1045.52,SKIPPED,SKIPPED,917.5,917.5,1813.66
5164615,510,64615,,,,,,,CHEMODENERVATION,522,208.8,0,443.7,443.7,SKIPPED,297.54,297.54,443.7,443.7,0,219.97,255.78,255.78,0,156.6,224.46,224.46,443.7
5165205,510,65205,,,,,,,REMOVAL FOREIGN BODY FROM EYE,305.6,122.24,0,305.6,259.76,SKIPPED,305.6,305.6,259.76,259.76,0,128.78,149.74,149.74,0,91.68,131.41,131.41,259.76
5165210,521,65210,,,,,,,REMOVAL FOREIGN BODY,122.9,49.16,0,122.9,104.46,SKIPPED,122.9,122.9,104.46,104.46,104.46,51.79,60.22,60.22,0,36.87,52.85,52.85,0
5165220,510,65220,,,,,,,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,323,129.2,0,323,274.55,SKIPPED,323,323,274.55,274.55,0,136.11,158.27,158.27,0,96.9,138.89,138.89,274.55
5165222,510,65222,,,,,,,"Removal of foreign body, external eye; c",340.75,136.3,0,340.75,289.64,SKIPPED,340.75,340.75,289.64,289.64,0,143.59,166.97,166.97,0,102.22,146.52,146.52,289.64
5167700,510,67700,,,,,,,DRAIN EYELID ABSCES,540,216,0,540,459,SKIPPED,540,540,459,459,0,227.56,264.6,264.6,0,162,232.2,232.2,459
5167800,510,67800,,,,,,,RMV EYELID LESION,732,292.8,0,622.2,622.2,SKIPPED,364.23,364.23,622.2,622.2,0,308.46,358.68,358.68,SKIPPED,SKIPPED,314.76,314.76,622.2
5167820,510,67820,,,,,,,REVISE EYELASHES,184,73.6,0,184,156.4,SKIPPED,184,184,156.4,156.4,0,77.54,90.16,90.16,0,55.2,79.12,79.12,156.4
5167938,510,67938,,,,,,,RMV FOREIGN BODY-EYELID,482,192.8,0,482,409.7,SKIPPED,482,482,409.7,409.7,0,203.11,236.18,236.18,SKIPPED,SKIPPED,207.26,207.26,409.7
5169110,510,69110,,,,,,,REMOVE EXTERNAL EAR PARTIAL,4050,1620,0,4050,3442.5,SKIPPED,4050,4050,3442.5,3442.5,0,1706.67,1984.5,1984.5,SKIPPED,SKIPPED,1741.5,1741.5,3442.5
5169200,510,69200,,,,,,,REMOVAL OF FOREIGN BODY FROM EAR,185.9,74.36,0,185.9,158.02,SKIPPED,185.9,185.9,158.02,158.02,0,78.34,91.09,91.09,0,55.77,79.94,79.94,158.02
5169209,510,69209,,,,,,,Removal of impacted cerumen with irrigat,85.1,34.04,0,85.1,72.34,SKIPPED,85.1,85.1,72.34,72.34,0,35.86,41.7,41.7,0,25.53,36.59,36.59,72.34
5169210,521,69210,,,,,,,Removal of impacted cerumen with instrum,85.1,34.04,0,85.1,72.34,SKIPPED,85.1,85.1,72.34,72.34,72.34,35.86,41.7,41.7,0,25.53,36.59,36.59,0
5187220,510,87220,,,,,,,TISSUE EXAM FOR FUNGI,50.9,20.36,0,43.26,43.26,SKIPPED,20.03,20.03,43.26,43.26,0,21.45,3.59,3.59,0,3.99,21.89,21.89,43.26
5190353,521,G0438,,,,,,,PPPS INITIAL VISIT,195.3,78.12,0,166,166,SKIPPED,148.43,148.43,166,166,166,82.3,95.7,95.7,0,58.59,83.98,83.98,0
5190439,521,G0439,,,,,,,PPPS SUBSEQ VISIT,191.1,76.44,0,162.44,162.44,SKIPPED,145.24,145.24,162.44,162.44,162.44,80.53,93.64,93.64,0,57.33,82.17,82.17,0
5190447,521,G0447,,,,,,,FAC-BEHAV CSL OBESITY 15M,5,2,0,4.25,4.25,SKIPPED,3.8,3.8,4.25,4.25,4.25,2.11,2.45,2.45,0,1.5,2.15,2.15,0
5190785,510,90785,,,,,,,INTERACTIVE COMPLEXITY,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,0,4.21,4.9,4.9,0,3,4.3,4.3,8.5
5190791,510,90791,,,,,,,PSYCH DIAGNOSTIC EVAL,20,8,0,17,17,SKIPPED,15.2,15.2,17,17,0,8.43,9.8,9.8,0,6,8.6,8.6,17
5190792,510,90792,,,,,,,PSYCH DIAGNOSTIC EVAL W/ MEDICAL SERVICE,20,8,0,17,17,SKIPPED,15.2,15.2,17,17,0,8.43,9.8,9.8,0,6,8.6,8.6,17
5190832,510,90832,,,,,,,PSYCH INDIVIDUAL THERAPY-30 MIN,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,0,4.21,4.9,4.9,0,3,4.3,4.3,8.5
5190833,510,90833,,,,,,,PSYCH PT/FAM W/ E&M-30 MIN,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,0,4.21,4.9,4.9,0,3,4.3,4.3,8.5
5190834,510,90834,,,,,,,PSYCH INDIVIDUAL SESSION-45 MIN,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,0,4.21,4.9,4.9,0,3,4.3,4.3,8.5
5190836,510,90836,,,,,,,PSYCH PT/FAM W/ E&M-45 MIN,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,0,4.21,4.9,4.9,0,3,4.3,4.3,8.5
5190837,510,90837,,,,,,,PSYCH INDIVIDUAL SESSION-60 MIN,15,6,0,12.75,12.75,SKIPPED,11.4,11.4,12.75,12.75,0,6.32,7.35,7.35,0,4.5,6.45,6.45,12.75
5190838,510,90838,,,,,,,PSYCH PT/FAM W/ E&M-60 MIN,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,0,4.21,4.9,4.9,0,3,4.3,4.3,8.5
5190839,510,90839,,,,,,,PSYCH CRISIS INTL. 60 MIN,15,6,0,12.75,12.75,SKIPPED,11.4,11.4,12.75,12.75,0,6.32,7.35,7.35,0,4.5,6.45,6.45,12.75
5190840,510,90840,,,,,,,PSYTX CRISIS EA ADDL 30 MIN,180,72,0,153,153,SKIPPED,136.8,136.8,153,153,0,75.85,88.2,88.2,0,54,77.4,77.4,153
5190846,510,90846,,,,,,,PSYCH FAMILY SESSION W/O PATIENT,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,0,4.21,4.9,4.9,0,3,4.3,4.3,8.5
5190847,510,90847,,,,,,,PSYCH FAMILY SESSION,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,0,4.21,4.9,4.9,0,3,4.3,4.3,8.5
5190863,510,90863,,,,,,,PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY,183,73.2,0,155.55,155.55,SKIPPED,139.08,139.08,155.55,155.55,0,77.12,89.67,89.67,0,54.9,78.69,78.69,155.55
5193014,780,Q3014,,,,,,,TELEHEALTH FACILITY FEE,30,12,0,30,25.5,SKIPPED,30,30,25.5,25.5,25.5,23.52,14.7,14.7,0,9,24,24,25.5
5194640,521,94640,,,,,,,NEBULIZER TX W/MEDS,77.7,31.08,0,77.7,66.04,SKIPPED,77.7,77.7,66.04,66.04,66.04,32.74,38.07,38.07,0,23.31,33.41,33.41,0
5196101,510,96101,,,,,,,PSYCH TESTING BY PSYCH,10,4,0,8.5,8.5,SKIPPED,7.6,7.6,8.5,8.5,0,4.21,4.9,4.9,0,3,4.3,4.3,8.5
5196160,510,96160,,,,,,,PT-FOCUSED HLTH RISK ASSMT,49,19.6,0,41.65,41.65,SKIPPED,18.76,18.76,41.65,41.65,0,20.65,24.01,24.01,0,14.7,21.07,21.07,41.65
5196161,510,96161,,,,,,,CAREGIVER HLTH RISK ASSMT SCORE,64,25.6,0,54.4,54.4,SKIPPED,18.76,18.76,54.4,54.4,0,26.97,31.36,31.36,0,19.2,27.52,27.52,54.4
5196374,510,96374,,,,,,,THER/PROPH/DIAG INJ IV PUSH,218.36,87.34,0,218.36,185.61,SKIPPED,218.36,218.36,185.61,185.61,0,92.01,107,107,0,65.51,93.89,93.89,185.61
5197597,510,97597,,,,,,,RMV DEVITAL TISS 20 CM/<,250.2,100.08,0,212.67,212.67,SKIPPED,115.9,115.9,212.67,212.67,0,105.44,122.6,122.6,0,75.06,107.59,107.59,212.67
5197598,510,97598,,,,,,,RMV DEVITAL TISS ADTL 20 CM<,238.9,95.56,0,203.06,203.06,SKIPPED,54.53,54.53,203.06,203.06,0,100.68,117.06,117.06,0,71.67,102.73,102.73,203.06
5198925,510,98925,,,,,,,OMT 1-2 REGIONS,45,18,0,45,38.25,SKIPPED,45,45,38.25,38.25,0,18.96,22.05,22.05,0,13.5,19.35,19.35,38.25
5199201,521,99201,,,,,,,CLINIC FACILITY LVL 1 NEW,36.88,14.75,0,36.88,31.35,SKIPPED,36.88,36.88,31.35,31.35,31.35,15.54,18.07,18.07,0,11.06,15.86,15.86,0
5199202,521,99202,,,,,,,CLINIC FACILITY LVL 2 NEW,50.92,20.37,0,50.92,43.28,SKIPPED,50.92,50.92,43.28,43.28,43.28,21.46,24.95,24.95,0,15.28,21.9,21.9,0
5199203,521,99203,,,,,,,CLINIC FACILITY LVL 3 NEW,64.9,25.96,0,64.9,55.16,SKIPPED,64.9,64.9,55.16,55.16,55.16,27.35,31.8,31.8,0,19.47,27.91,27.91,0
5199204,521,99204,,,,,,,CLINIC FACILITY LVL 4 NEW,73.02,29.21,0,73.02,62.07,SKIPPED,73.02,73.02,62.07,62.07,62.07,30.77,35.78,35.78,0,21.91,31.4,31.4,0
5199205,521,99205,,,,,,,CLINIC FACILITY LVL 5 NEW,78.94,31.58,0,78.94,67.1,SKIPPED,78.94,78.94,67.1,67.1,67.1,33.26,38.68,38.68,0,23.68,33.94,33.94,0
5199211,521,99211,,,,,,,CLINIC FACILITY LVL 1 ESTABLISHED,25.84,10.34,0,25.84,21.96,SKIPPED,25.84,25.84,21.96,21.96,21.96,10.89,12.66,12.66,0,7.75,11.11,11.11,0
5199212,521,99212,,,,,,,CLINIC FACILITY LVL 2 ESTABLISHED,38.36,15.34,0,38.36,32.61,SKIPPED,38.36,38.36,32.61,32.61,32.61,16.16,18.8,18.8,0,11.51,16.49,16.49,0
5199213,521,99213,,,,,,,CLINIC FACILITY LVL 3 ESTABLISHED,45.02,18.01,0,45.02,38.27,SKIPPED,45.02,45.02,38.27,38.27,38.27,18.97,22.06,22.06,0,13.51,19.36,19.36,0
5199214,521,99214,,,,,,,CLINIC FACILITY LVL 4 ESTABLISHED,60.5,24.2,0,60.5,51.42,SKIPPED,60.5,60.5,51.42,51.42,51.42,25.5,29.64,29.64,0,18.15,26.02,26.02,0
5199215,521,99215,,,,,,,CLINIC FACILITY LVL 5 ESTABLISHED,70.84,28.34,0,70.84,60.21,SKIPPED,70.84,70.84,60.21,60.21,60.21,29.85,34.71,34.71,0,21.25,30.46,30.46,0
5199354,510,99354,,,,,,,PROLONG E&M/PSYCTX SERV O/P,137.6,55.04,0,137.6,116.96,SKIPPED,137.6,137.6,116.96,116.96,0,57.99,67.42,67.42,0,41.28,59.17,59.17,116.96
5199355,510,99355,,,,,,,PROLONG E&M/PSYCTX SERV OP ADD 30 MIN,95,38,0,95,80.75,SKIPPED,95,95,80.75,80.75,0,40.03,46.55,46.55,0,28.5,40.85,40.85,80.75
5199358,510,99358,,,,,,,PROLONGED SERVICE NON FACE TO FACE ONLY,148,59.2,0,148,125.8,SKIPPED,148,148,125.8,125.8,0,62.37,72.52,72.52,0,44.4,63.64,63.64,125.8
5199359,510,99359,,,,,,,PROLONGED SERVICE NON FACE/FACE 15 ADDTL,74,29.6,0,74,62.9,SKIPPED,74,74,62.9,62.9,0,31.18,36.26,36.26,0,22.2,31.82,31.82,62.9
5199381,521,99381,,,,,,,INIT PM E/M NEW PT INFANT,128.1,51.24,0,128.1,108.88,SKIPPED,128.1,128.1,108.88,108.88,108.88,53.98,62.77,62.77,0,38.43,55.08,55.08,0
5199382,521,99382,,,,,,,INIT PM E/M NEW PT 1-4YRS,128.1,51.24,0,128.1,108.88,SKIPPED,128.1,128.1,108.88,108.88,108.88,53.98,62.77,62.77,0,38.43,55.08,55.08,0
5199383,521,99383,,,,,,,PREV VISIT NEW PT 5-11YRS,160.7,64.28,0,160.7,136.6,SKIPPED,160.7,160.7,136.6,136.6,136.6,67.72,78.74,78.74,0,48.21,69.1,69.1,0
5199384,521,99384,,,,,,,PREV VISIT NEW PT 12-17YRS,194.3,77.72,0,194.3,165.16,SKIPPED,194.3,194.3,165.16,165.16,165.16,81.88,95.21,95.21,0,58.29,83.55,83.55,0
5199385,521,99385,,,,,,,PREV VISIT NEW PT 18-39 YRS,226.8,90.72,0,226.8,192.78,SKIPPED,226.8,226.8,192.78,192.78,192.78,95.57,111.13,111.13,0,68.04,97.52,97.52,0
5199386,521,99386,,,,,,,PREV VISIT NEW PT 40-64YRS,259.4,103.76,0,259.4,220.49,SKIPPED,259.4,259.4,220.49,220.49,220.49,109.31,127.11,127.11,0,77.82,111.54,111.54,0
5199387,521,99387,,,,,,,INIT PM EM NEW PT 65 & OLDER,260.4,104.16,0,260.4,221.34,SKIPPED,260.4,260.4,221.34,221.34,221.34,109.73,127.6,127.6,0,78.12,111.97,111.97,0
5199391,521,99391,,,,,,,PM RE-EVAL EST PT INFANT,105,42,0,105,89.25,SKIPPED,105,105,89.25,89.25,89.25,44.25,51.45,51.45,0,31.5,45.15,45.15,0
5199392,521,99392,,,,,,,PREV VISIT EST PT 1-4YRS,105,42,0,105,89.25,SKIPPED,105,105,89.25,89.25,89.25,44.25,51.45,51.45,0,31.5,45.15,45.15,0
5199393,521,99393,,,,,,,PREV VISIT EST PT 5-11YRS,132.3,52.92,0,132.3,112.46,SKIPPED,132.3,132.3,112.46,112.46,112.46,55.75,64.83,64.83,0,39.69,56.89,56.89,0
5199394,521,99394,,,,,,,PREV VISIT EST PT 12-17YRS,159.6,63.84,0,159.6,135.66,SKIPPED,159.6,159.6,135.66,135.66,135.66,67.26,78.2,78.2,0,47.88,68.63,68.63,0
5199395,521,99395,,,,,,,PREV VISIT EST PT 18-39YRS,188,75.2,0,188,159.8,SKIPPED,188,188,159.8,159.8,159.8,79.22,92.12,92.12,0,56.4,80.84,80.84,0
5199396,521,99396,,,,,,,PREV VISIT EST PT 40-64YRS,212.1,84.84,0,212.1,180.28,SKIPPED,212.1,212.1,180.28,180.28,180.28,89.38,103.93,103.93,0,63.63,91.2,91.2,0
5199397,521,99397,,,,,,,PREV RE-EVAL EST PT 65 & OLDER,237.3,94.92,0,237.3,201.7,SKIPPED,237.3,237.3,201.7,201.7,201.7,100,116.28,116.28,0,71.19,102.04,102.04,0
5199406,510,99406,,,,,,,BEHAV CHNG SMOKING 3-10MIN,46.2,18.48,0,46.2,39.27,SKIPPED,46.2,46.2,39.27,39.27,0,19.47,22.64,22.64,0,13.86,19.87,19.87,39.27
5199407,510,99407,,,,,,,BEHAV CHNG SMOKING >10 MIN,62,24.8,0,62,52.7,SKIPPED,62,62,52.7,52.7,0,26.13,30.38,30.38,0,18.6,26.66,26.66,52.7
5199417,510,99417,,,,,,,PROLONGED E/M EACH 15 MIN,98,39.2,0,83.3,83.3,SKIPPED,74.48,74.48,83.3,83.3,0,41.3,48.02,48.02,0,29.4,42.14,42.14,83.3
5199439,510,99439,,,,,,,CHRON CARE MANAGEMENT EA ADDL 20 MIN,106,42.4,0,90.1,90.1,SKIPPED,80.56,80.56,90.1,90.1,0,44.67,51.94,51.94,0,31.8,45.58,45.58,90.1
5199490,510,99490,,,,,,,CHRONIC CARE MGMT SRVC.,115.5,46.2,0,115.5,98.18,SKIPPED,115.5,115.5,98.18,98.18,0,48.68,56.6,56.6,0,34.65,49.67,49.67,98.18
5199495,510,99495,,,,,,,TRANS CARE MGMT 14 DAY DISCH,225.8,90.32,0,225.8,191.93,SKIPPED,225.8,225.8,191.93,191.93,0,95.15,110.64,110.64,0,67.74,97.09,97.09,191.93
5199496,510,99496,,,,,,,TRANSCARE MGMT 7 DAY DISCH,204.8,81.92,0,204.8,174.08,SKIPPED,204.8,204.8,174.08,174.08,0,86.3,100.35,100.35,0,61.44,88.06,88.06,174.08
5199497,510,99497,,,,,,,ADVNCD CARE PLAN 30 MIN,108,43.2,0,108,91.8,SKIPPED,108,108,91.8,91.8,0,45.51,52.92,52.92,0,32.4,46.44,46.44,91.8
5199498,510,99498,,,,,,,ADVNCD CARE PLAN ADTL 30 MIN,95,38,0,95,80.75,SKIPPED,95,95,80.75,80.75,0,40.03,46.55,46.55,0,28.5,40.85,40.85,80.75
5199999,983,,,,,,,,NO-SHOW FEE(LARSEN),52.5,21,0,44.62,44.62,SKIPPED,39.9,39.9,44.62,44.62,44.62,0,25.72,25.72,0,15.75,0,0,0
51G0101,510,G0101,,,,,,,CA SCREEN;PELVIC/BREAST EXAM,92.61,37.04,0,92.61,78.72,SKIPPED,92.61,92.61,78.72,78.72,0,39.02,45.38,45.38,0,27.78,39.82,39.82,78.72
51G2025,521,G2025,,,,,,,MEDICARE RHC TELEHEALTH NH H&P/INITIAL,150,60,0,127.5,127.5,SKIPPED,114,114,127.5,127.5,127.5,63.21,73.5,73.5,0,45,64.5,64.5,0
51Q0091,510,Q0091,,,,,,,SCREENING PAP SMEAR,49,19.6,0,49,41.65,SKIPPED,49,49,41.65,41.65,0,20.65,24.01,24.01,0,14.7,21.07,21.07,41.65
5210021,510,10021,,,,,,,FNA PROCEDURE W/O IMAGE,669.9,267.96,0,569.42,569.42,SKIPPED,347.13,347.13,569.42,569.42,0,282.3,328.25,328.25,0,200.97,288.06,288.06,569.42
5210040,510,10040,,,,,,,ACNE SURGERY,389.6,155.84,0,389.6,331.16,SKIPPED,389.6,389.6,331.16,331.16,0,164.18,190.9,190.9,0,116.88,167.53,167.53,331.16
5210060,521,10060,,,,,,,DRAIN SKIN ABSCESS,445.2,178.08,0,378.42,378.42,SKIPPED,347.13,347.13,378.42,378.42,378.42,187.61,218.15,218.15,0,133.56,191.44,191.44,0
5210061,521,10061,,,,,,,DRAINAGE OF SKIN ABCESS,573.3,229.32,0,535.23,487.3,SKIPPED,535.23,535.23,487.3,487.3,487.3,241.59,280.92,280.92,SKIPPED,SKIPPED,246.52,246.52,0
5210080,510,10080,,,,,,,DRAINAGE OF PILONIDAL CYST,794.9,317.96,0,675.66,675.66,SKIPPED,636.12,636.12,675.66,675.66,0,334.97,389.5,389.5,0,238.47,341.81,341.81,675.66
5210120,521,10120,,,,,,,REMOVAL FOREIGN BODY,668.9,267.56,0,568.56,568.56,SKIPPED,516.42,516.42,568.56,568.56,568.56,281.88,327.76,327.76,SKIPPED,SKIPPED,287.63,287.63,0
5210121,521,10121,,,,,,,INCISION & REMVE FGN BDY,2262.8,905.12,0,2262.8,1923.38,SKIPPED,2262.8,2262.8,1923.38,1923.38,1923.38,953.54,1108.77,1108.77,SKIPPED,SKIPPED,973,973,0
5210140,521,10140,,,,,,,"I&D HEMATOMA,SEROMA FLD",1600.2,640.08,0,1360.17,1360.17,SKIPPED,497.61,497.61,1360.17,1360.17,1360.17,674.33,784.1,784.1,SKIPPED,SKIPPED,688.09,688.09,0
5210160,521,10160,,,,,,,PUNC ASP OF CYST,623.7,249.48,0,530.14,530.14,SKIPPED,393.3,393.3,530.14,530.14,530.14,262.83,305.61,305.61,0,187.11,268.19,268.19,0
5211000,510,11000,,,,,,,DEBRID.INFECTED SKIN-UP TO 10% BODY SURF,1102.5,441,0,937.12,937.12,SKIPPED,155.61,155.61,937.12,937.12,0,464.6,540.22,540.22,0,330.75,474.08,474.08,937.12
5211012,510,11012,,,,,,,DBRDMT FX&/DISLC SUBQ T/M/F BONE,3644,1457.6,0,3644,3097.4,SKIPPED,3644,3644,3097.4,3097.4,0,1535.58,1785.56,1785.56,SKIPPED,SKIPPED,1566.92,1566.92,3097.4
5211042,761,11042,,,,,,,DEB SUBQ TISSUE 20SQ CM<,585.9,234.36,246.9,585.9,498.02,SKIPPED,585.9,585.9,498.02,498.02,498.02,246.9,287.09,287.09,SKIPPED,SKIPPED,251.94,251.94,498.02
5211043,521,11043,,,,,,,DEB MUSC/FASCIA 20 OR <,768.6,307.44,0,768.6,653.31,SKIPPED,768.6,768.6,653.31,653.31,653.31,323.89,376.61,376.61,SKIPPED,SKIPPED,330.5,330.5,0
5211044,521,11044,,,,,,,DEB BONE 20 SQ CM <,1523.6,609.44,0,1523.6,1295.06,SKIPPED,1523.6,1523.6,1295.06,1295.06,1295.06,642.05,746.56,746.56,SKIPPED,SKIPPED,655.15,655.15,0
5211045,521,11045,,,,,,,DEB SUBQ TISSUE ADD-20 SQ,856.8,342.72,0,728.28,728.28,SKIPPED,0,0,728.28,728.28,728.28,361.05,419.83,419.83,0,257.04,368.42,368.42,0
5211046,521,11046,,,,,,,DEB MUSC/FASCIA ADD-20 SQ,976.5,390.6,0,830.02,830.02,SKIPPED,0,0,830.02,830.02,830.02,411.5,478.48,478.48,0,292.95,419.9,419.9,0
5211055,521,11055,,,,,,,TRIM SKIN LESION,210,84,0,210,178.5,SKIPPED,210,210,178.5,178.5,178.5,88.49,102.9,102.9,0,63,90.3,90.3,0
5211056,510,11056,,,,,,,TRIM SKIN LESION(2-4),416.7,166.68,0,416.7,354.2,SKIPPED,416.7,416.7,354.2,354.2,0,175.6,204.18,204.18,0,125.01,179.18,179.18,354.2
5211057,510,11057,,,,,,,TRIM SKIN LESION(>4),425.1,170.04,0,361.34,361.34,SKIPPED,203.49,203.49,361.34,361.34,0,179.13,208.3,208.3,0,127.53,182.79,182.79,361.34
5211100,521,11104,,,,,,,PUNC BX OF SKIN LESION,401.1,160.44,0,401.1,340.94,SKIPPED,401.1,401.1,340.94,340.94,340.94,169.02,196.54,196.54,0,120.33,172.47,172.47,0
5211101,521,11105,,,,,,,PUNCH BX EACH ADD'L,388.5,155.4,0,330.22,330.22,SKIPPED,0,0,330.22,330.22,330.22,163.72,190.36,190.36,0,116.55,167.06,167.06,0
5211102,510,11102,,,,,,,TANGENTIAL BX SKIN SINGLE LES,311.29,124.52,0,311.29,264.6,SKIPPED,311.29,311.29,264.6,264.6,0,131.17,152.53,152.53,0,93.39,133.85,133.85,264.6
5211103,510,11103,,,,,,,TANGNTL BX SKIN EA SEP/ADDL,242.34,96.94,0,205.99,205.99,SKIPPED,0,0,205.99,205.99,0,102.13,118.75,118.75,0,72.7,104.21,104.21,205.99
5211106,510,11106,,,,,,,INCISIONAL BIOPSY SKIN SINGLE LESION,1069.72,427.89,0,909.26,909.26,SKIPPED,532.33,532.33,909.26,909.26,0,450.78,524.16,524.16,0,320.92,459.98,459.98,909.26
5211107,510,11107,,,,,,,INCISIONAL BX(ADD ON),566.34,226.54,0,481.39,481.39,SKIPPED,0,0,481.39,481.39,0,238.66,277.51,277.51,0,169.9,243.53,243.53,481.39
5211200,521,11200,,,,,,,ELECTROCAUTERY 15 OR LESS,293,117.2,0,293,249.05,SKIPPED,293,293,249.05,249.05,249.05,123.47,143.57,143.57,0,87.9,125.99,125.99,0
5211201,510,11201,,,,,,,REMOVE SKIN TAGS ADD-ON(ADTL.10),155.6,62.24,0,132.26,132.26,SKIPPED,0,0,132.26,132.26,0,65.57,76.24,76.24,0,46.68,66.91,66.91,132.26
5211300,521,11300,,,,,,,SHAVE BIOPSY,246.8,98.72,0,246.8,209.78,SKIPPED,246.8,246.8,209.78,209.78,209.78,104,120.93,120.93,0,74.04,106.12,106.12,0
5211301,521,11301,,,,,,,SHAVE SKIN LESION,255.4,102.16,0,255.4,217.09,SKIPPED,255.4,255.4,217.09,217.09,217.09,107.62,125.15,125.15,0,76.62,109.82,109.82,0
5211303,521,11303,,,,,,,SHAVE SKIN LESION,447.3,178.92,0,447.3,380.2,SKIPPED,447.3,447.3,380.2,380.2,380.2,188.49,219.18,219.18,0,134.19,192.34,192.34,0
5211305,521,11305,,,,,,,SHAVE SKIN LESION,249.9,99.96,0,249.9,212.42,SKIPPED,249.9,249.9,212.42,212.42,212.42,105.31,122.45,122.45,0,74.97,107.46,107.46,0
5211306,521,11306,,,,,,,SHAVE SKIN LESION,260.22,104.09,0,260.22,221.19,SKIPPED,260.22,260.22,221.19,221.19,221.19,109.65,127.51,127.51,0,78.07,111.89,111.89,0
5211307,521,11307,,,,,,,SHAVE SKIN LESION,308.9,123.56,0,308.9,262.56,SKIPPED,308.9,308.9,262.56,262.56,262.56,130.17,151.36,151.36,SKIPPED,SKIPPED,132.83,132.83,0
5211310,521,11310,,,,,,,SHAVE SKIN LESION,249.9,99.96,0,249.9,212.42,SKIPPED,249.9,249.9,212.42,212.42,212.42,105.31,122.45,122.45,SKIPPED,SKIPPED,107.46,107.46,0
5211311,521,11311,,,,,,,SHAVE SKIN LESION,249.9,99.96,0,249.9,212.42,SKIPPED,249.9,249.9,212.42,212.42,212.42,105.31,122.45,122.45,SKIPPED,SKIPPED,107.46,107.46,0
5211312,521,11312,,,,,,,SHAVE SKIN LESION,349.7,139.88,0,349.7,297.24,SKIPPED,349.7,349.7,297.24,297.24,297.24,147.36,171.35,171.35,SKIPPED,SKIPPED,150.37,150.37,0
5211313,521,11313,,,,,,,SHAVE SKIN LESION,397.18,158.87,0,397.18,337.6,SKIPPED,397.18,397.18,337.6,337.6,337.6,167.37,194.62,194.62,SKIPPED,SKIPPED,170.79,170.79,0
5211400,521,11400,,,,,,,"EXC BENIGN,TRUNK,ARMS",726.6,290.64,0,617.61,617.61,SKIPPED,436.05,436.05,617.61,617.61,617.61,306.19,356.03,356.03,SKIPPED,SKIPPED,312.44,312.44,0
5211401,521,11401,,,,,,,EXCISION ARM LESION,1256.9,502.76,0,1068.36,1068.36,SKIPPED,478.8,478.8,1068.36,1068.36,1068.36,529.66,615.88,615.88,SKIPPED,SKIPPED,540.47,540.47,0
5211402,521,11402,,,,,,,EXCISION BENIGN LESION,1819.7,727.88,0,1546.74,1546.74,SKIPPED,526.68,526.68,1546.74,1546.74,1546.74,766.82,891.65,891.65,SKIPPED,SKIPPED,782.47,782.47,0
5211403,521,11403,,,,,,,EXCISION SKIN NEOPLASM,3326.4,1330.56,0,2827.44,2827.44,SKIPPED,572.85,572.85,2827.44,2827.44,2827.44,1401.74,1629.94,1629.94,SKIPPED,SKIPPED,1430.35,1430.35,0
5211404,521,11404,,,,,,,EXC TR-EXT+B9+MARG3.1-4CM,4181.1,1672.44,0,4181.1,3553.94,SKIPPED,4181.1,4181.1,3553.94,3553.94,3553.94,1761.91,2048.74,2048.74,SKIPPED,SKIPPED,1797.87,1797.87,0
5211406,521,11406,,,,,,,EXC TR-EXT B9+MARG,5404.4,2161.76,0,5404.4,4593.74,SKIPPED,5404.4,5404.4,4593.74,4593.74,4593.74,2277.41,2648.16,2648.16,SKIPPED,SKIPPED,2323.89,2323.89,0
5211420,521,11420,,,,,,,#EX BN LZ SP NK H/F,1124.6,449.84,0,955.91,955.91,SKIPPED,401.85,401.85,955.91,955.91,955.91,473.91,551.05,551.05,SKIPPED,SKIPPED,483.58,483.58,0
5211421,521,11421,,,,,,,EXC H-F-NK-SP B9=MARG 0.6,1251.6,500.64,0,1063.86,1063.86,SKIPPED,480.51,480.51,1063.86,1063.86,1063.86,527.43,613.28,613.28,SKIPPED,SKIPPED,538.19,538.19,0
5211422,521,11422,,,,,,,EXC BEN LESION 1.1-2CM,1631.7,652.68,0,1386.94,1386.94,SKIPPED,530.1,530.1,1386.94,1386.94,1386.94,687.6,799.53,799.53,SKIPPED,SKIPPED,701.63,701.63,0
5211423,521,11423,,,,,,,EXC H-F-NK-SP B9-MARG 2.1,2133.6,853.44,0,1813.56,1813.56,SKIPPED,574.56,574.56,1813.56,1813.56,1813.56,899.1,1045.46,1045.46,SKIPPED,SKIPPED,917.45,917.45,0
5211424,510,11424,,,,,,,EXC H-F-NK-SP B9-MARG 3.1-4,3069.2,1227.68,0,3069.2,2608.82,SKIPPED,3069.2,3069.2,2608.82,2608.82,0,1293.36,1503.91,1503.91,SKIPPED,SKIPPED,1319.76,1319.76,2608.82
5211426,521,11426,,,,,,,EXC H-F NK-SP B9-MARG>4,3271.8,1308.72,0,3271.8,2781.03,SKIPPED,3271.8,3271.8,2781.03,2781.03,2781.03,1378.73,1603.18,1603.18,SKIPPED,SKIPPED,1406.87,1406.87,0
5211440,521,11440,,,,,,,EXCISION OF LESION,640.5,256.2,0,544.42,544.42,SKIPPED,459.99,459.99,544.42,544.42,544.42,269.91,313.84,313.84,SKIPPED,SKIPPED,275.42,275.42,0
5211441,521,11441,,,,,,,REMOVAL OF SKIN LESION,780.2,312.08,0,663.17,663.17,SKIPPED,521.55,521.55,663.17,663.17,663.17,328.78,382.3,382.3,SKIPPED,SKIPPED,335.49,335.49,0
5211442,510,11442,,,,,,,EXC FACE MN B9 1.1-2,1962.5,785,0,1668.12,1668.12,SKIPPED,569.43,569.43,1668.12,1668.12,0,827,961.62,961.62,SKIPPED,SKIPPED,843.88,843.88,1668.12
5211443,510,11443,,,,,,,EXC FEENL MAL 3.1-4,2032,812.8,0,1727.2,1727.2,SKIPPED,629.28,629.28,1727.2,1727.2,0,856.28,995.68,995.68,SKIPPED,SKIPPED,873.76,873.76,1727.2
5211444,510,11444,,,,,,,EXC FACE MN B9 3.1-4,2319.7,927.88,0,2319.7,1971.74,SKIPPED,2319.7,2319.7,1971.74,1971.74,0,977.52,1136.65,1136.65,SKIPPED,SKIPPED,997.47,997.47,1971.74
5211446,510,11446,,,,,,,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M,3887,1554.8,0,3887,3303.95,SKIPPED,3887,3887,3303.95,3303.95,0,1637.98,1904.63,1904.63,SKIPPED,SKIPPED,1671.41,1671.41,3303.95
5211600,521,11600,,,,,,,EXCISION OF SQUMOUS CELL,1296.8,518.72,0,1102.28,1102.28,SKIPPED,624.15,624.15,1102.28,1102.28,1102.28,546.47,635.43,635.43,SKIPPED,SKIPPED,557.62,557.62,0
5211601,521,11601,,,,,,,EX MALIG LESION 0.6-1.0,911.4,364.56,0,774.69,774.69,SKIPPED,711.36,711.36,774.69,774.69,774.69,384.06,446.59,446.59,SKIPPED,SKIPPED,391.9,391.9,0
5211602,521,11602,,,,,,,EX MALIG LESION 1.1-2.0CM,924,369.6,0,785.4,785.4,SKIPPED,766.08,766.08,785.4,785.4,785.4,389.37,452.76,452.76,SKIPPED,SKIPPED,397.32,397.32,0
5211603,510,11603,,,,,,,EX MALIG LESION 2.1-3.0CM,1425.8,570.32,0,1211.93,1211.93,SKIPPED,829.35,829.35,1211.93,1211.93,0,600.83,698.64,698.64,SKIPPED,SKIPPED,613.09,613.09,1211.93
5211604,521,11604,,,,,,,EX MALIG LESION 3.1-4.0CM,1631.7,652.68,0,1631.7,1386.94,SKIPPED,1631.7,1631.7,1386.94,1386.94,1386.94,687.6,799.53,799.53,SKIPPED,SKIPPED,701.63,701.63,0
5211606,521,11606,,,,,,,EXC TR-EXT MLG=MARG>4,2494.8,997.92,0,2494.8,2120.58,SKIPPED,2494.8,2494.8,2120.58,2120.58,2120.58,1051.3,1222.45,1222.45,SKIPPED,SKIPPED,1072.76,1072.76,0
5211620,521,11620,,,,,,,"EXCIS, MAL LESION, SCALP",1350.3,540.12,0,1147.76,1147.76,SKIPPED,627.57,627.57,1147.76,1147.76,1147.76,569.02,661.65,661.65,SKIPPED,SKIPPED,580.63,580.63,0
5211621,521,11621,,,,,,,EXC MAL LESION SCALP,1480.5,592.2,0,1258.42,1258.42,SKIPPED,713.07,713.07,1258.42,1258.42,1258.42,623.89,725.44,725.44,SKIPPED,SKIPPED,636.62,636.62,0
5211622,510,11622,,,,,,,EX MG LZ SP NK H/F 1,2749.7,1099.88,0,2337.24,2337.24,SKIPPED,778.05,778.05,2337.24,2337.24,0,1158.72,1347.35,1347.35,SKIPPED,SKIPPED,1182.37,1182.37,2337.24
5211623,521,11623,,,,,,,"EX MAL LESION SCPL,HND,FT",1494.2,597.68,0,1270.07,1270.07,SKIPPED,853.29,853.29,1270.07,1270.07,1270.07,629.66,732.16,732.16,SKIPPED,SKIPPED,642.51,642.51,0
5211624,510,11624,,,,,,,EX S/N/H/F/G MAT+MRG 3.1-4,3327.3,1330.92,0,3327.3,2828.2,SKIPPED,3327.3,3327.3,2828.2,2828.2,0,1402.13,1630.38,1630.38,SKIPPED,SKIPPED,1430.74,1430.74,2828.2
5211626,510,11626,,,,,,,EXC S/N/H/F/G MAL MRG>4CM,6055.4,2422.16,0,6055.4,5147.09,SKIPPED,6055.4,6055.4,5147.09,5147.09,0,2551.74,2967.15,2967.15,SKIPPED,SKIPPED,2603.82,2603.82,5147.09
5211640,521,11640,,,,,,,EXC MALIGN LESION 2.0-3.0,1551.9,620.76,0,1319.12,1319.12,SKIPPED,651.51,651.51,1319.12,1319.12,1319.12,653.97,760.43,760.43,SKIPPED,SKIPPED,667.32,667.32,0
5211641,521,11641,,,,,,,EXC MALIGNANT LESION FACE,1584.5,633.8,0,1346.82,1346.82,SKIPPED,733.59,733.59,1346.82,1346.82,1346.82,667.71,776.4,776.4,SKIPPED,SKIPPED,681.34,681.34,0
5211642,510,11642,,,,,,,EXC FEENL MAL 1.1-2,1928.3,771.32,0,1639.06,1639.06,SKIPPED,807.12,807.12,1639.06,1639.06,0,812.59,944.87,944.87,SKIPPED,SKIPPED,829.17,829.17,1639.06
5211643,510,11643,,,,,,,EXC FEENL MAL 2.1-3,2452,980.8,0,2084.2,2084.2,SKIPPED,884.07,884.07,2084.2,2084.2,0,1033.27,1201.48,1201.48,SKIPPED,SKIPPED,1054.36,1054.36,2084.2
5211644,510,11644,,,,,,,EXC FEENL MAL 3.1-4,3294.3,1317.72,0,3294.3,2800.16,SKIPPED,3294.3,3294.3,2800.16,2800.16,0,1388.22,1614.21,1614.21,SKIPPED,SKIPPED,1416.55,1416.55,2800.16
5211646,510,11646,,,,,,,EXC F/E/E/N/L MAL+MRG>4CM,4234.7,1693.88,0,4234.7,3599.5,SKIPPED,4234.7,4234.7,3599.5,3599.5,0,1784.5,2075,2075,SKIPPED,SKIPPED,1820.92,1820.92,3599.5
5211719,510,11719,,,,,,,TRIM NAILS,151.2,60.48,0,151.2,128.52,SKIPPED,151.2,151.2,128.52,128.52,0,63.72,74.09,74.09,0,45.36,65.02,65.02,128.52
5211720,521,11720,,,,,,,DEBRIDE NAIL 1-5,188,75.2,0,188,159.8,SKIPPED,188,188,159.8,159.8,159.8,79.22,92.12,92.12,0,56.4,80.84,80.84,0
5211721,521,11721,,,,,,,DEBRID OF NAIL 6 OR >,170.1,68.04,0,170.1,144.58,SKIPPED,170.1,170.1,144.58,144.58,144.58,71.68,83.35,83.35,0,51.03,73.14,73.14,0
5211730,521,11730,,,,,,,AVULSION OF NAIL,461,184.4,0,461,391.85,SKIPPED,461,461,391.85,391.85,391.85,194.27,225.89,225.89,0,138.3,198.23,198.23,0
5211732,521,11732,,,,,,,AVUL NAIL PLATE EA ADD,354.9,141.96,0,301.66,301.66,SKIPPED,0,0,301.66,301.66,301.66,149.56,173.9,173.9,0,106.47,152.61,152.61,0
52117360,521,17360,,,,,,,CHEMICAL PEEL,509.3,203.72,0,509.3,432.9,SKIPPED,509.3,509.3,432.9,432.9,432.9,214.62,249.56,249.56,0,152.79,219,219,0
5211740,521,11740,,,,,,,EVAC SUBUNGUAL HEMATOMA,177.5,71,0,177.5,150.88,SKIPPED,177.5,177.5,150.88,150.88,150.88,74.8,86.98,86.98,0,53.25,76.33,76.33,0
5211750,521,11750,,,,,,,EX NAIL/MATRIX PART,975.5,390.2,0,829.18,829.18,SKIPPED,456.57,456.57,829.18,829.18,829.18,411.08,478,478,SKIPPED,SKIPPED,419.47,419.47,0
5211752,510,26236,,,,,,,RMV NAIL BED/TIP,4143.5,1657.4,0,4143.5,3521.98,SKIPPED,4143.5,4143.5,3521.98,3521.98,0,1746.08,2030.32,2030.32,SKIPPED,SKIPPED,1781.71,1781.71,3521.98
5211755,510,11755,,,,,,,BX NAIL UNIT,1246.4,498.56,0,1059.44,1059.44,SKIPPED,400.14,400.14,1059.44,1059.44,0,525.23,610.74,610.74,SKIPPED,SKIPPED,535.95,535.95,1059.44
5211765,521,11765,,,,,,,REMOVAL OF TOENAIL,356.86,142.74,0,356.86,303.33,SKIPPED,356.86,356.86,303.33,303.33,303.33,150.38,174.86,174.86,0,107.06,153.45,153.45,0
5211770,510,11770,,,,,,,REMOVE PILONIDAL CYST SIMPLE,5371,2148.4,0,5371,4565.35,SKIPPED,5371,5371,4565.35,4565.35,0,2263.34,2631.79,2631.79,SKIPPED,SKIPPED,2309.53,2309.53,4565.35
5211771,510,11771,,,,,,,RMV PILONIDAL CYST,6361,2544.4,0,6361,5406.85,SKIPPED,6361,6361,5406.85,5406.85,0,2680.53,3116.89,3116.89,SKIPPED,SKIPPED,2735.23,2735.23,5406.85
5211900,521,11900,,,,,,,INTRALESION INJECT 7 LESIONS,239.4,95.76,0,239.4,203.49,SKIPPED,239.4,239.4,203.49,203.49,203.49,100.88,117.31,117.31,0,71.82,102.94,102.94,0
5211976,521,11976,,,,,,,REMOVAL OF CONTRACEPTIVE,707.7,283.08,0,601.54,601.54,SKIPPED,360.81,360.81,601.54,601.54,601.54,298.22,346.77,346.77,0,212.31,304.31,304.31,0
5211981,510,11981,,,,,,,"INSERTION, NONBIODEGRADABLE DRUG IMPLANT",1560.3,624.12,0,1326.26,1326.26,SKIPPED,498.94,498.94,1326.26,1326.26,0,657.51,764.55,764.55,SKIPPED,SKIPPED,670.93,670.93,1326.26
5211982,521,11982,,,,,,,REMOVAL IMPLANT DEVICE,946.1,378.44,0,946.1,804.18,SKIPPED,946.1,946.1,804.18,804.18,804.18,398.68,463.59,463.59,SKIPPED,SKIPPED,406.82,406.82,0
5211983,510,11983,,,,,,,REMOVAL WITH REINSERTION DRUG IMPLANT,1525.7,610.28,0,1525.7,1296.84,SKIPPED,1525.7,1525.7,1296.84,1296.84,0,642.93,747.59,747.59,SKIPPED,SKIPPED,656.05,656.05,1296.84
5212001,521,12001,,,,,,,SUTURING OF LACERATION,420,168,0,420,357,SKIPPED,420,420,357,357,357,176.99,205.8,205.8,0,126,180.6,180.6,0
5212002,521,12002,,,,,,,SUTURE LAC 2.6 - 7.6 CM,487.2,194.88,0,487.2,414.12,SKIPPED,487.2,487.2,414.12,414.12,414.12,205.31,238.73,238.73,0,146.16,209.5,209.5,0
5212004,521,12004,,,,,,,WOUND REPAIR 12 CM,614.3,245.72,0,614.3,522.16,SKIPPED,614.3,614.3,522.16,522.16,522.16,258.87,301.01,301.01,0,184.29,264.15,264.15,0
5212005,510,12005,,,,,,,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-,777,310.8,0,777,660.45,SKIPPED,777,777,660.45,660.45,0,327.43,380.73,380.73,SKIPPED,SKIPPED,334.11,334.11,660.45
5212011,521,12011,,,,,,,REPAIR SUPERFICIAL WOUND,314,125.6,0,314,266.9,SKIPPED,314,314,266.9,266.9,266.9,132.32,153.86,153.86,0,94.2,135.02,135.02,0
5212013,521,12013,,,,,,,WOUND REPAIR FACE,552.3,220.92,0,552.3,469.46,SKIPPED,552.3,552.3,469.46,469.46,469.46,232.74,270.63,270.63,0,165.69,237.49,237.49,0
5212014,510,12014,,,,,,,Repair of superficial wounds face 5.1cm,621.44,248.58,0,621.44,528.22,SKIPPED,621.44,621.44,528.22,528.22,0,261.88,304.51,304.51,0,186.43,267.22,267.22,528.22
5212020,510,12020,,,,,,,CLOSURE OF SPLIT WOUND,2060.1,824.04,0,2060.1,1751.08,SKIPPED,2060.1,2060.1,1751.08,1751.08,0,868.12,1009.45,1009.45,SKIPPED,SKIPPED,885.84,885.84,1751.08
5212031,510,12031,,,,,,,Repair-Intermediate 2.5 cm or less scal,1112.24,444.9,0,945.4,945.4,SKIPPED,766.08,766.08,945.4,945.4,0,468.69,545,545,SKIPPED,SKIPPED,478.26,478.26,945.4
5212032,521,12032,,,,,,,INTMD WND REPAIR S/TR/EXT,783.3,313.32,0,769.02,665.8,SKIPPED,769.02,769.02,665.8,665.8,665.8,330.08,383.82,383.82,SKIPPED,SKIPPED,336.82,336.82,0
5212041,510,12041,,,,,,,RPR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM,1060,424,0,901,901,SKIPPED,747.27,747.27,901,901,0,446.68,519.4,519.4,SKIPPED,SKIPPED,455.8,455.8,901
5212042,510,12042,,,,,,,INTMD RPR N-HF/GENIT2.6-7.5,1134,453.6,0,963.9,963.9,SKIPPED,769.02,769.02,963.9,963.9,0,477.87,555.66,555.66,SKIPPED,SKIPPED,487.62,487.62,963.9
5212051,510,12051,,,,,,,INTMD RPR FACE/MM 2.5 CM OR LESS,1150,460,0,977.5,977.5,SKIPPED,769.02,769.02,977.5,977.5,0,484.61,563.5,563.5,SKIPPED,SKIPPED,494.5,494.5,977.5
5213100,510,13100,,,,,,,CMPLX RPR TRUNK 1.1-2.5 CM,2239.92,895.97,0,2239.92,1903.93,SKIPPED,2239.92,2239.92,1903.93,1903.93,0,943.91,1097.56,1097.56,SKIPPED,SKIPPED,963.17,963.17,1903.93
5213131,521,13131,,,,,,,COMPLEX FACE LACERATION,822.06,328.82,0,822.06,698.75,SKIPPED,822.06,822.06,698.75,698.75,698.75,346.42,402.81,402.81,SKIPPED,SKIPPED,353.49,353.49,0
5216000,510,16000,,,,,,,INITIAL TREATMENT OF BURNS,388.5,155.4,0,388.5,330.22,SKIPPED,388.5,388.5,330.22,330.22,0,163.72,190.36,190.36,0,116.55,167.06,167.06,330.22
5216020,510,16020,,,,,,,DRESS/DEBRID P-THICK BURN,592.5,237,0,592.5,503.62,SKIPPED,592.5,592.5,503.62,503.62,0,249.68,290.32,290.32,0,177.75,254.78,254.78,503.62
5217000,521,17000,,,,,,,DESTRUCT PREMALG LESION,246.8,98.72,0,246.8,209.78,SKIPPED,246.8,246.8,209.78,209.78,209.78,104,120.93,120.93,0,74.04,106.12,106.12,0
5217003,521,17003,,,,,,,DESTRUCT PREMALG LESION 2-14,59.9,23.96,0,50.92,50.92,SKIPPED,0,0,50.92,50.92,50.92,25.24,29.35,29.35,0,17.97,25.76,25.76,0
5217004,521,17004,,,,,,,DESTROY PREMAL LESIONS 15>,525,210,0,446.25,446.25,SKIPPED,436.05,436.05,446.25,446.25,446.25,221.24,257.25,257.25,SKIPPED,SKIPPED,225.75,225.75,0
5217110,521,17110,,,,,,,DESTRUCT BEN LESION 1-14,237.04,94.82,0,237.04,201.48,SKIPPED,237.04,237.04,201.48,201.48,201.48,99.89,116.15,116.15,0,71.11,101.93,101.93,0
5217111,521,17111,,,,,,,DESTRUCT BENIGN LES15 OR>,457.8,183.12,0,457.8,389.13,SKIPPED,457.8,457.8,389.13,389.13,389.13,192.91,224.32,224.32,0,137.34,196.85,196.85,0
5217250,521,17250,,,,,,,CHEMICAL CAUTERY TISSUE,363.3,145.32,0,363.3,308.8,SKIPPED,363.3,363.3,308.8,308.8,308.8,153.1,178.02,178.02,0,108.99,156.22,156.22,0
5217280,510,17280,,,,,,,Destruct. malig.lesion face (0.5 cm or <,421.04,168.42,0,421.04,357.88,SKIPPED,421.04,421.04,357.88,357.88,0,177.43,206.31,206.31,0,126.31,181.05,181.05,357.88
5217281,510,17281,,,,,,,Destruction malignant lesion face (0.6 t,587.43,234.97,0,521.55,499.32,SKIPPED,521.55,521.55,499.32,499.32,0,247.54,287.84,287.84,SKIPPED,SKIPPED,252.59,252.59,499.32
5217282,510,17282,,,,,,,Destruction malignant lesion face (1.1 t,647.41,258.96,0,588.24,550.3,SKIPPED,588.24,588.24,550.3,550.3,0,272.82,317.23,317.23,SKIPPED,SKIPPED,278.39,278.39,550.3
5217283,510,17283,,,,,,,Destruction malignant lesion face (2.1 t,717.86,287.14,0,666.9,610.18,SKIPPED,666.9,666.9,610.18,610.18,0,302.51,351.75,351.75,SKIPPED,SKIPPED,308.68,308.68,610.18
5217284,510,17284,,,,,,,Destruction malignant lesion face (3.1 t,871.32,348.53,0,740.62,740.62,SKIPPED,738.72,738.72,740.62,740.62,0,367.18,426.95,426.95,SKIPPED,SKIPPED,374.67,374.67,740.62
5217285,510,17286,,,,,,,Destruction malignant lesion face (Over,1089.47,435.79,0,926.05,926.05,SKIPPED,863.55,863.55,926.05,926.05,0,459.1,533.84,533.84,SKIPPED,SKIPPED,468.47,468.47,926.05
5217340,521,17340,,,,,,,CRYOTHERAPY,193.2,77.28,0,164.22,164.22,SKIPPED,151.05,151.05,164.22,164.22,164.22,81.42,94.67,94.67,0,57.96,83.08,83.08,0
5217999,510,17999,,,,,,,"UNLISTED PROC.SKIN, MUCOUS MEMBRANE,SUBQ",4011,1604.4,0,3409.35,3409.35,SKIPPED,802.51,802.51,3409.35,3409.35,0,1690.24,1965.39,1965.39,0,1203.3,1724.73,1724.73,3409.35
5219020,510,19020,,,,,,,INCISION/DRAIN BREAST LESION,4648.74,1859.5,0,4648.74,3951.43,SKIPPED,4648.74,4648.74,3951.43,3951.43,0,1958.98,2277.88,2277.88,SKIPPED,SKIPPED,1998.96,1998.96,3951.43
5219100,510,19100,,,,,,,BX BREST W/O IMAGE,1966,786.4,0,1966,1671.1,SKIPPED,1966,1966,1671.1,1671.1,0,828.47,963.34,963.34,SKIPPED,SKIPPED,845.38,845.38,1671.1
5219101,510,19101,,,,,,,OPEN BX OF BREAST,4940.58,1976.23,0,4940.58,4199.49,SKIPPED,4940.58,4940.58,4199.49,4199.49,0,2081.96,2420.88,2420.88,SKIPPED,SKIPPED,2124.45,2124.45,4199.49
5219120,510,19120,,,,,,,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/>,6799.1,2719.64,0,6799.1,5779.24,SKIPPED,6799.1,6799.1,5779.24,5779.24,0,2865.14,3331.56,3331.56,SKIPPED,SKIPPED,2923.61,2923.61,5779.24
5220206,510,20206,,,,,,,NEEDLE BX MUSCLE-PERCUTANEOUS,2194.5,877.8,0,2194.5,1865.32,SKIPPED,2194.5,2194.5,1865.32,1865.32,0,924.77,1075.3,1075.3,SKIPPED,SKIPPED,943.64,943.64,1865.32
5220520,510,20520,,,,,,,RMV FOREIGN BODY-SIMPLE,2636.4,1054.56,0,2240.94,2240.94,SKIPPED,630.99,630.99,2240.94,2240.94,0,1110.98,1291.84,1291.84,0,790.92,1133.65,1133.65,2240.94
5220526,510,20526,,,,,,,CARPEL TUNNEL INJ,531.3,212.52,0,451.6,451.6,SKIPPED,189.81,189.81,451.6,451.6,0,223.89,260.34,260.34,SKIPPED,SKIPPED,228.46,228.46,451.6
5220550,510,20550,,,,,,,JOINT INJECTION,595.4,238.16,0,506.09,506.09,SKIPPED,114.57,114.57,506.09,506.09,0,250.9,291.75,291.75,SKIPPED,SKIPPED,256.02,256.02,506.09
5220551,510,20551,,,,,,,INJ SING TENDON/INSERT,526.1,210.44,0,447.18,447.18,SKIPPED,153.9,153.9,447.18,447.18,0,221.7,257.79,257.79,SKIPPED,SKIPPED,226.22,226.22,447.18
5220552,510,20552,,,,,,,TRIG POINT 2 MUSCLE,658.7,263.48,0,559.9,559.9,SKIPPED,143.64,143.64,559.9,559.9,0,277.58,322.76,322.76,SKIPPED,SKIPPED,283.24,283.24,559.9
5220553,510,20553,,,,,,,TRIG POINT 3 MUSCLE,664.9,265.96,0,565.16,565.16,SKIPPED,167.58,167.58,565.16,565.16,0,280.19,325.8,325.8,SKIPPED,SKIPPED,285.91,285.91,565.16
5220600,521,20600,,,,,,,ARTHROCENTESIS/ INJ SM FIN,367.5,147,0,312.38,312.38,SKIPPED,109.44,109.44,312.38,312.38,312.38,154.87,180.08,180.08,0,110.25,158.03,158.03,0
5220604,510,20604,,,,,,,DRAIN/INJ JOINT/BURSA W/ US,602,240.8,0,511.7,511.7,SKIPPED,181.26,181.26,511.7,511.7,0,253.68,294.98,294.98,0,180.6,258.86,258.86,511.7
5220605,983,20605,,,,,,,ARTHROCENTESIS/INJ MD FIN,593.3,237.32,0,504.3,504.3,SKIPPED,116.28,116.28,504.3,504.3,504.3,40.49,290.72,290.72,0,177.99,41.32,41.32,0
5220606,510,20606,,,,,,,DRAIN/INJ JOINT/BURSA W/US,388,155.2,0,329.8,329.8,SKIPPED,198.36,198.36,329.8,329.8,0,163.5,190.12,190.12,0,116.4,166.84,166.84,329.8
5220610,510,20610,,,,,,,ARTHROCENTESIS/RT/LT INJ LG,835.9,334.36,0,710.52,710.52,SKIPPED,138.51,138.51,710.52,710.52,0,352.25,409.59,409.59,0,250.77,359.44,359.44,710.52
5220611,510,20611,,,,,,,DRAIN/INJ JOINT/BURSA W/US,552.3,220.92,0,469.46,469.46,SKIPPED,227.43,227.43,469.46,469.46,0,232.74,270.63,270.63,0,165.69,237.49,237.49,469.46
5220612,510,20612,,,,,,,RT/LT GANGILION INJECTION,406.1,162.44,0,345.18,345.18,SKIPPED,159.03,159.03,345.18,345.18,0,171.13,198.99,198.99,SKIPPED,SKIPPED,174.62,174.62,345.18
5220670,510,20670,,,,,,,RMV SUPPORT IMPLANT(SUPERFICIAL),4832.9,1933.16,0,4832.9,4107.96,SKIPPED,4832.9,4832.9,4107.96,4107.96,0,2036.59,2368.12,2368.12,SKIPPED,SKIPPED,2078.15,2078.15,4107.96
5220950,510,20950,,,,,,,FLUID PRESSURE MUSCLE,783,313.2,0,783,665.55,SKIPPED,783,783,665.55,665.55,0,329.96,383.67,383.67,0,234.9,336.69,336.69,665.55
5221011,510,21011,,,,,,,EXC TUMOR OF FACE,3654,1461.6,0,3105.9,3105.9,SKIPPED,1090.98,1090.98,3105.9,3105.9,0,1539.8,1790.46,1790.46,0,1096.2,1571.22,1571.22,3105.9
5221014,510,21014,,,,,,,EXC FACE TUM DEEP 2 CM/>,4356,1742.4,0,4356,3702.6,SKIPPED,4356,4356,3702.6,3702.6,0,1835.62,2134.44,2134.44,SKIPPED,SKIPPED,1873.08,1873.08,3702.6
5222310,510,22310,,,,,,,CLOSED TX VERT FX W/O MANI REQ CAST/BRAC,1162.37,464.95,0,1020.78,988.01,SKIPPED,1020.78,1020.78,988.01,988.01,0,489.82,569.56,569.56,SKIPPED,SKIPPED,499.82,499.82,988.01
5223500,510,23500,,,,,,,TRT CLAVICLE FX,1020.9,408.36,0,1020.78,867.76,SKIPPED,1020.78,1020.78,867.76,867.76,0,430.21,500.24,500.24,SKIPPED,SKIPPED,438.99,438.99,867.76
5223570,510,23570,,,,,,,Closed treatment of scapular fracture,858,343.2,0,858,729.3,SKIPPED,858,858,729.3,729.3,0,361.56,420.42,420.42,SKIPPED,SKIPPED,368.94,368.94,729.3
5223600,510,23600,,,,,,,TRT PROXIMAL HUMERUS FX,1299.9,519.96,0,1104.92,1104.92,SKIPPED,531.76,531.76,1104.92,1104.92,0,547.78,636.95,636.95,SKIPPED,SKIPPED,558.96,558.96,1104.92
5223620,510,23620,,,,,,,TRT HUMERAS FX,1071,428.4,0,910.35,910.35,SKIPPED,531.76,531.76,910.35,910.35,0,451.32,524.79,524.79,SKIPPED,SKIPPED,460.53,460.53,910.35
5224075,510,24075,,,,,,,EXCISION ELBOW TUMOR,5039.8,2015.92,0,5039.8,4283.83,SKIPPED,5039.8,5039.8,4283.83,4283.83,0,2123.77,2469.5,2469.5,SKIPPED,SKIPPED,2167.11,2167.11,4283.83
5224500,510,24500,,,,,,,TRT HUMERUS FX,1101,440.4,0,1020.78,935.85,SKIPPED,1020.78,1020.78,935.85,935.85,0,463.96,539.49,539.49,SKIPPED,SKIPPED,473.43,473.43,935.85
5224530,510,24530,,,,,,,TRT HUMERUS FX,1154,461.6,0,1020.78,980.9,SKIPPED,1020.78,1020.78,980.9,980.9,0,486.3,565.46,565.46,SKIPPED,SKIPPED,496.22,496.22,980.9
5224576,510,24576,,,,,,,Closed treatment humeral condyle fx with,1143.92,457.57,0,1020.78,972.33,SKIPPED,1020.78,1020.78,972.33,972.33,0,482.05,560.52,560.52,SKIPPED,SKIPPED,491.89,491.89,972.33
5224620,510,24620,,,,,,,CLOSED TX ELBOW FX W/ MANIP,2124.7,849.88,0,2124.7,1806,SKIPPED,2124.7,2124.7,1806,1806,0,895.35,1041.1,1041.1,SKIPPED,SKIPPED,913.62,913.62,1806
5224640,510,24640,,,,,,,Closed treatment of child nursemaid elbo,892.7,357.08,0,758.8,758.8,SKIPPED,258.21,258.21,758.8,758.8,0,376.18,437.42,437.42,SKIPPED,SKIPPED,383.86,383.86,758.8
5224650,510,24650,,,,,,,TRT RADIAL HEAD/NECK FX,1070.6,428.24,0,910.01,910.01,SKIPPED,531.76,531.76,910.01,910.01,0,451.15,524.59,524.59,SKIPPED,SKIPPED,460.36,460.36,910.01
5224670,510,24670,,,,,,,CLOSED TX ULNAR FRACTURE PROXIMAL END W/,1045.5,418.2,0,1020.78,888.68,SKIPPED,1020.78,1020.78,888.68,888.68,0,440.58,512.3,512.3,SKIPPED,SKIPPED,449.57,449.57,888.68
5225065,510,25065,,,,,,,BX FOREARM SOFT TISSUES,3529.16,1411.66,0,2999.79,2999.79,SKIPPED,843.03,843.03,2999.79,2999.79,0,1487.19,1729.29,1729.29,SKIPPED,SKIPPED,1517.54,1517.54,2999.79
5225500,510,25500,,,,,,,closed treatment of radial shaft fractur,1168.13,467.25,0,992.91,992.91,SKIPPED,531.76,531.76,992.91,992.91,0,492.25,572.38,572.38,SKIPPED,SKIPPED,502.3,502.3,992.91
5225530,510,25530,,,,,,,TRT FX OF ULNA,851.6,340.64,0,723.86,723.86,SKIPPED,531.76,531.76,723.86,723.86,0,358.87,417.28,417.28,SKIPPED,SKIPPED,366.19,366.19,723.86
5225560,510,25560,,,,,,,TREAT FRACTURE RADIUS & ULNA,961,384.4,0,816.85,816.85,SKIPPED,531.76,531.76,816.85,816.85,0,404.97,470.89,470.89,SKIPPED,SKIPPED,413.23,413.23,816.85
5225600,510,25600,,,,,,,TRT DISTAL RADIUS FX,1323.1,529.24,0,1124.64,1124.64,SKIPPED,531.76,531.76,1124.64,1124.64,0,557.55,648.32,648.32,SKIPPED,SKIPPED,568.93,568.93,1124.64
5225605,510,25605,,,,,,,TREAT FRACTURE RADIUS/ULNA,2769,1107.6,0,2769,2353.65,SKIPPED,2769,2769,2353.65,2353.65,0,1166.86,1356.81,1356.81,SKIPPED,SKIPPED,1190.67,1190.67,2353.65
5225622,510,25622,,,,,,,TRT WRIST BONE FX,1049,419.6,0,891.65,891.65,SKIPPED,531.76,531.76,891.65,891.65,0,442.05,514.01,514.01,SKIPPED,SKIPPED,451.07,451.07,891.65
5225630,510,25630,,,,,,,TRT WRIST BONE FX,921,368.4,0,782.85,782.85,SKIPPED,531.76,531.76,782.85,782.85,0,388.11,451.29,451.29,SKIPPED,SKIPPED,396.03,396.03,782.85
5225650,510,25650,,,,,,,TRT WRIST BONE FX,1135,454,0,964.75,964.75,SKIPPED,531.76,531.76,964.75,964.75,0,478.29,556.15,556.15,SKIPPED,SKIPPED,488.05,488.05,964.75
5225660,510,25660,,,,,,,TRT WRIST DISLOCATION,1317,526.8,0,1119.45,1119.45,SKIPPED,1020.78,1020.78,1119.45,1119.45,0,554.98,645.33,645.33,SKIPPED,SKIPPED,566.31,566.31,1119.45
5226432,510,26432,,,,,,,RPR FINGER TENDON,4132.86,1653.14,0,4132.86,3512.93,SKIPPED,4132.86,4132.86,3512.93,3512.93,0,1741.59,2025.1,2025.1,SKIPPED,SKIPPED,1777.13,1777.13,3512.93
5226600,510,26600,,,,,,,TRT METACARPAL FX,1176.4,470.56,0,999.94,999.94,SKIPPED,531.76,531.76,999.94,999.94,0,495.73,576.44,576.44,SKIPPED,SKIPPED,505.85,505.85,999.94
5226641,510,26641,,,,,,,TREAT THUMB DISLOCATION,1136,454.4,0,965.6,965.6,SKIPPED,531.76,531.76,965.6,965.6,0,478.71,556.64,556.64,SKIPPED,SKIPPED,488.48,488.48,965.6
5226720,510,26720,,,,,,,TRT PROXIMAL PHALANX FX,968,387.2,0,822.8,822.8,SKIPPED,531.76,531.76,822.8,822.8,0,407.92,474.32,474.32,SKIPPED,SKIPPED,416.24,416.24,822.8
5226740,510,26740,,,,,,,TRT VOLAR PLATE FX,944.9,377.96,0,803.16,803.16,SKIPPED,531.76,531.76,803.16,803.16,0,398.18,463,463,0,283.47,406.31,406.31,803.16
5226750,510,26750,,,,,,,TRT DISTAL PHALANX FX,931.7,372.68,0,791.94,791.94,SKIPPED,531.76,531.76,791.94,791.94,0,392.62,456.53,456.53,0,279.51,400.63,400.63,791.94
5226765,510,26765,,,,,,,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,4690,1876,0,4690,3986.5,SKIPPED,4690,4690,3986.5,3986.5,0,1976.37,2298.1,2298.1,SKIPPED,SKIPPED,2016.7,2016.7,3986.5
5226770,510,26770,,,,,,,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1015,406,0,1015,862.75,SKIPPED,1015,1015,862.75,862.75,0,427.72,497.35,497.35,0,304.5,436.45,436.45,862.75
5226775,510,26775,,,,,,,CLTX IPHAL JT DISLC W/MANJ REQ ANES,1527,610.8,0,1297.95,1297.95,SKIPPED,587.1,587.1,1297.95,1297.95,0,643.48,748.23,748.23,SKIPPED,SKIPPED,656.61,656.61,1297.95
5227086,510,27086,,,,,,,RMV HIP FOREIGN BODY,4528,1811.2,0,4528,3848.8,SKIPPED,4528,4528,3848.8,3848.8,0,1908.1,2218.72,2218.72,SKIPPED,SKIPPED,1947.04,1947.04,3848.8
5227193,510,27193,,,,,,,TRT PELVIC RING FX,1305.4,522.16,0,1109.59,1109.59,SKIPPED,992.1,992.1,1109.59,1109.59,0,550.09,639.65,639.65,0,391.62,561.32,561.32,1109.59
5227197,510,27197,,,,,,,CLOSED TX PELVIC RING FX,628,251.2,0,628,533.8,SKIPPED,628,628,533.8,533.8,0,264.64,307.72,307.72,0,188.4,270.04,270.04,533.8
5227220,510,27220,,,,,,,TRT HIP SOCKET FX,1639.1,655.64,0,1393.24,1393.24,SKIPPED,1020.78,1020.78,1393.24,1393.24,0,690.71,803.16,803.16,SKIPPED,SKIPPED,704.81,704.81,1393.24
5227246,510,27246,,,,,,,CLTX GREATER TROCHANTERIC FX W/O MANJ,1356,542.4,0,1152.6,1152.6,SKIPPED,1020.78,1020.78,1152.6,1152.6,0,571.42,664.44,664.44,SKIPPED,SKIPPED,583.08,583.08,1152.6
5227267,510,27267,,,,,,,CLTX THIGH FX,1514.1,605.64,0,1514.1,1286.98,SKIPPED,1514.1,1514.1,1286.98,1286.98,0,638.04,741.91,741.91,SKIPPED,SKIPPED,651.06,651.06,1286.98
5227337,510,27337,,,,,,,EXC THIGH/KNEE LES SC 3 CM/>,6140.78,2456.31,0,6140.78,5219.66,SKIPPED,6140.78,6140.78,5219.66,5219.66,0,2587.73,3008.98,3008.98,SKIPPED,SKIPPED,2640.54,2640.54,5219.66
5227508,510,27508,,,,,,,TRT THIGH FX,1483,593.2,0,1260.55,1260.55,SKIPPED,1020.78,1020.78,1260.55,1260.55,0,624.94,726.67,726.67,SKIPPED,SKIPPED,637.69,637.69,1260.55
5227520,510,27520,,,,,,,TRT KNEECAP FX,1041.6,416.64,0,1020.78,885.36,SKIPPED,1020.78,1020.78,885.36,885.36,0,438.93,510.38,510.38,SKIPPED,SKIPPED,447.89,447.89,885.36
5227530,510,27530,,,,,,,TRT KNEE FX,1319.9,527.96,0,1121.92,1121.92,SKIPPED,1020.78,1020.78,1121.92,1121.92,0,556.21,646.75,646.75,SKIPPED,SKIPPED,567.56,567.56,1121.92
5227618,510,27618,,,,,,,EXC TUMOR SOFT TISSUE OF LEG/ANKLE>3CM,4260.32,1704.13,0,4260.32,3621.27,SKIPPED,4260.32,4260.32,3621.27,3621.27,0,1795.3,2087.56,2087.56,SKIPPED,SKIPPED,1831.94,1831.94,3621.27
5227750,510,27750,,,,,,,TRT TIBIAL SHAFT FX.,1346.1,538.44,0,1144.18,1144.18,SKIPPED,1020.78,1020.78,1144.18,1144.18,0,567.24,659.59,659.59,SKIPPED,SKIPPED,578.82,578.82,1144.18
5227760,510,27760,,,,,,,TRT CLTX MEDICAL ANKLE FX,1330.8,532.32,0,1131.18,1131.18,SKIPPED,1020.78,1020.78,1131.18,1131.18,0,560.8,652.09,652.09,SKIPPED,SKIPPED,572.24,572.24,1131.18
5227767,510,27767,,,,,,,CLOSED TREATMENT PST MALLEOLUS FRACTURE,934,373.6,0,793.9,793.9,SKIPPED,531.76,531.76,793.9,793.9,0,393.59,457.66,457.66,SKIPPED,SKIPPED,401.62,401.62,793.9
5227780,510,27780,,,,,,,TRT PROXIMAL FIBULA FX,1218.3,487.32,0,1035.56,1035.56,SKIPPED,1020.78,1020.78,1035.56,1035.56,0,513.39,596.97,596.97,SKIPPED,SKIPPED,523.87,523.87,1035.56
5227786,510,27786,,,,,,,TRT DIST FIB CLSD W/,936,374.4,0,936,795.6,SKIPPED,936,936,795.6,795.6,0,394.43,458.64,458.64,SKIPPED,SKIPPED,402.48,402.48,795.6
5227788,510,27788,,,,,,,TRT ANKLE FX(LATERAL MALLEOLUS),1908.3,763.32,0,1622.06,1622.06,SKIPPED,1020.78,1020.78,1622.06,1622.06,0,804.16,935.07,935.07,SKIPPED,SKIPPED,820.57,820.57,1622.06
5227808,510,27808,,,,,,,TRT BIMALLEOLAR ANKLE FX,1265.7,506.28,0,1075.84,1075.84,SKIPPED,1020.78,1020.78,1075.84,1075.84,0,533.36,620.19,620.19,SKIPPED,SKIPPED,544.25,544.25,1075.84
5227824,510,27824,,,,,,,CLOSED TRT DISTAL TIBIA W/O MANIPULATION,1039.44,415.78,0,1020.78,883.52,SKIPPED,1020.78,1020.78,883.52,883.52,0,438.02,509.33,509.33,SKIPPED,SKIPPED,446.96,446.96,883.52
5228010,510,28010,,,,,,,TENOTOMY PERCUTANEOUS,2956.91,1182.76,0,2513.37,2513.37,SKIPPED,589.95,589.95,2513.37,2513.37,0,1246.04,1448.89,1448.89,SKIPPED,SKIPPED,1271.47,1271.47,2513.37
5228043,510,28043,,,,,,,EXC FOOT/TOE TUM SC <1.5 CM,4111,1644.4,0,4111,3494.35,SKIPPED,4111,4111,3494.35,3494.35,0,1732.38,2014.39,2014.39,SKIPPED,SKIPPED,1767.73,1767.73,3494.35
5228108,510,28108,,,,,,,EXC/CURTG CST/B9 TUM PHALANGES FOOT,4175,1670,0,4175,3548.75,SKIPPED,4175,4175,3548.75,3548.75,0,1759.34,2045.75,2045.75,SKIPPED,SKIPPED,1795.25,1795.25,3548.75
5228124,510,28124,,,,,,,PARTIAL EXCISION OF TOE,3991,1596.4,0,3392.35,3392.35,SKIPPED,1439.82,1439.82,3392.35,3392.35,0,1681.81,1955.59,1955.59,SKIPPED,SKIPPED,1716.13,1716.13,3392.35
5228153,510,28153,,,,,,,PARTIAL REMOVAL OF TOE,3756,1502.4,0,3756,3192.6,SKIPPED,3756,3756,3192.6,3192.6,0,1582.78,1840.44,1840.44,SKIPPED,SKIPPED,1615.08,1615.08,3192.6
5228190,510,28190,,,,,,,RMV FOREIGN BODY (FOOT),1744,697.6,0,1482.4,1482.4,SKIPPED,902.88,902.88,1482.4,1482.4,0,734.92,854.56,854.56,0,523.2,749.92,749.92,1482.4
5228232,510,28232,,,,,,,"TENOTOMY, OPEN, TENDON FLEXOR",2632,1052.8,0,2237.2,2237.2,SKIPPED,1263.69,1263.69,2237.2,2237.2,0,1109.12,1289.68,1289.68,SKIPPED,SKIPPED,1131.76,1131.76,2237.2
5228240,510,28240,,,,,,,RELEASE OF BIG TOE,3604.9,1441.96,0,3604.9,3064.16,SKIPPED,3604.9,3604.9,3064.16,3064.16,0,1519.11,1766.4,1766.4,SKIPPED,SKIPPED,1550.11,1550.11,3064.16
5228270,510,28270,,,,,,,RELEASE FOOT CONTRACTURE,3269,1307.6,0,3269,2778.65,SKIPPED,3269,3269,2778.65,2778.65,0,1377.56,1601.81,1601.81,SKIPPED,SKIPPED,1405.67,1405.67,2778.65
5228272,510,28272,,,,,,,CAPSULOTOMY IPHAL JOINT EACH,4084.48,1633.79,0,3471.81,3471.81,SKIPPED,1227.78,1227.78,3471.81,3471.81,0,1721.2,2001.4,2001.4,SKIPPED,SKIPPED,1756.33,1756.33,3471.81
5228288,510,28288,,,,,,,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,4659.43,1863.77,0,4659.43,3960.52,SKIPPED,4659.43,4659.43,3960.52,3960.52,0,1963.48,2283.12,2283.12,SKIPPED,SKIPPED,2003.55,2003.55,3960.52
5228400,510,28400,,,,,,,CLOSED TRT CALCANEUS FX W/O MANIP.,967.1,386.84,0,967.1,822.04,SKIPPED,967.1,967.1,822.04,822.04,0,407.53,473.88,473.88,SKIPPED,SKIPPED,415.85,415.85,822.04
5228430,510,28430,,,,,,,TRT ANKLE FX(TALUS),1050.7,420.28,0,893.1,893.1,SKIPPED,531.76,531.76,893.1,893.1,0,442.76,514.84,514.84,SKIPPED,SKIPPED,451.8,451.8,893.1
5228450,510,28450,,,,,,,TRT MIDFOOT FX,824.3,329.72,0,700.66,700.66,SKIPPED,531.76,531.76,700.66,700.66,0,347.36,403.91,403.91,SKIPPED,SKIPPED,354.45,354.45,700.66
5228470,510,28470,,,,,,,TRT METATARSAL FX,973.2,389.28,0,827.22,827.22,SKIPPED,531.76,531.76,827.22,827.22,0,410.11,476.87,476.87,SKIPPED,SKIPPED,418.48,418.48,827.22
5228485,510,28485,,,,,,,TREAT METATARSAL FRACTURE,7702.78,3081.11,0,7702.78,6547.36,SKIPPED,7702.78,7702.78,6547.36,6547.36,0,3245.96,3774.36,3774.36,SKIPPED,SKIPPED,3312.2,3312.2,6547.36
5228490,510,28490,,,,,,,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,583.06,233.22,0,495.6,495.6,SKIPPED,494.19,494.19,495.6,495.6,0,245.71,285.7,285.7,SKIPPED,SKIPPED,250.72,250.72,495.6
5228505,510,28505,,,,,,,TRT BIG TOE FX,6209,2483.6,0,6209,5277.65,SKIPPED,6209,6209,5277.65,5277.65,0,2616.47,3042.41,3042.41,SKIPPED,SKIPPED,2669.87,2669.87,5277.65
5228510,510,28510,,,,,,,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MA,546.23,218.49,0,464.3,464.3,SKIPPED,388.17,388.17,464.3,464.3,0,230.18,267.65,267.65,0,163.87,234.88,234.88,464.3
5228515,510,28515,,,,,,,TRT PHALANX FX(OTHER THAN GREAT TOE),1054,421.6,0,895.9,895.9,SKIPPED,502.74,502.74,895.9,895.9,0,444.16,516.46,516.46,SKIPPED,SKIPPED,453.22,453.22,895.9
5228899,521,28899,,,,,,,FOOT/TOES SURGERY PROCEDURE,497.7,199.08,0,497.7,423.04,SKIPPED,497.7,497.7,423.04,423.04,423.04,209.73,243.87,243.87,0,149.31,214.01,214.01,0
5229085,983,29085,,,,,,,APPLY HAND/WRIST CAST(GAUNTLET),455.4,182.16,0,387.09,387.09,SKIPPED,295.83,295.83,387.09,387.09,387.09,72.81,223.15,223.15,SKIPPED,SKIPPED,74.3,74.3,0
5229105,983,29105,,,,,,,ARM SPLINT LONG,488.5,195.4,0,415.22,415.22,SKIPPED,259.92,259.92,415.22,415.22,415.22,44.83,239.36,239.36,0,146.55,45.74,45.74,0
5229125,521,29125,,,,,,,WRIST SPLINT,254.1,101.64,0,254.1,215.98,SKIPPED,254.1,254.1,215.98,215.98,215.98,107.07,124.51,124.51,0,76.23,109.26,109.26,0
5229126,983,29126,,,,,,,ARM SPLINT SHORT STATIC,476.3,190.52,0,476.3,404.86,SKIPPED,476.3,476.3,404.86,404.86,404.86,53.39,233.39,233.39,0,142.89,54.48,54.48,0
5229130,521,29130,,,,,,,FINGER SPLINT,175.4,70.16,0,175.4,149.09,SKIPPED,175.4,175.4,149.09,149.09,149.09,73.91,85.95,85.95,0,52.62,75.42,75.42,0
5229405,521,29405,,,,,,,APPL SHORT LEG CAST,368.6,147.44,0,313.31,313.31,SKIPPED,241.11,241.11,313.31,313.31,313.31,155.33,180.61,180.61,SKIPPED,SKIPPED,158.5,158.5,0
5229445,510,29445,,,,,,,APPLICATION RIDGE TOTAL ONTACT LEG CAST,787.68,315.07,0,669.53,669.53,SKIPPED,300.96,300.96,669.53,669.53,0,331.93,385.96,385.96,SKIPPED,SKIPPED,338.7,338.7,669.53
5229505,510,29505,,,,,,,LEG SPLINT LONG,474.1,189.64,0,402.98,402.98,SKIPPED,283.86,283.86,402.98,402.98,0,199.78,232.31,232.31,0,142.23,203.86,203.86,402.98
5229515,521,29515,,,,,,,APPL LOWER LEG SPLINT,599.6,239.84,0,509.66,509.66,SKIPPED,212.04,212.04,509.66,509.66,509.66,252.67,293.8,293.8,0,179.88,257.83,257.83,0
5229540,510,29540,,,,,,,STRAPPING OF ANKLE/FOOT,269.9,107.96,0,229.42,229.42,SKIPPED,56.43,56.43,229.42,229.42,0,113.74,132.25,132.25,0,80.97,116.06,116.06,229.42
5229580,521,29580,,,,,,,STRAPPING UNNA BOOT,454.7,181.88,0,386.5,386.5,SKIPPED,193.23,193.23,386.5,386.5,386.5,191.61,222.8,222.8,0,136.41,195.52,195.52,0
5230300,510,30300,,,,,,,REMOVE NASAL FOREIGN BODY,575,230,0,498.94,488.75,SKIPPED,498.94,498.94,488.75,488.75,0,242.3,281.75,281.75,0,172.5,247.25,247.25,488.75
5230801,510,30801,,,,,,,ABLATE INF TURBINATE SUPERF,1831.2,732.48,0,1831.2,1556.52,SKIPPED,1831.2,1831.2,1556.52,1556.52,0,771.67,897.29,897.29,SKIPPED,SKIPPED,787.42,787.42,1556.52
5230901,521,30901,,,,,,,CONTROL OF NOSEBLEED,623.7,249.48,0,530.14,530.14,SKIPPED,498.94,498.94,530.14,530.14,530.14,262.83,305.61,305.61,0,187.11,268.19,268.19,0
5236468,510,36468,,,,,,,SCLEROTHERAPY,150.9,60.36,0,150.9,128.26,SKIPPED,150.9,150.9,128.26,128.26,0,63.59,73.94,73.94,0,45.27,64.89,64.89,128.26
5236590,510,36590,,,,,,,REMOVE TUNNELED CV CATH,3234.4,1293.76,0,2909.71,2749.24,SKIPPED,2909.71,2909.71,2749.24,2749.24,0,1362.97,1584.86,1584.86,SKIPPED,SKIPPED,1390.79,1390.79,2749.24
5237609,510,37609,,,,,,,"Ligation or biopsy, temporal artery",5659.16,2263.66,0,5659.16,4810.29,SKIPPED,5659.16,5659.16,4810.29,4810.29,0,2384.77,2772.99,2772.99,SKIPPED,SKIPPED,2433.44,2433.44,4810.29
5237785,510,37785,,,,,,,INCISION AND REMOVAL OF VARICOSE VEIN,5888.2,2355.28,0,5888.2,5004.97,SKIPPED,5888.2,5888.2,5004.97,5004.97,0,2481.29,2885.22,2885.22,SKIPPED,SKIPPED,2531.93,2531.93,5004.97
5238505,510,38505,,,,,,,NEEDLE BX LYMPH NODES,1701,680.4,0,1701,1445.85,SKIPPED,1701,1701,1445.85,1445.85,0,716.8,833.49,833.49,SKIPPED,SKIPPED,731.43,731.43,1445.85
5240810,510,40810,,,,,,,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH,3296.52,1318.61,0,2802.04,2802.04,SKIPPED,745.56,745.56,2802.04,2802.04,0,1389.15,1615.29,1615.29,0,988.96,1417.5,1417.5,2802.04
5240812,510,40812,,,,,,,EXCISE/RPR MOUTH LESION,3961.7,1584.68,0,3367.44,3367.44,SKIPPED,949.05,949.05,3367.44,3367.44,0,1669.46,1941.23,1941.23,0,1188.51,1703.53,1703.53,3367.44
5240820,510,40820,,,,,,,TRT MOUTH LESION,3443,1377.2,0,2926.55,2926.55,SKIPPED,1034.55,1034.55,2926.55,2926.55,0,1450.88,1687.07,1687.07,SKIPPED,SKIPPED,1480.49,1480.49,2926.55
5241010,510,41010,,,,,,,INCISION OF TONGUE FOLD,1882.7,753.08,0,1882.7,1600.3,SKIPPED,1882.7,1882.7,1600.3,1600.3,0,793.37,922.52,922.52,SKIPPED,SKIPPED,809.56,809.56,1600.3
5241115,510,41115,,,,,,,EXCISION OF TONGUE FOLD,2356.2,942.48,0,2002.77,2002.77,SKIPPED,851.58,851.58,2002.77,2002.77,0,992.91,1154.54,1154.54,SKIPPED,SKIPPED,1013.17,1013.17,2002.77
5241899,510,41899,,,,,,,DENTOALVEOLAR STRUCTURE,2150.8,860.32,0,1828.18,1828.18,SKIPPED,847.88,847.88,1828.18,1828.18,0,906.34,1053.89,1053.89,0,645.24,924.84,924.84,1828.18
5243762,510,43762,,,,,,,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTR,885.81,354.32,0,885.81,752.94,SKIPPED,885.81,885.81,752.94,752.94,0,373.28,434.05,434.05,0,265.74,380.9,380.9,752.94
5245108,510,45108,,,,,,,RMV ANORECTAL LESION,4348,1739.2,0,4348,3695.8,SKIPPED,4348,4348,3695.8,3695.8,0,1832.25,2130.52,2130.52,SKIPPED,SKIPPED,1869.64,1869.64,3695.8
5246030,510,46030,,,,,,,REMOVAL ANAL SETON OTHER MARKER,3161,1264.4,0,3161,2686.85,SKIPPED,3161,3161,2686.85,2686.85,0,1332.05,1548.89,1548.89,SKIPPED,SKIPPED,1359.23,1359.23,2686.85
5246050,521,46050,,,,,,,I & D PERIANANL ABCESS,1063.7,425.48,0,1063.7,904.14,SKIPPED,1063.7,1063.7,904.14,904.14,904.14,448.24,521.21,521.21,SKIPPED,SKIPPED,457.39,457.39,0
5246083,510,46083,,,,,,,INCISE EXT HEMORRHOID,1141.5,456.6,0,970.28,970.28,SKIPPED,567.96,567.96,970.28,970.28,0,481.03,559.34,559.34,0,342.45,490.85,490.85,970.28
5246221,510,46221,,,,,,,LIGATION OF HEMORRHOID,1894,757.6,0,1609.9,1609.9,SKIPPED,855,855,1609.9,1609.9,0,798.13,928.06,928.06,SKIPPED,SKIPPED,814.42,814.42,1609.9
5246320,521,46320,,,,,,,ENUCLERAT OF HEMORRHOID,2325.8,930.32,0,1976.93,1976.93,SKIPPED,577.98,577.98,1976.93,1976.93,1976.93,980.09,1139.64,1139.64,SKIPPED,SKIPPED,1000.09,1000.09,0
5246600,510,46600,,,,,,,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN,464.23,185.69,0,464.23,394.6,SKIPPED,464.23,464.23,394.6,394.6,0,195.63,227.47,227.47,0,139.27,199.62,199.62,394.6
5246900,510,46900,,,,,,,DESTRUCTION LESION ANUS-SIMPLE,778,311.2,0,769.02,661.3,SKIPPED,769.02,769.02,661.3,661.3,0,327.85,381.22,381.22,0,233.4,334.54,334.54,661.3
5246910,510,46910,,,,,,,DESTRUCTION LESION ANUS-ELECT.,3430,1372,0,2915.5,2915.5,SKIPPED,887.49,887.49,2915.5,2915.5,0,1445.4,1680.7,1680.7,0,1029,1474.9,1474.9,2915.5
5246922,510,46922,,,,,,,EXCISION OF ANAL LESION(S),4471.72,1788.69,0,4471.72,3800.96,SKIPPED,4471.72,4471.72,3800.96,3800.96,0,1884.38,2191.14,2191.14,SKIPPED,SKIPPED,1922.84,1922.84,3800.96
5249180,510,49180,,,,,,,NEEDLE BX ABDOMEN,1868,747.2,0,1868,1587.8,SKIPPED,1868,1868,1587.8,1587.8,0,787.18,915.32,915.32,SKIPPED,SKIPPED,803.24,803.24,1587.8
5249422,510,49422,,,,,,,Removal of tunneled intraperitoneal cath,5558.48,2223.39,0,5558.48,4724.71,SKIPPED,5558.48,5558.48,4724.71,4724.71,0,2342.35,2723.66,2723.66,SKIPPED,SKIPPED,2390.15,2390.15,4724.71
5249460,510,49460,,,,,,,Mechanical removal of obstructive materi,1122.04,448.82,0,1122.04,953.73,SKIPPED,1122.04,1122.04,953.73,953.73,0,472.83,549.8,549.8,SKIPPED,SKIPPED,482.48,482.48,953.73
5251700,510,51700,,,,,,,IRRIGATION OF BLADDER,594.6,237.84,0,505.41,505.41,SKIPPED,247.95,247.95,505.41,505.41,0,250.57,291.35,291.35,0,178.38,255.68,255.68,505.41
5251701,510,51701,,,,,,,IN & OUT CATH,290.8,116.32,0,290.8,247.18,SKIPPED,290.8,290.8,247.18,247.18,0,122.54,142.49,142.49,0,87.24,125.04,125.04,247.18
5251702,510,51702,,,,,,,INSERT TEMP BLADDER CATH,352,140.8,0,352,299.2,SKIPPED,352,352,299.2,299.2,0,148.33,172.48,172.48,0,105.6,151.36,151.36,299.2
5255000,510,55000,,,,,,,DRAINAGE OF HYDROCELE,1095,438,0,930.75,930.75,SKIPPED,309.51,309.51,930.75,930.75,0,461.43,536.55,536.55,0,328.5,470.85,470.85,930.75
5255250,521,55250,,,,,,,VASECTOMY,5646.9,2258.76,0,5646.9,4799.86,SKIPPED,5646.9,5646.9,4799.86,4799.86,4799.86,2379.61,2766.98,2766.98,SKIPPED,SKIPPED,2428.17,2428.17,0
5256405,983,56405,,,,,,,I&D VULVA PERINEAL,890.96,356.38,0,757.32,757.32,SKIPPED,242.82,242.82,757.32,757.32,757.32,140.54,436.57,436.57,SKIPPED,SKIPPED,143.41,143.41,0
5256420,510,56420,,,,,,,INCISION/DRAIN OF BARTHOLIN GLAND,667,266.8,0,566.95,566.95,SKIPPED,316.35,316.35,566.95,566.95,0,281.07,326.83,326.83,SKIPPED,SKIPPED,286.81,286.81,566.95
5257160,521,57160,,,,,,,INSERT PESSARY,327.6,131.04,0,278.46,278.46,SKIPPED,198.36,198.36,278.46,278.46,278.46,138.05,160.52,160.52,0,98.28,140.87,140.87,0
5257456,510,57456,,,,,,,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,721,288.4,0,612.85,612.85,SKIPPED,295.83,295.83,612.85,612.85,0,303.83,353.29,353.29,SKIPPED,SKIPPED,310.03,310.03,612.85
5258100,521,58100,,,,,,,ENDOMETRIAL BIOPSY,412.7,165.08,0,350.8,350.8,SKIPPED,232.56,232.56,350.8,350.8,350.8,173.91,202.22,202.22,SKIPPED,SKIPPED,177.46,177.46,0
5258300,521,58300,,,,,,,INSERT INTRAUTERINE DEVICE,667.8,267.12,0,567.63,567.63,SKIPPED,262.53,262.53,567.63,567.63,567.63,281.41,327.22,327.22,0,200.34,287.15,287.15,0
5258301,521,58301,,,,,,,REMOVE INTRAUTERINE DEVICE,456.8,182.72,0,388.28,388.28,SKIPPED,218.88,218.88,388.28,388.28,388.28,192.49,223.83,223.83,0,137.04,196.42,196.42,0
5262311,510,62322,,,,,,,INJ SPINE LUMBAR/SACRAL,2071.7,828.68,0,2071.7,1760.94,SKIPPED,2071.7,2071.7,1760.94,1760.94,0,873.01,1015.13,1015.13,0,621.51,890.83,890.83,1760.94
5264400,510,64400,,,,,,,N BLOCK INJ TRIGEMINAL,702,280.8,0,596.7,596.7,SKIPPED,408.69,408.69,596.7,596.7,0,295.82,343.98,343.98,0,210.6,301.86,301.86,596.7
5264405,510,64405,,,,,,,OCCIPITAL NERVE BLOCK,1391.3,556.52,0,1182.6,1182.6,SKIPPED,306.09,306.09,1182.6,1182.6,0,586.29,681.74,681.74,0,417.39,598.26,598.26,1182.6
5264418,510,64418,,,,,,,INJ AA&/STRD SUPRASCULAR NERVE,1432.28,572.91,0,1217.44,1217.44,SKIPPED,362.52,362.52,1217.44,1217.44,0,603.56,701.82,701.82,0,429.68,615.88,615.88,1217.44
5264421,510,64421,,,,,,,MULTI NERVE BLOCK INJ RIB AREA,1779,711.6,0,1779,1512.15,SKIPPED,1779,1779,1512.15,1512.15,0,749.67,871.71,871.71,SKIPPED,SKIPPED,764.97,764.97,1512.15
5264425,510,64425,,,,,,,ILLIOINGUINAL NERVE BLOCK,1200.2,480.08,0,1020.17,1020.17,SKIPPED,324.9,324.9,1020.17,1020.17,0,505.77,588.1,588.1,0,360.06,516.09,516.09,1020.17
5264445,510,64445,,,,,,,N BLOCK INJ SCIATIC SNG,1684,673.6,0,1431.4,1431.4,SKIPPED,389.88,389.88,1431.4,1431.4,0,709.64,825.16,825.16,0,505.2,724.12,724.12,1431.4
5264447,510,64447,,,,,,,INJECTION AA&/STRD FEMORAL NERVE,1908.99,763.6,0,1622.64,1622.64,SKIPPED,314.64,314.64,1622.64,1622.64,0,804.45,935.41,935.41,0,572.7,820.87,820.87,1622.64
5264450,521,64450,,,,,,,NERVE BLOCK>PERIPHERAL,1285.2,514.08,0,1092.42,1092.42,SKIPPED,249.66,249.66,1092.42,1092.42,1092.42,541.59,629.75,629.75,0,385.56,552.64,552.64,0
5264455,521,64455,,,,,,,MORTON'S NEUROMA INJECT,405.3,162.12,0,344.5,344.5,SKIPPED,94.05,94.05,344.5,344.5,344.5,170.79,198.6,198.6,SKIPPED,SKIPPED,174.28,174.28,0
5264520,510,64520,,,,,,,INJECTION ANES LMBR/THRC PARAVERTBRL SYM,2299.16,919.66,0,2299.16,1954.29,SKIPPED,2299.16,2299.16,1954.29,1954.29,0,968.87,1126.59,1126.59,SKIPPED,SKIPPED,988.64,988.64,1954.29
5264615,510,64615,,,,,,,CHEMODENERVATION,760.98,304.39,0,646.83,646.83,SKIPPED,297.54,297.54,646.83,646.83,0,320.68,372.88,372.88,0,228.29,327.22,327.22,646.83
5265205,510,65205,,,,,,,REMOVAL FOREIGN BODY FROM EYE,419,167.6,0,419,356.15,SKIPPED,419,419,356.15,356.15,0,176.57,205.31,205.31,0,125.7,180.17,180.17,356.15
5265210,521,65210,,,,,,,REMOVE FOREIGN BODY EYE,148.88,59.55,0,148.88,126.55,SKIPPED,148.88,148.88,126.55,126.55,126.55,62.74,72.95,72.95,0,44.66,64.02,64.02,0
5265220,510,65220,,,,,,,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,435,174,0,435,369.75,SKIPPED,435,435,369.75,369.75,0,183.31,213.15,213.15,0,130.5,187.05,187.05,369.75
5265222,510,65222,,,,,,,"Removal of foreign body, external eye; c",444.05,177.62,0,444.05,377.44,SKIPPED,444.05,444.05,377.44,377.44,0,187.12,217.58,217.58,0,133.22,190.94,190.94,377.44
5267700,510,67700,,,,,,,DRAIN EYELID ABSCES,1107,442.8,0,940.95,940.95,SKIPPED,662.29,662.29,940.95,940.95,0,466.49,542.43,542.43,0,332.1,476.01,476.01,940.95
5267800,510,67800,,,,,,,RMV EYELID LESION,976,390.4,0,829.6,829.6,SKIPPED,364.23,364.23,829.6,829.6,0,411.29,478.24,478.24,SKIPPED,SKIPPED,419.68,419.68,829.6
5267820,510,67820,,,,,,,REVISE EYELASHES,268,107.2,0,268,227.8,SKIPPED,268,268,227.8,227.8,0,112.94,131.32,131.32,0,80.4,115.24,115.24,227.8
5267938,510,67938,,,,,,,RMV FOREIGN BODY-EYELID,960.8,384.32,0,816.68,816.68,SKIPPED,662.29,662.29,816.68,816.68,0,404.88,470.79,470.79,SKIPPED,SKIPPED,413.14,413.14,816.68
5269110,510,69110,,,,,,,REMOVE EXTERNAL EAR PARTIAL,4683,1873.2,0,4683,3980.55,SKIPPED,4683,4683,3980.55,3980.55,0,1973.42,2294.67,2294.67,SKIPPED,SKIPPED,2013.69,2013.69,3980.55
5269200,510,69200,,,,,,,REMOVAL OF FOREIGN BODY FROM EAR,403.2,161.28,0,403.2,342.72,SKIPPED,403.2,403.2,342.72,342.72,0,169.91,197.57,197.57,0,120.96,173.38,173.38,342.72
5269209,510,69209,,,,,,,Removal of impacted cerumen with irrigat,137.6,55.04,0,137.6,116.96,SKIPPED,137.6,137.6,116.96,116.96,0,57.99,67.42,67.42,0,41.28,59.17,59.17,116.96
5269210,521,69210,,,,,,,Removal of impacted cerumen with instrum,137.6,55.04,0,137.6,116.96,SKIPPED,137.6,137.6,116.96,116.96,116.96,57.99,67.42,67.42,0,41.28,59.17,59.17,0
5287220,510,87220,,,,,,,TISSUE EXAM FOR FUNGI,63.1,25.24,0,53.64,53.64,SKIPPED,20.03,20.03,53.64,53.64,0,26.59,3.59,3.59,0,3.99,27.13,27.13,53.64
5290785,510,90785,,,,,,,INTERACTIVE COMPLEXITY,31.74,12.7,0,26.98,26.98,SKIPPED,24.12,24.12,26.98,26.98,0,13.38,15.55,15.55,0,9.52,13.65,13.65,26.98
5290791,510,90791,,,,,,,PSYCH DIAGNOSTIC EVAL,293.02,117.21,0,249.07,249.07,SKIPPED,222.7,222.7,249.07,249.07,0,123.48,143.58,143.58,0,87.91,126,126,249.07
5290792,510,90792,,,,,,,PSYCH DIAGNOSTIC EVAL W/ MEDICAL SERVICE,327.02,130.81,0,277.97,277.97,SKIPPED,248.54,248.54,277.97,277.97,0,137.81,160.24,160.24,0,98.11,140.62,140.62,277.97
5290832,510,90832,,,,,,,PSYCH INDIVIDUAL THERAPY-30 MIN,142.5,57,0,121.12,121.12,SKIPPED,108.3,108.3,121.12,121.12,0,60.05,69.82,69.82,0,42.75,61.28,61.28,121.12
5290833,510,90833,,,,,,,PSYCH PT/FAM W/ E&M-30 MIN,148.18,59.27,0,125.95,125.95,SKIPPED,112.62,112.62,125.95,125.95,0,62.45,72.61,72.61,0,44.45,63.72,63.72,125.95
5290834,510,90834,,,,,,,PSYCH INDIVIDUAL SESSION-45 MIN,190.46,76.18,0,161.89,161.89,SKIPPED,144.75,144.75,161.89,161.89,0,80.26,93.33,93.33,0,57.14,81.9,81.9,161.89
5290836,510,90836,,,,,,,PSYCH PT/FAM W/ E&M-45 MIN,186.92,74.77,0,158.88,158.88,SKIPPED,142.06,142.06,158.88,158.88,0,78.77,91.59,91.59,0,56.08,80.38,80.38,158.88
5290837,510,90837,,,,,,,PSYCH INDIVIDUAL SESSION-60 MIN,285.66,114.26,0,242.81,242.81,SKIPPED,217.1,217.1,242.81,242.81,0,120.37,139.97,139.97,0,85.7,122.83,122.83,242.81
5290838,510,90838,,,,,,,PSYCH PT/FAM W/ E&M-60 MIN,247.06,98.82,0,210,210,SKIPPED,187.77,187.77,210,210,0,104.12,121.06,121.06,0,74.12,106.24,106.24,210
5290839,510,90839,,,,,,,PSYCH CRISIS INTL. 60 MIN,298.1,119.24,0,253.38,253.38,SKIPPED,226.56,226.56,253.38,253.38,0,125.62,146.07,146.07,0,89.43,128.18,128.18,253.38
5290840,510,90840,,,,,,,PSYTX CRISIS EA ADDL 30 MIN,305.62,122.25,0,259.78,259.78,SKIPPED,232.27,232.27,259.78,259.78,0,128.79,149.75,149.75,0,91.69,131.42,131.42,259.78
5290846,510,90846,,,,,,,PSYCH FAMILY SESSION W/O PATIENT,229.84,91.94,0,195.36,195.36,SKIPPED,174.68,174.68,195.36,195.36,0,96.85,112.62,112.62,0,68.95,98.83,98.83,195.36
5290847,510,90847,,,,,,,PSYCH FAMILY SESSION,239.18,95.67,0,203.3,203.3,SKIPPED,181.78,181.78,203.3,203.3,0,100.79,117.2,117.2,0,71.75,102.85,102.85,203.3
5290863,510,90863,,,,,,,PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY,235,94,0,199.75,199.75,SKIPPED,178.6,178.6,199.75,199.75,0,99.03,115.15,115.15,0,70.5,101.05,101.05,199.75
5293285,510,93285,,,,,,,PROGRAMMING DEVICE EVAL.SUBQ CARDIAC MON,188.69,75.48,0,179.26,160.39,SKIPPED,179.26,179.26,160.39,160.39,0,79.52,92.46,92.46,0,56.61,81.14,81.14,160.39
5295992,510,95992,,,,,,,CANALITH REPOSITIONING PROC.,253.1,101.24,0,215.14,215.14,SKIPPED,182.4,182.4,215.14,215.14,0,106.65,124.02,124.02,0,75.93,108.83,108.83,215.14
5296101,510,96101,,,,,,,PSYCH TESTING BY PSYCH,180.2,72.08,0,153.17,153.17,SKIPPED,136.95,136.95,153.17,153.17,0,75.94,88.3,88.3,0,54.06,77.49,77.49,153.17
5296160,510,96160,,,,,,,PT-FOCUSED HLTH RISK ASSMT,55,22,0,46.75,46.75,SKIPPED,18.76,18.76,46.75,46.75,0,23.18,26.95,26.95,0,16.5,23.65,23.65,46.75
5296161,510,96161,,,,,,,CAREGIVER HLTH RISK ASSMT SCORE,70,28,0,59.5,59.5,SKIPPED,18.76,18.76,59.5,59.5,0,29.5,34.3,34.3,0,21,30.1,30.1,59.5
5296374,510,96374,,,,,,,THER/PROPH/DIAG INJ IV PUSH,326.96,130.78,0,277.92,277.92,SKIPPED,223.3,223.3,277.92,277.92,0,137.78,160.21,160.21,0,98.09,140.59,140.59,277.92
5297597,510,97597,,,,,,,RMV DEVITAL TISS 20 CM/<,409.8,163.92,0,348.33,348.33,SKIPPED,115.9,115.9,348.33,348.33,0,172.69,200.8,200.8,0,122.94,176.21,176.21,348.33
5297598,510,97598,,,,,,,RMV DEVITAL TISS ADTL 20 CM<,291.9,116.76,0,248.12,248.12,SKIPPED,54.53,54.53,248.12,248.12,0,123.01,143.03,143.03,0,87.57,125.52,125.52,248.12
5298925,510,98925,,,,,,,OMT 1-2 REGIONS,92.06,36.82,0,92.06,78.25,SKIPPED,92.06,92.06,78.25,78.25,0,38.8,45.11,45.11,0,27.62,39.59,39.59,78.25
5299201,521,99201,,,,,,,CLINIC VISIT LVL 1 NEW,94.74,37.9,0,94.74,80.53,SKIPPED,94.74,94.74,80.53,80.53,80.53,39.93,46.42,46.42,0,28.42,40.74,40.74,0
5299202,521,99202,,,,,,,CLINIC VISIT LVL 2 NEW,160.06,64.02,0,160.06,136.05,SKIPPED,160.06,160.06,136.05,136.05,136.05,67.45,78.43,78.43,0,48.02,68.83,68.83,0
5299203,521,99203,,,,,,,CLINIC VISIT LVL 3 NEW,230.28,92.11,0,230.28,195.74,SKIPPED,230.28,230.28,195.74,195.74,195.74,97.04,112.84,112.84,0,69.08,99.02,99.02,0
5299204,521,99204,,,,,,,CLINIC VISIT LVL 4 NEW,352.48,140.99,0,352.48,299.61,SKIPPED,352.48,352.48,299.61,299.61,299.61,148.54,172.72,172.72,0,105.74,151.57,151.57,0
5299205,521,99205,,,,,,,CLINIC VISIT LVL 5 NEW,443.84,177.54,0,443.84,377.26,SKIPPED,443.84,443.84,377.26,377.26,377.26,187.03,217.48,217.48,0,133.15,190.85,190.85,0
5299211,521,99211,,,,,,,CLINIC VISIT LVL 1 ESTABLISHED,45.78,18.31,0,44.32,38.91,SKIPPED,44.32,44.32,38.91,38.91,38.91,19.3,22.43,22.43,0,13.73,19.69,19.69,0
5299212,521,99212,,,,,,,CLINIC VISIT LVL 2 ESTABLISHED,93.38,37.35,0,93.38,79.37,SKIPPED,93.38,93.38,79.37,79.37,79.37,39.35,45.76,45.76,0,28.01,40.15,40.15,0
5299213,521,99213,,,,,,,CLINIC VISIT LVL 3 ESTABLISHED,155.94,62.38,0,155.94,132.55,SKIPPED,155.94,155.94,132.55,132.55,132.55,65.71,76.41,76.41,0,46.78,67.05,67.05,0
5299214,521,99214,,,,,,,CLINIC VISIT LVL 4 ESTABLISHED,230.5,92.2,0,230.5,195.92,SKIPPED,230.5,230.5,195.92,195.92,195.92,97.14,112.94,112.94,0,69.15,99.12,99.12,0
5299215,521,99215,,,,,,,CLINIC VISIT LVL 5 ESTABLISHED,311.12,124.45,0,311.12,264.45,SKIPPED,311.12,311.12,264.45,264.45,264.45,131.1,152.45,152.45,0,93.34,133.78,133.78,0
5299354,510,99354,,,,,,,PROLONG E&M/PSYCTX SERV O/P,281.84,112.74,0,281.84,239.56,SKIPPED,281.84,281.84,239.56,239.56,0,118.77,138.1,138.1,0,84.55,121.19,121.19,239.56
5299355,510,99355,,,,,,,PROLONG E&M/PSYCTX SERV OP ADD 30 MIN,213.14,85.26,0,213.14,181.17,SKIPPED,213.14,213.14,181.17,181.17,0,89.82,104.44,104.44,0,63.94,91.65,91.65,181.17
5299358,510,99358,,,,,,,PROLONGED SERVICE NON FACE TO FACE ONLY,362.46,144.98,0,362.46,308.09,SKIPPED,362.46,362.46,308.09,308.09,0,152.74,177.61,177.61,0,108.74,155.86,155.86,308.09
5299359,510,99359,,,,,,,PROLONGED SERVICE NON FACE/FACE 15 ADDTL,181.23,72.49,0,181.23,154.05,SKIPPED,181.23,181.23,154.05,154.05,0,76.37,88.8,88.8,0,54.37,77.93,77.93,154.05
5299381,521,99381,,,,,,,INIT PM E/M NEW PT INFANT,232.1,92.84,0,232.1,197.28,SKIPPED,232.1,232.1,197.28,197.28,197.28,97.8,113.73,113.73,0,69.63,99.8,99.8,0
5299382,521,99382,,,,,,,INIT PM E/M NEW PT 1-4YRS,245.7,98.28,0,245.7,208.84,SKIPPED,245.7,245.7,208.84,208.84,208.84,103.54,120.39,120.39,0,73.71,105.65,105.65,0
5299383,521,99383,,,,,,,PREV VISIT NEW PT 5-11YRS,278.3,111.32,0,278.3,236.56,SKIPPED,278.3,278.3,236.56,236.56,236.56,117.28,136.37,136.37,0,83.49,119.67,119.67,0
5299384,521,99384,,,,,,,PREV VISIT NEW PT 12-17YRS,328.7,131.48,0,328.7,279.4,SKIPPED,328.7,328.7,279.4,279.4,279.4,138.51,161.06,161.06,0,98.61,141.34,141.34,0
5299385,521,99385,,,,,,,PREV VISIT NEW PT 18-39YRS,361.2,144.48,0,361.2,307.02,SKIPPED,361.2,361.2,307.02,307.02,307.02,152.21,176.99,176.99,0,108.36,155.32,155.32,0
5299386,521,99386,,,,,,,PREV VISIT NEW PT 40-64YRS,540.8,216.32,0,540.8,459.68,SKIPPED,540.8,540.8,459.68,459.68,459.68,227.89,264.99,264.99,0,162.24,232.54,232.54,0
5299387,521,99387,,,,,,,PREV VISIT NEW PT 65 & OLDER,440,176,0,440,374,SKIPPED,440,440,374,374,374,185.42,215.6,215.6,0,132,189.2,189.2,0
5299391,521,99391,,,,,,,PHYS RE-EVAL EST PT INFANT,212.1,84.84,0,212.1,180.28,SKIPPED,212.1,212.1,180.28,180.28,180.28,89.38,103.93,103.93,0,63.63,91.2,91.2,0
5299392,521,99392,,,,,,,PREV VISIT & EST PT 1-4 YRS,217.4,86.96,0,217.4,184.79,SKIPPED,217.4,217.4,184.79,184.79,184.79,91.61,106.53,106.53,0,65.22,93.48,93.48,0
5299393,521,99393,,,,,,,PHYS EST PT 5-11YRS,236.3,94.52,0,236.3,200.86,SKIPPED,236.3,236.3,200.86,200.86,200.86,99.58,115.79,115.79,0,70.89,101.61,101.61,0
5299394,521,99394,,,,,,,PHYS EST PT 12-17YRS,291.9,116.76,0,291.9,248.12,SKIPPED,291.9,291.9,248.12,248.12,248.12,123.01,143.03,143.03,0,87.57,125.52,125.52,0
5299395,521,99395,,,,,,,PHYS EST PT 18-39YRS,363.3,145.32,0,363.3,308.8,SKIPPED,363.3,363.3,308.8,308.8,308.8,153.1,178.02,178.02,0,108.99,156.22,156.22,0
5299396,521,99396,,,,,,,PHYS EST PT 40-64YRS,401.1,160.44,0,401.1,340.94,SKIPPED,401.1,401.1,340.94,340.94,340.94,169.02,196.54,196.54,0,120.33,172.47,172.47,0
5299397,521,99397,,,,,,,PREV REEVAL EST PT 65 & OLDER,364.4,145.76,0,364.4,309.74,SKIPPED,364.4,364.4,309.74,309.74,309.74,153.56,178.56,178.56,0,109.32,156.69,156.69,0
5299406,510,99406,,,,,,,BEHAV CHNG SMOKING 3-10MIN,31.22,12.49,0,31.22,26.54,SKIPPED,31.22,31.22,26.54,26.54,0,13.15,15.3,15.3,0,9.37,13.42,13.42,26.54
5299407,510,99407,,,,,,,BEHAV CHNG SMOKING >10 MIN,60.28,24.11,0,60.28,51.24,SKIPPED,60.28,60.28,51.24,51.24,0,25.4,29.54,29.54,0,18.08,25.92,25.92,51.24
5299417,510,99417,,,,,,,PROLONGED E/M EACH 15 MIN,148,59.2,0,125.8,125.8,SKIPPED,112.48,112.48,125.8,125.8,0,62.37,72.52,72.52,0,44.4,63.64,63.64,125.8
5299490,510,99490,,,,,,,CHRONIC CARE MGMT SRVC.,197.4,78.96,0,167.79,167.79,SKIPPED,155.14,155.14,167.79,167.79,0,83.18,96.73,96.73,0,59.22,84.88,84.88,167.79
5299495,510,99495,,,,,,,TRANS CARE MGMT 14 DAY DISCH,351.18,140.47,0,351.18,298.5,SKIPPED,351.18,351.18,298.5,298.5,0,147.99,172.08,172.08,0,105.35,151.01,151.01,298.5
5299496,510,99496,,,,,,,TRANSCARE MGMT 7 DAY DISCH,551.66,220.66,0,540.03,468.91,SKIPPED,540.03,540.03,468.91,468.91,0,232.47,270.31,270.31,0,165.5,237.21,237.21,468.91
5299497,510,99497,,,,,,,ADVNCD CARE PLAN 30 MIN,182.52,73.01,0,182.52,155.14,SKIPPED,182.52,182.52,155.14,155.14,0,76.91,89.43,89.43,0,54.76,78.48,78.48,155.14
5299498,510,99498,,,,,,,ADVNCD CARE PLAN ADTL 30 MIN,161.48,64.59,0,161.48,137.26,SKIPPED,161.48,161.48,137.26,137.26,0,68.05,79.13,79.13,0,48.44,69.44,69.44,137.26
5299999,510,99213,,,,,,,OCCUPATIONAL HEA-PRE EMPLOYMENT PHYSICAL,67,26.8,0,67,56.95,SKIPPED,67,67,56.95,56.95,0,28.23,32.83,32.83,0,20.1,28.81,28.81,56.95
52G0101,510,G0101,,,,,,,CERVICAL OR VAGINAL CANCER SCRRENING,145.79,58.32,0,134.66,123.92,SKIPPED,134.66,134.66,123.92,123.92,0,61.44,71.44,71.44,0,43.74,62.69,62.69,123.92
52G2025,521,G2025,,,,,,,MEDICARE RHC TELEHEALTH,150,60,0,127.5,127.5,SKIPPED,114,114,127.5,127.5,127.5,63.21,73.5,73.5,0,45,64.5,64.5,0
52Q0091,510,Q0091,,,,,,,SCREENING PAP SMEAR,85.48,34.19,0,76.38,72.66,SKIPPED,76.38,76.38,72.66,72.66,0,36.02,41.89,41.89,0,25.64,36.76,36.76,72.66
5310060,510,10060,,,,,,,DRAINAGE OF SKIN ABSCESS-SIMPLE,394.68,157.87,0,347.13,335.48,SKIPPED,347.13,347.13,335.48,335.48,0,166.32,193.39,193.39,0,118.4,169.71,169.71,335.48
5310061,510,10061,,,,,,,DRAINAGE OF SKIN ABSCESS-COMPLICATED,394.68,157.87,0,394.68,335.48,SKIPPED,394.68,394.68,335.48,335.48,0,166.32,193.39,193.39,SKIPPED,SKIPPED,169.71,169.71,335.48
5310127,510,G0127,,,,,,,TRIM DYSTROPHIC NAILS,104.74,41.9,0,104.74,89.03,SKIPPED,104.74,104.74,89.03,89.03,0,44.14,51.32,51.32,0,31.42,45.04,45.04,89.03
5310160,510,10160,,,,,,,PUNCTURE ASPRATE ABS,272.28,108.91,0,272.28,231.44,SKIPPED,272.28,272.28,231.44,231.44,0,114.74,133.42,133.42,0,81.68,117.08,117.08,231.44
5311042,761,11042,,,,,,,DEB SUBQ TISSUE 20SQ CM/<,626.02,250.41,263.81,626.02,532.12,SKIPPED,626.02,626.02,532.12,532.12,532.12,263.81,306.75,306.75,SKIPPED,SKIPPED,269.19,269.19,532.12
5311043,510,11043,,,,,,,DEB MUSC/FASCIA 20 SQ CM/<,596.21,238.48,0,596.21,506.78,SKIPPED,596.21,596.21,506.78,506.78,0,251.24,292.14,292.14,SKIPPED,SKIPPED,256.37,256.37,506.78
5311044,510,11044,,,,,,,DEB BONE 20 SQ CM/<,1659.41,663.76,0,1659.41,1410.5,SKIPPED,1659.41,1659.41,1410.5,1410.5,0,699.28,813.11,813.11,SKIPPED,SKIPPED,713.55,713.55,1410.5
5311045,510,11045,,,,,,,DEB SUBQ TIS ADD-ON,569.1,227.64,0,483.74,483.74,SKIPPED,0,0,483.74,483.74,0,239.82,278.86,278.86,0,170.73,244.71,244.71,483.74
5311046,510,11046,,,,,,,DEB MUSC/FASCIA ADD-ON,569.1,227.64,0,483.74,483.74,SKIPPED,0,0,483.74,483.74,0,239.82,278.86,278.86,0,170.73,244.71,244.71,483.74
5311047,510,11047,,,,,,,DEB BONE ADD-ON,913.22,365.29,0,776.24,776.24,SKIPPED,0,0,776.24,776.24,0,384.83,447.48,447.48,0,273.97,392.68,392.68,776.24
5311055,510,11055,,,,,,,TRIM SKIN LESION(1 LESION),240.07,96.03,0,240.07,204.06,SKIPPED,240.07,240.07,204.06,204.06,0,101.17,117.63,117.63,0,72.02,103.23,103.23,204.06
5311056,510,11056,,,,,,,TRIM SKIN LESION(2-4 LESIONS),356.14,142.46,0,356.14,302.72,SKIPPED,356.14,356.14,302.72,302.72,0,150.08,174.51,174.51,0,106.84,153.14,153.14,302.72
5311057,510,11057,,,,,,,TRIM SKIN LESION(MORE THAN 4 LESIONS),356.14,142.46,0,302.72,302.72,SKIPPED,203.49,203.49,302.72,302.72,0,150.08,174.51,174.51,0,106.84,153.14,153.14,302.72
5311100,510,11104,,,,,,,BIOPSY SKIN LESION(1 LESION),276.53,110.61,0,276.53,235.05,SKIPPED,276.53,276.53,235.05,235.05,0,116.53,135.5,135.5,0,82.96,118.91,118.91,235.05
5311101,510,11105,,,,,,,BIOPSY SKIN LESION EACH ADTL.,185,74,0,157.25,157.25,SKIPPED,0,0,157.25,157.25,0,77.96,90.65,90.65,0,55.5,79.55,79.55,157.25
5311106,510,11106,,,,,,,Incisional biopsy of skin; single lesion,329.78,131.91,0,329.78,280.31,SKIPPED,329.78,329.78,280.31,280.31,0,138.97,161.59,161.59,0,98.93,141.81,141.81,280.31
5311719,510,11719,,,,,,,TRIM NAIL(S),127.63,51.05,0,127.63,108.49,SKIPPED,127.63,127.63,108.49,108.49,0,53.78,62.54,62.54,0,38.29,54.88,54.88,108.49
5311720,510,11720,,,,,,,DEBRIDE NAIL 1-5,127.63,51.05,0,127.63,108.49,SKIPPED,127.63,127.63,108.49,108.49,0,53.78,62.54,62.54,0,38.29,54.88,54.88,108.49
5311721,510,11721,,,,,,,DEBRIDE NAIL 6 OR MORE,127.63,51.05,0,127.63,108.49,SKIPPED,127.63,127.63,108.49,108.49,0,53.78,62.54,62.54,0,38.29,54.88,54.88,108.49
5311730,510,11730,,,,,,,REMOVAL OF NAIL PLATE,185,74,0,185,157.25,SKIPPED,185,185,157.25,157.25,0,77.96,90.65,90.65,0,55.5,79.55,79.55,157.25
5311732,510,11732,,,,,,,REMOVAL OF NAIL PLATE ADD-ON,185,74,0,157.25,157.25,SKIPPED,0,0,157.25,157.25,0,77.96,90.65,90.65,0,55.5,79.55,79.55,157.25
5311750,510,11750,,,,,,,REMOVAL OF NAIL BED,922.57,369.03,0,784.18,784.18,SKIPPED,456.57,456.57,784.18,784.18,0,388.78,452.06,452.06,SKIPPED,SKIPPED,396.71,396.71,784.18
5313160,510,13160,,,,,,,LATE CLOSURE OF WOUND,5952.54,2381.02,0,5952.54,5059.66,SKIPPED,5952.54,5952.54,5059.66,5059.66,0,2508.4,2916.74,2916.74,SKIPPED,SKIPPED,2559.59,2559.59,5059.66
5315110,510,15110,,,,,,,EPIDRM AGRFT T/A/L 1ST 100 CM,3424.66,1369.86,0,3424.66,2910.96,SKIPPED,3424.66,3424.66,2910.96,2910.96,0,1443.15,1678.08,1678.08,SKIPPED,SKIPPED,1472.6,1472.6,2910.96
5315271,510,15271,,,,,,,SKIN SUB GRAFT TRNK/ARM/LEG,1815.53,726.21,0,1815.53,1543.2,SKIPPED,1815.53,1815.53,1543.2,1543.2,0,765.07,889.61,889.61,SKIPPED,SKIPPED,780.68,780.68,1543.2
5315272,510,15272,,,,,,,SKIN SUB GRAFT TRNK/ARM/LEG ADD-ON,221.72,88.69,0,188.46,188.46,SKIPPED,0,0,188.46,188.46,0,93.43,108.64,108.64,0,66.52,95.34,95.34,188.46
5315273,510,15273,,,,,,,SKIN SUB GRFT T/ARM/LG CHILD,3137.52,1255.01,0,3137.52,2666.89,SKIPPED,3137.52,3137.52,2666.89,2666.89,0,1322.15,1537.38,1537.38,SKIPPED,SKIPPED,1349.13,1349.13,2666.89
5315274,510,15274,,,,,,,SKIN SUB GRFT T/ARM/LG CHILD ADD-ON,650.18,260.07,0,552.65,552.65,SKIPPED,0,0,552.65,552.65,0,273.99,318.59,318.59,0,195.05,279.58,279.58,552.65
5315275,510,15275,,,,,,,SKIN SUB GRAFT FACE/NK/HF/G,1815.53,726.21,0,1815.53,1543.2,SKIPPED,1815.53,1815.53,1543.2,1543.2,0,765.07,889.61,889.61,SKIPPED,SKIPPED,780.68,780.68,1543.2
5315276,510,15276,,,,,,,SKIN SUB GRAFT FACE/NK/HF/G ADD-ON,221.72,88.69,0,188.46,188.46,SKIPPED,0,0,188.46,188.46,0,93.43,108.64,108.64,0,66.52,95.34,95.34,188.46
5315277,510,15277,,,,,,,SKN SUB GRFT F/N/HF/G CHILD,1815.53,726.21,0,1815.53,1543.2,SKIPPED,1815.53,1815.53,1543.2,1543.2,0,765.07,889.61,889.61,SKIPPED,SKIPPED,780.68,780.68,1543.2
5315278,510,15278,,,,,,,SKN SUB GRFT F/N/HF/G CHILD ADD-ON,650.18,260.07,0,552.65,552.65,SKIPPED,0,0,552.65,552.65,0,273.99,318.59,318.59,0,195.05,279.58,279.58,552.65
5316020,510,16020,,,,,,,DRESS/DEBRID P-THICK BURN SMALL,356.14,142.46,0,356.14,302.72,SKIPPED,356.14,356.14,302.72,302.72,0,150.08,174.51,174.51,0,106.84,153.14,153.14,302.72
5316025,510,16025,,,,,,,DRESS/DEBRID P-THICK BURN MEDIUM,356.14,142.46,0,356.14,302.72,SKIPPED,356.14,356.14,302.72,302.72,0,150.08,174.51,174.51,0,106.84,153.14,153.14,302.72
5316030,510,16030,,,,,,,DRESS/DEBRID P-THICK BURN LARGE,690.04,276.02,0,690.04,586.53,SKIPPED,690.04,690.04,586.53,586.53,0,290.79,338.12,338.12,SKIPPED,SKIPPED,296.72,296.72,586.53
5317250,510,17250,,,,,,,CHEMICAL CAUTERY OF TISSUE,356.14,142.46,0,356.14,302.72,SKIPPED,356.14,356.14,302.72,302.72,0,150.08,174.51,174.51,0,106.84,153.14,153.14,302.72
5328010,510,28010,,,,,,,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,2574.56,1029.82,0,2188.38,2188.38,SKIPPED,589.95,589.95,2188.38,2188.38,0,1084.92,1261.53,1261.53,SKIPPED,SKIPPED,1107.06,1107.06,2188.38
5329445,510,29445,,,,,,,APPLY RIGID LEG CAST,544.18,217.67,0,462.55,462.55,SKIPPED,300.96,300.96,462.55,462.55,0,229.32,266.65,266.65,SKIPPED,SKIPPED,234,234,462.55
5329580,510,29580,,,,,,,APPLY UNNA BOOT(UNILATERAL),311.65,124.66,0,264.9,264.9,SKIPPED,193.23,193.23,264.9,264.9,0,131.33,152.71,152.71,0,93.5,134.01,134.01,264.9
5329581,510,29581,,,,,,,APPLY MULTLAY COMPRS LWL LG(UNILATERAL),311.65,124.66,0,307.8,264.9,SKIPPED,307.8,307.8,264.9,264.9,0,131.33,152.71,152.71,0,93.5,134.01,134.01,264.9
5329582,510,29580,,,,,,,APPLY UNNA BOOT(BILATERAL),623.31,249.32,0,529.81,529.81,SKIPPED,193.23,193.23,529.81,529.81,0,262.66,305.42,305.42,0,186.99,268.02,268.02,529.81
5329583,510,29581,,,,,,,APPLY MULTLAY COMPRS LWL LG(BILATERAL),623.31,249.32,0,529.81,529.81,SKIPPED,307.8,307.8,529.81,529.81,0,262.66,305.42,305.42,0,186.99,268.02,268.02,529.81
5369210,510,69210,,,,,,,REMOVE IMPACTED EAR WAX,127.63,51.05,0,127.63,108.49,SKIPPED,127.63,127.63,108.49,108.49,0,53.78,62.54,62.54,0,38.29,54.88,54.88,108.49
5393921,921,93921,,,,,,,LOWER XTREMITY ART 2 LEVELS(UNILATERAL),151.49,60.6,0,128.77,128.77,SKIPPED,115.13,115.13,128.77,128.77,128.77,63.84,74.23,74.23,0,45.45,65.14,65.14,128.77
5393922,921,93922,,,,,,,UPR/L XTREMITY ART 2 LEVELS(BILATERAL),302.87,121.15,0,302.87,257.44,SKIPPED,302.87,302.87,257.44,257.44,257.44,127.63,148.41,148.41,0,90.86,130.23,130.23,257.44
5393923,921,93923,,,,,,,UPR/L XTREMITY STDY 3+LEVELS(BILATERAL),302.87,121.15,0,302.87,257.44,SKIPPED,302.87,302.87,257.44,257.44,257.44,127.63,175.83,175.83,0,87.28,130.23,130.23,257.44
5396372,510,96372,,,,,,,THER/PROPH/DIAG INJ SC/IM,130.55,52.22,0,130.55,110.97,SKIPPED,130.55,130.55,110.97,110.97,0,55.02,63.97,63.97,0,39.16,56.14,56.14,110.97
5397597,510,97597,,,,,,,RMVL DEVITAL TIS 20 CM/<,304.12,121.65,0,258.5,258.5,SKIPPED,115.9,115.9,258.5,258.5,0,128.15,149.02,149.02,0,91.24,130.77,130.77,258.5
5397598,510,97598,,,,,,,RMVL DEVITAL TIS ADDL 20 CM<,290.39,116.16,0,246.83,246.83,SKIPPED,54.53,54.53,246.83,246.83,0,122.37,142.29,142.29,0,87.12,124.87,124.87,246.83
5397602,510,97602,,,,,,,WOUND CARE NON-SELECTIVE,356.14,142.46,0,356.14,302.72,SKIPPED,356.14,356.14,302.72,302.72,0,150.08,174.51,174.51,0,106.84,153.14,153.14,302.72
5397605,510,97605,,,,,,,NEG PRESS WOUND TX<50CM,240.07,96.03,0,240.07,204.06,SKIPPED,240.07,240.07,204.06,204.06,0,101.17,117.63,117.63,0,72.02,103.23,103.23,204.06
5397606,510,97606,,,,,,,NEG PRESS WOUND TX>50CM,356.14,142.46,0,356.14,302.72,SKIPPED,356.14,356.14,302.72,302.72,0,150.08,174.51,174.51,0,106.84,153.14,153.14,302.72
5397607,510,97607,,,,,,,NEG PRESSURE WOUND THERAPY NON DME = 5,626.19,250.48,0,626.19,532.26,SKIPPED,626.19,626.19,532.26,532.26,0,263.87,306.83,306.83,0,187.86,269.26,269.26,532.26
5397608,510,97608,,,,,,,NEG PRESSURE WOUND THERAPY NON DME >50 S,550.8,220.32,0,550.8,468.18,SKIPPED,550.8,550.8,468.18,468.18,0,232.1,269.89,269.89,0,165.24,236.84,236.84,468.18
5399183,940,G0277,,,,,,,HBO TX -PER 30 MIN,1118.67,447.47,0,950.87,950.87,SKIPPED,542.31,542.31,950.87,950.87,950.87,471.41,548.15,548.15,0,335.6,481.03,481.03,950.87
5399201,510,99201,,,,,,,FACILITY LVL 1-NEW,236.16,94.46,0,200.74,200.74,SKIPPED,129.58,129.58,200.74,200.74,0,99.52,115.72,115.72,0,70.85,101.55,101.55,200.74
5399202,510,99202,,,,,,,FACILITY LVL 2-NEW,236.16,94.46,0,236.16,200.74,SKIPPED,236.16,236.16,200.74,200.74,0,99.52,115.72,115.72,0,70.85,101.55,101.55,200.74
5399203,510,99203,,,,,,,FACILITY LVL 3-NEW,236.16,94.46,0,236.16,200.74,SKIPPED,236.16,236.16,200.74,200.74,0,99.52,115.72,115.72,0,70.85,101.55,101.55,200.74
5399204,510,99204,,,,,,,FACILITY LVL 4-NEW,236.16,94.46,0,236.16,200.74,SKIPPED,236.16,236.16,200.74,200.74,0,99.52,115.72,115.72,0,70.85,101.55,101.55,200.74
5399205,510,99205,,,,,,,FACILITY LVL 5-NEW,236.16,94.46,0,236.16,200.74,SKIPPED,236.16,236.16,200.74,200.74,0,99.52,115.72,115.72,0,70.85,101.55,101.55,200.74
5399211,510,99211,,,,,,,FACILITY LVL 1-EST.,236.16,94.46,0,200.74,200.74,SKIPPED,44.32,44.32,200.74,200.74,0,99.52,115.72,115.72,0,70.85,101.55,101.55,200.74
5399212,510,99212,,,,,,,FACILITY LVL 2-EST.,236.16,94.46,0,200.74,200.74,SKIPPED,122.74,122.74,200.74,200.74,0,99.52,115.72,115.72,0,70.85,101.55,101.55,200.74
5399213,510,99213,,,,,,,FACILITY LVL 3-EST.,236.16,94.46,0,236.16,200.74,SKIPPED,236.16,236.16,200.74,200.74,0,99.52,115.72,115.72,0,70.85,101.55,101.55,200.74
5399214,510,99214,,,,,,,FACILITY LVL 4-EST.,236.16,94.46,0,236.16,200.74,SKIPPED,236.16,236.16,200.74,200.74,0,99.52,115.72,115.72,0,70.85,101.55,101.55,200.74
5399215,510,99215,,,,,,,FACILITY LVL 5-EST.,236.16,94.46,0,236.16,200.74,SKIPPED,236.16,236.16,200.74,200.74,0,99.52,115.72,115.72,0,70.85,101.55,101.55,200.74
5410060,983,10060,,,,,,,DRAINAGE OF SKIN ABSCESS-SIMPLE,240.8,96.32,0,240.8,204.68,SKIPPED,240.8,240.8,204.68,204.68,204.68,115.12,117.99,117.99,0,72.24,117.47,117.47,0
5410061,983,10061,,,,,,,DRAINAGE OF SKIN ABSCESS-COMPLICATED,407.34,162.94,0,407.34,346.24,SKIPPED,407.34,407.34,346.24,346.24,346.24,200.8,199.6,199.6,SKIPPED,SKIPPED,204.9,204.9,0
5410127,983,G0127,,,,,,,TRIM DYSTROPHIC NAILS,17.81,7.12,0,17.81,15.14,SKIPPED,17.81,17.81,15.14,15.14,15.14,8.35,8.73,8.73,0,5.34,8.52,8.52,0
5410160,983,10160,,,,,,,PUNCTURE ASPRATE ABS,314.82,125.93,0,314.82,267.6,SKIPPED,314.82,314.82,267.6,267.6,267.6,104.09,154.26,154.26,0,94.45,106.21,106.21,0
5411042,983,11042,,,,,,,DEB SUQ TIS 20 SQ CM/<,212.5,85,0,212.5,180.62,SKIPPED,212.5,212.5,180.62,180.62,180.62,65.59,104.12,104.12,SKIPPED,SKIPPED,66.93,66.93,0
5411043,983,11043,,,,,,,DEB MUSC/FASCIA 20 SQ CM/<,413.16,165.26,0,413.16,351.19,SKIPPED,413.16,413.16,351.19,351.19,351.19,166.79,202.45,202.45,SKIPPED,SKIPPED,170.19,170.19,0
5411044,983,11044,,,,,,,DEB BONE 20 SQ CM/<,617.12,246.85,0,617.12,524.55,SKIPPED,617.12,617.12,524.55,524.55,524.55,243.61,302.39,302.39,SKIPPED,SKIPPED,248.58,248.58,0
5411045,983,11045,,,,,,,DEB SUBQ TIS ADD-ON,90.75,36.3,0,77.14,77.14,SKIPPED,0,0,77.14,77.14,77.14,28.25,44.47,44.47,0,27.22,28.83,28.83,0
5411046,983,11046,,,,,,,DEB MUSC/FASCIA ADD-ON,189.76,75.9,0,161.3,161.3,SKIPPED,0,0,161.3,161.3,161.3,59.63,92.98,92.98,0,56.93,60.85,60.85,0
5411047,983,11047,,,,,,,DEB BONE ADD-ON,323.45,129.38,0,274.93,274.93,SKIPPED,0,0,274.93,274.93,274.93,104.39,158.49,158.49,0,97.04,106.52,106.52,0
5411055,983,11055,,,,,,,TRIM SKIN LESION(1 LESION),55.79,22.32,0,55.79,47.42,SKIPPED,55.79,55.79,47.42,47.42,47.42,17.53,27.34,27.34,0,16.74,17.89,17.89,0
5411056,983,11056,,,,,,,TRIM SKIN LESION(2-4 LESIONS),78.81,31.52,0,78.81,66.99,SKIPPED,78.81,78.81,66.99,66.99,66.99,24.51,38.62,38.62,0,23.64,25.01,25.01,0
5411057,983,11057,,,,,,,TRIM SKIN LESION(MORE THAN 4 LESIONS),104.08,41.63,0,104.08,88.47,SKIPPED,104.08,104.08,88.47,88.47,88.47,31.7,51,51,0,31.22,32.35,32.35,0
5411100,983,11104,,,,,,,BIOPSY SKIN LESION(1 LESION),122.41,48.96,0,122.41,104.05,SKIPPED,122.41,122.41,104.05,104.05,104.05,51.18,59.98,59.98,0,36.72,52.22,52.22,0
5411101,983,11105,,,,,,,BIOPSY SKIN LESION EACH ADTL.,80.23,32.09,0,68.2,68.2,SKIPPED,0,0,68.2,68.2,68.2,28.01,39.31,39.31,0,24.07,28.58,28.58,0
5411106,983,11106,,,,,,,Incisional biopsy of skin; single lesion,126.76,50.7,0,126.76,107.75,SKIPPED,126.76,126.76,107.75,107.75,107.75,62,62.11,62.11,0,38.03,63.27,63.27,0
5411719,983,11719,,,,,,,TRIM NAIL(S),19.69,7.88,0,19.69,16.74,SKIPPED,19.69,19.69,16.74,16.74,16.74,8.35,9.65,9.65,0,5.91,8.52,8.52,0
5411720,983,11720,,,,,,,DEBRIDE NAIL 1-5,37.56,15.02,0,37.56,31.93,SKIPPED,37.56,37.56,31.93,31.93,31.93,16,18.4,18.4,0,11.27,16.33,16.33,0
5411721,983,11721,,,,,,,DEBRIDE NAIL 6 OR MORE,62.72,25.09,0,62.72,53.31,SKIPPED,62.72,62.72,53.31,53.31,53.31,26.44,30.73,30.73,0,18.82,26.98,26.98,0
5411730,983,11730,,,,,,,REMOVAL OF NAIL PLATE,128.97,51.59,0,128.97,109.62,SKIPPED,128.97,128.97,109.62,109.62,109.62,59.03,63.2,63.2,0,38.69,60.23,60.23,0
5411732,983,11732,,,,,,,REMOVAL OF NAIL PLATE ADD-ON,51.9,20.76,0,44.12,44.12,SKIPPED,0,0,44.12,44.12,44.12,19.08,25.43,25.43,0,15.57,19.47,19.47,0
5411750,983,11750,,,,,,,REMOVAL OF NAIL BED,348.2,139.28,0,348.2,295.97,SKIPPED,348.2,348.2,295.97,295.97,295.97,111.66,170.62,170.62,SKIPPED,SKIPPED,113.94,113.94,0
5413160,983,13160,,,,,,,LATE CLOSURE OF WOUND,1922.63,769.05,0,1922.63,1634.24,SKIPPED,1922.63,1922.63,1634.24,1634.24,1634.24,868.41,942.09,942.09,SKIPPED,SKIPPED,886.13,886.13,0
5415110,983,15110,,,,,,,EPIDRM AGRFT T/A/L 1ST 100 CM,1585.16,634.06,0,1585.16,1347.39,SKIPPED,1585.16,1585.16,1347.39,1347.39,1347.39,769.65,776.73,776.73,SKIPPED,SKIPPED,785.36,785.36,0
5415271,983,15271,,,,,,,SKIN SUB GRAFT TRNK/ARM/LEG,214.9,85.96,0,214.9,182.66,SKIPPED,214.9,214.9,182.66,182.66,182.66,91.07,105.3,105.3,SKIPPED,SKIPPED,92.93,92.93,0
5415272,983,15272,,,,,,,SKIN SUB GRAFT TRNK/ARM/LEG ADD-ON,60.92,24.37,0,51.78,51.78,SKIPPED,0,0,51.78,51.78,51.78,18.93,29.85,29.85,0,18.28,19.32,19.32,0
5415273,983,15273,,,,,,,SKIN SUB GRFT T/ARM/LG CHILD,512.83,205.13,0,512.83,435.91,SKIPPED,512.83,512.83,435.91,435.91,435.91,213.51,251.29,251.29,SKIPPED,SKIPPED,217.87,217.87,0
5415274,983,15274,,,,,,,SKIN SUB GRFT T/ARM/LG CHILD ADD-ON,115.84,46.34,0,98.46,98.46,SKIPPED,0,0,98.46,98.46,98.46,48.71,56.76,56.76,0,34.75,49.7,49.7,0
5415275,983,15275,,,,,,,SKIN SUB GRAFT FACE/NK/HF/G,245.42,98.17,0,245.42,208.61,SKIPPED,245.42,245.42,208.61,208.61,208.61,102.38,120.26,120.26,SKIPPED,SKIPPED,104.47,104.47,0
5415276,983,15276,,,,,,,SKIN SUB GRAFT FACE/NK/HF/G ADD-ON,63.09,25.24,0,53.63,53.63,SKIPPED,0,0,53.63,53.63,53.63,27.66,30.91,30.91,0,18.93,28.22,28.22,0
5415277,983,15277,,,,,,,SKN SUB GRFT F/N/HF/G CHILD,572.63,229.05,0,572.63,486.74,SKIPPED,572.63,572.63,486.74,486.74,486.74,243.4,280.59,280.59,SKIPPED,SKIPPED,248.37,248.37,0
5415278,983,15278,,,,,,,SKN SUB GRFT F/N/HF/G CHILD ADD-ON,144.89,57.96,0,123.16,123.16,SKIPPED,0,0,123.16,123.16,123.16,61.06,71,71,0,43.47,62.31,62.31,0
5416020,983,16020,,,,,,,DRESS/DEBRID P-THICK BURN SMALL,135.17,54.07,0,135.17,114.89,SKIPPED,135.17,135.17,114.89,114.89,114.89,59.25,66.23,66.23,0,40.55,60.46,60.46,0
5416025,983,16025,,,,,,,DRESS/DEBRID P-THICK BURN MEDIUM,281.27,112.51,0,281.27,239.08,SKIPPED,281.27,281.27,239.08,239.08,239.08,120.94,137.82,137.82,0,84.38,123.41,123.41,0
5416030,983,16030,,,,,,,DRESS/DEBRID P-THICK BURN LARGE,331.97,132.79,0,331.97,282.17,SKIPPED,331.97,331.97,282.17,282.17,282.17,142.15,162.67,162.67,SKIPPED,SKIPPED,145.05,145.05,0
5417250,983,17250,,,,,,,CHEMICAL CAUTERY OF TISSUE,91.77,36.71,0,91.77,78,SKIPPED,91.77,91.77,78,78,78,40.55,44.97,44.97,0,27.53,41.38,41.38,0
5428010,983,28010,,,,,,,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,530.2,212.08,0,530.2,450.67,SKIPPED,530.2,530.2,450.67,450.67,450.67,228.05,259.8,259.8,SKIPPED,SKIPPED,232.7,232.7,0
5429445,983,29445,,,,,,,APPLY RIGID LEG CAST,265.95,106.38,0,265.95,226.06,SKIPPED,265.95,265.95,226.06,226.06,226.06,108.62,130.32,130.32,SKIPPED,SKIPPED,110.84,110.84,0
5429580,983,29580,,,,,,,APPLY UNNA BOOT(UNILATERAL),88.73,35.49,0,88.73,75.42,SKIPPED,88.73,88.73,75.42,75.42,75.42,29.23,43.48,43.48,0,26.62,29.83,29.83,0
5429581,983,29581,,,,,,,APPLY MULTLAY COMPRS LWL LG(UNILATERAL),64.83,25.93,0,64.83,55.11,SKIPPED,64.83,64.83,55.11,55.11,55.11,30.57,31.77,31.77,0,19.45,31.19,31.19,0
5429582,983,29580,,,,,,,APPLY UNNA BOOT(BILATERAL),99.48,39.79,0,99.48,84.56,SKIPPED,99.48,99.48,84.56,84.56,84.56,29.23,48.75,48.75,0,29.84,29.83,29.83,0
5429583,983,29581,,,,,,,APPLY MULTLAY COMPRS LWL LG(BILATERAL),67.34,26.94,0,67.34,57.24,SKIPPED,67.34,67.34,57.24,57.24,57.24,30.57,33,33,0,20.2,31.19,31.19,0
5469210,983,69210,,,,,,,REMOVE IMPACTED EAR WAX,83.14,33.26,0,83.14,70.67,SKIPPED,83.14,83.14,70.67,70.67,70.67,35.9,40.74,40.74,0,24.94,36.63,36.63,0
5493922,972,93922,,,,,,,UPR/L XTREMITY ART 2 LEVELS(BILATERAL),45.38,18.15,0,45.38,38.57,SKIPPED,45.38,45.38,38.57,38.57,38.57,13.27,22.24,22.24,0,13.61,13.54,13.54,0
5493923,972,93923,,,,,,,UPR/L XTREMITY STDY 3+LEVELS(BILATERAL),79.58,31.83,0,79.58,67.64,SKIPPED,79.58,79.58,67.64,67.64,67.64,23.98,79.58,79.58,0,79.58,24.47,24.47,0
5497597,983,97597,,,,,,,RMVL DEVITAL TIS 20 CM/< PROF,82.59,33.04,0,82.59,70.2,SKIPPED,82.59,82.59,70.2,70.2,70.2,39.82,40.47,40.47,0,24.78,40.63,40.63,0
5497598,983,97598,,,,,,,RMVL DEVITAL TIS ADDL 20CM<,38.87,15.55,0,38.87,33.04,SKIPPED,38.87,38.87,33.04,33.04,33.04,27.43,19.05,19.05,0,11.66,27.99,27.99,0
5497605,983,97605,,,,,,,NEG PRESS WOUND TX<50CM,89.84,35.94,0,89.84,76.36,SKIPPED,89.84,89.84,76.36,76.36,76.36,27.87,44.02,44.02,0,26.95,28.44,28.44,0
5497606,983,97606,,,,,,,NEG PRESS WOUND TX>50CM,97.24,38.9,0,97.24,82.65,SKIPPED,97.24,97.24,82.65,82.65,82.65,30.57,47.65,47.65,0,29.17,31.19,31.19,0
5497607,983,97607,,,,,,,NEG PRESSURE WOUND THERAPY NON DME = 5,94.03,37.61,0,94.03,79.93,SKIPPED,94.03,94.03,79.93,79.93,79.93,24.14,46.07,46.07,0,28.21,24.63,24.63,0
5497608,983,97608,,,,,,,NEG PRESSURE WOUND THERAPY NON DME >50 S,103.51,41.4,0,103.51,87.98,SKIPPED,103.51,103.51,87.98,87.98,87.98,27.07,50.72,50.72,0,31.05,27.62,27.62,0
5499024,983,99024,,,,,,,POST OP FOLLOW-UP VISIT,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0
5499070,270,99070,,,,,,,SPECIAL SUPPLIES PHYS/QHP,199.5,79.8,0,169.58,169.58,SKIPPED,151.62,151.62,169.58,169.58,169.58,84.07,97.76,97.76,0,59.85,85.79,85.79,169.58
5499201,983,99201,,,,,,,PHYSICIAN LVL 1-NEW,63.79,25.52,0,63.79,54.22,SKIPPED,63.79,63.79,54.22,54.22,54.22,29.4,31.26,31.26,0,19.14,30,30,0
5499202,983,99202,,,,,,,PHYSICIAN LVL 2-NEW,119.93,47.97,0,119.93,101.94,SKIPPED,119.93,119.93,101.94,101.94,101.94,53.59,58.77,58.77,0,35.98,54.68,54.68,0
5499203,983,99203,,,,,,,PHYSICIAN LVL 3-NEW,185.12,74.05,0,185.12,157.35,SKIPPED,185.12,185.12,157.35,157.35,157.35,91.23,90.71,90.71,0,55.54,93.09,93.09,0
5499204,983,99204,,,,,,,PHYSICIAN LVL 4-NEW,315.34,126.14,0,315.34,268.04,SKIPPED,315.34,315.34,268.04,268.04,268.04,148.22,154.52,154.52,0,94.6,151.24,151.24,0
5499205,983,99205,,,,,,,PHYSICIAN LVL 5-NEW,404.6,161.84,0,404.6,343.91,SKIPPED,404.6,404.6,343.91,343.91,343.91,201.14,198.25,198.25,0,121.38,205.25,205.25,0
5499211,983,99211,,,,,,,PHYSICIAN LVL 1-EST,21.77,8.71,0,21.77,18.5,SKIPPED,21.77,21.77,18.5,18.5,18.5,9.85,10.67,10.67,0,6.53,10.05,10.05,0
5499212,983,99212,,,,,,,PHYSICIAN LVL 2-EST,60.09,24.04,0,60.09,51.08,SKIPPED,60.09,60.09,51.08,51.08,51.08,39.69,29.44,29.44,0,18.03,40.5,40.5,0
5499213,983,99213,,,,,,,PHYSICIAN LVL 3-EST,122.47,48.99,0,122.47,104.1,SKIPPED,122.47,122.47,104.1,104.1,104.1,73.47,60.01,60.01,0,36.74,74.97,74.97,0
5499214,983,99214,,,,,,,PHYSICIAN LVL 4-EST,188.93,75.57,0,188.93,160.59,SKIPPED,188.93,188.93,160.59,160.59,160.59,108.16,92.58,92.58,0,56.68,110.37,110.37,0
5499215,983,99215,,,,,,,PHYSICIAN LVL 5-EST,265.45,106.18,0,265.45,225.63,SKIPPED,265.45,265.45,225.63,225.63,225.63,160.17,130.07,130.07,0,79.64,163.44,163.44,0
5511042,761,11042,,,,,,,DEB SUBQ TIS 20 SQ CM/<,774.06,309.62,326.19,774.06,657.95,SKIPPED,774.06,774.06,657.95,657.95,657.95,326.19,379.29,379.29,SKIPPED,SKIPPED,332.85,332.85,657.95
5511045,510,11045,,,,,,,DEB SUBQ TIS ADD-ON,659.85,263.94,0,560.87,560.87,SKIPPED,0,0,560.87,560.87,0,278.07,323.33,323.33,0,197.96,283.74,283.74,560.87
5511106,510,11106,,,,,,,Incisional biopsy of skin; single lesion,456.54,182.62,0,456.54,388.06,SKIPPED,456.54,456.54,388.06,388.06,0,192.38,223.7,223.7,0,136.96,196.31,196.31,388.06
5515271,510,15271,,,,,,,SKIN SUB GRAFT T/A/L FIRST 25 SQ CM,2030.43,812.17,0,2030.43,1725.87,SKIPPED,2030.43,2030.43,1725.87,1725.87,0,855.62,994.91,994.91,SKIPPED,SKIPPED,873.08,873.08,1725.87
5515272,510,15272,,,,,,,SKIN SUB GRAFT T/A/L EACH ADDTL.25 SQ CM,282.64,113.06,0,240.24,240.24,SKIPPED,0,0,240.24,240.24,0,119.11,138.49,138.49,0,84.79,121.54,121.54,240.24
5529445,983,29445,,,,,,,RIGID TOTAL CONTACT LEG CAST,810.13,324.05,0,688.61,688.61,SKIPPED,300.96,300.96,688.61,688.61,688.61,108.62,396.96,396.96,SKIPPED,SKIPPED,110.84,110.84,0
5529581,983,29581,,,,,,,APPLICATION MULTILAYER COMPRESSION SYSTE,564.75,225.9,0,480.04,480.04,SKIPPED,307.8,307.8,480.04,480.04,480.04,30.57,276.73,276.73,0,169.42,31.19,31.19,0
5554101,636,Q4101,,,,,,,"APLIGRAF, PER 1 SQ CM",321.63,128.65,0,273.39,273.39,SKIPPED,34.4,34.4,273.39,273.39,273.39,135.53,157.6,157.6,0,96.49,138.3,138.3,273.39
5554102,636,Q4101,,,,,,,"APLIGRAF, PER 1 SQ CM (WASTED)",321.63,128.65,0,273.39,273.39,SKIPPED,34.4,34.4,273.39,273.39,273.39,135.53,157.6,157.6,0,96.49,138.3,138.3,273.39
5554106,636,Q4106,,,,,,,"DERMAGRAFT, PER 1 SQ CM",361.83,144.73,0,307.56,307.56,SKIPPED,36.99,36.99,307.56,307.56,307.56,152.48,177.3,177.3,0,108.55,155.59,155.59,307.56
5554107,636,Q4106,,,,,,,"DERMAGRAFT, PER 1 SQ CM (WASTED)",361.83,144.73,0,307.56,307.56,SKIPPED,36.99,36.99,307.56,307.56,307.56,152.48,177.3,177.3,0,108.55,155.59,155.59,307.56
5554110,636,Q4110,,,,,,,"PRIMATRIX , PER 1 SQ CM",584.28,233.71,0,496.64,496.64,SKIPPED,53.02,53.02,496.64,496.64,496.64,246.22,286.3,286.3,0,175.28,251.24,251.24,496.64
5554111,636,Q4110,,,,,,,"PRIMATRIX , PER 1 SQ CM (WASTED)",584.28,233.71,0,496.64,496.64,SKIPPED,53.02,53.02,496.64,496.64,496.64,246.22,286.3,286.3,0,175.28,251.24,251.24,496.64
5554121,636,Q4121,,,,,,,"THERASKIN, PER 1 SQ CM",381.99,152.8,0,324.69,324.69,SKIPPED,50.78,50.78,324.69,324.69,324.69,160.97,187.18,187.18,0,114.6,164.26,164.26,324.69
5554122,636,Q4121,,,,,,,"THERASKIN, PER 1 SQ CM (WASTED)",381.99,152.8,0,324.69,324.69,SKIPPED,50.78,50.78,324.69,324.69,324.69,160.97,187.18,187.18,0,114.6,164.26,164.26,324.69
5554123,636,Q4161,,,,,,,BIO-CONNEKT WOUND MATRIX,97,38.8,0,82.45,82.45,SKIPPED,73.72,73.72,82.45,82.45,82.45,40.88,47.53,47.53,0,29.1,41.71,41.71,82.45
5554124,636,Q4161,,,,,,,BIO-CONNEKT WOUND MATRIX (WASTED),97,38.8,0,82.45,82.45,SKIPPED,73.72,73.72,82.45,82.45,82.45,40.88,47.53,47.53,0,29.1,41.71,41.71,82.45
5554131,636,Q4186,,,,,,,"EPIFIX, PER 1 SQ CM",837.64,335.06,0,728.57,711.99,SKIPPED,728.57,728.57,711.99,711.99,711.99,352.99,410.44,410.44,0,251.29,360.19,360.19,711.99
5554132,636,Q4186,,,,,,,"EPIFIX, PER 1 SQ CM (WASTED)",837.64,335.06,0,728.57,711.99,SKIPPED,728.57,728.57,711.99,711.99,711.99,352.99,410.44,410.44,0,251.29,360.19,360.19,711.99
5554133,636,Q4133,,,,,,,GRAFIX PRIME/PRIME PL PER SQ CM,347.29,138.92,0,295.2,295.2,SKIPPED,263.94,263.94,295.2,295.2,295.2,146.34,170.17,170.17,0,104.19,149.33,149.33,295.2
5554134,636,Q4133,,,,,,,GRAFIX PRIME/PRIME PL PER SQ CM(WASTED),347.29,138.92,0,295.2,295.2,SKIPPED,263.94,263.94,295.2,295.2,295.2,146.34,170.17,170.17,0,104.19,149.33,149.33,295.2
5554135,636,Q4132,,,,,,,GRAFIX CORE PER SQ CM,347.29,138.92,0,295.2,295.2,SKIPPED,263.94,263.94,295.2,295.2,295.2,146.34,170.17,170.17,0,104.19,149.33,149.33,295.2
5554136,636,Q4132,,,,,,,GRAFIX CORE PER SQ CM(WASTED),347.29,138.92,0,295.2,295.2,SKIPPED,263.94,263.94,295.2,295.2,295.2,146.34,170.17,170.17,0,104.19,149.33,149.33,295.2
5554158,636,Q4158,,,,,,,KERECIS PER SQ CM,1496.81,598.72,0,1272.29,1272.29,SKIPPED,1137.58,1137.58,1272.29,1272.29,1272.29,630.76,733.44,733.44,0,449.04,643.63,643.63,1272.29
5554159,636,Q4159,,,,,,,"AFFINITY, PER 1 SQ CM",544.36,217.74,0,462.71,462.71,SKIPPED,413.71,413.71,462.71,462.71,462.71,229.39,266.74,266.74,0,163.31,234.07,234.07,462.71
5554160,636,Q4160,,,,,,,"NUSHIELD, PER 1SQ CM",544.36,217.74,0,462.71,462.71,SKIPPED,413.71,413.71,462.71,462.71,462.71,229.39,266.74,266.74,0,163.31,234.07,234.07,462.71
5554161,636,Q4160,,,,,,,"NUSHIELD, PER 1SQ CM-WASTED",544.36,217.74,0,462.71,462.71,SKIPPED,413.71,413.71,462.71,462.71,462.71,229.39,266.74,266.74,0,163.31,234.07,234.07,462.71
5554162,636,Q4159,,,,,,,"AFFINITY, PER 1 SQ CM-WASTED",544.36,217.74,0,462.71,462.71,SKIPPED,413.71,413.71,462.71,462.71,462.71,229.39,266.74,266.74,0,163.31,234.07,234.07,462.71
5554184,636,C1849,,,,,,,MICROLYTE 5cmX5cm,716.63,286.65,0,609.14,609.14,SKIPPED,544.64,544.64,609.14,609.14,609.14,301.99,351.15,351.15,0,214.99,308.15,308.15,609.14
55541849,636,C1849,,,,,,,MICROLYTE 5CMX5CM,716.63,286.65,0,609.14,609.14,SKIPPED,544.64,544.64,609.14,609.14,609.14,301.99,351.15,351.15,0,214.99,308.15,308.15,609.14
5554185,636,C1849,,,,,,,MICROLYTE 10cmx10cm,1433.25,573.3,0,1218.26,1218.26,SKIPPED,1089.27,1089.27,1218.26,1218.26,1218.26,603.97,702.29,702.29,0,429.98,616.3,616.3,1218.26
5554196,636,Q4196,,,,,,,"PURAPLY, PER 1 SQ CM",544.36,217.74,0,462.71,462.71,SKIPPED,447.55,447.55,462.71,462.71,462.71,229.39,266.74,266.74,0,163.31,234.07,234.07,462.71
5597602,983,97602,,,,,,,NON-SELECTIVE DEBRID W/O ANEST,543.64,217.46,0,543.64,462.09,SKIPPED,543.64,543.64,462.09,462.09,462.09,0,266.38,266.38,0,163.09,0,0,0
5597607,510,97607,,,,,,,"npwt, non durable medical",720.22,288.09,0,720.22,612.19,SKIPPED,720.22,720.22,612.19,612.19,0,303.5,352.91,352.91,0,216.07,309.69,309.69,612.19
5599183,983,99183,,,,,,,HBO TX-PER SESSION,278.96,111.58,0,278.96,237.12,SKIPPED,278.96,278.96,237.12,237.12,237.12,117.04,136.69,136.69,0,83.69,119.43,119.43,0
5690101,510,99201,,,,,,,LVL1 TECH(99201)-LVL1 PROF(99201),94.74,37.9,0,94.74,80.53,SKIPPED,94.74,94.74,80.53,80.53,0,39.93,46.42,46.42,0,28.42,40.74,40.74,80.53
5690102,510,99202,,,,,,,LVL1 TECH(99201)-LVL2 PROF(99202),160.06,64.02,0,160.06,136.05,SKIPPED,160.06,160.06,136.05,136.05,0,67.45,78.43,78.43,0,48.02,68.83,68.83,136.05
5690103,510,99203,,,,,,,LVL1 TECH(99201)-LVL3 PROF(99203),230.28,92.11,0,230.28,195.74,SKIPPED,230.28,230.28,195.74,195.74,0,97.04,112.84,112.84,0,69.08,99.02,99.02,195.74
5690104,510,99204,,,,,,,LVL1 TECH(99201)-LVL4 PROF(99204),352.48,140.99,0,352.48,299.61,SKIPPED,352.48,352.48,299.61,299.61,0,148.54,172.72,172.72,0,105.74,151.57,151.57,299.61
5690105,510,99205,,,,,,,LVL1 TECH(99201)-LVL5 PROF(99205),443.84,177.54,0,443.84,377.26,SKIPPED,443.84,443.84,377.26,377.26,0,187.03,217.48,217.48,0,133.15,190.85,190.85,377.26
5690201,510,99201,,,,,,,LVL2 TECH(99202)-LVL1 PROF(99201),94.74,37.9,0,94.74,80.53,SKIPPED,94.74,94.74,80.53,80.53,0,39.93,46.42,46.42,0,28.42,40.74,40.74,80.53
5690202,510,99202,,,,,,,LVL2 TECH(99202)-LVL2 PROF(99202),160.06,64.02,0,160.06,136.05,SKIPPED,160.06,160.06,136.05,136.05,0,67.45,78.43,78.43,0,48.02,68.83,68.83,136.05
5690203,510,99203,,,,,,,LVL2 TECH(99202)-LVL3 PROF(99203),230.28,92.11,0,230.28,195.74,SKIPPED,230.28,230.28,195.74,195.74,0,97.04,112.84,112.84,0,69.08,99.02,99.02,195.74
5690204,510,99204,,,,,,,LVL2 TECH(99202)-LVL4 PROF(99204),352.48,140.99,0,352.48,299.61,SKIPPED,352.48,352.48,299.61,299.61,0,148.54,172.72,172.72,0,105.74,151.57,151.57,299.61
5690205,510,99205,,,,,,,LVL2 TECH(99202)-LVL5 PROF(99205),443.84,177.54,0,443.84,377.26,SKIPPED,443.84,443.84,377.26,377.26,0,187.03,217.48,217.48,0,133.15,190.85,190.85,377.26
5690301,510,99201,,,,,,,LVL3 TECH(99203)-LVL1 PROF(99201),94.74,37.9,0,94.74,80.53,SKIPPED,94.74,94.74,80.53,80.53,0,39.93,46.42,46.42,0,28.42,40.74,40.74,80.53
5690302,510,99202,,,,,,,LVL3 TECH(99203)-LVL2 PROF(99202),160.06,64.02,0,160.06,136.05,SKIPPED,160.06,160.06,136.05,136.05,0,67.45,78.43,78.43,0,48.02,68.83,68.83,136.05
5690303,510,99203,,,,,,,LVL3 TECH(99203)-LVL3 PROF(99203),230.28,92.11,0,230.28,195.74,SKIPPED,230.28,230.28,195.74,195.74,0,97.04,112.84,112.84,0,69.08,99.02,99.02,195.74
5690304,510,99204,,,,,,,LVL3 TECH(99203)-LVL4 PROF(99204),352.48,140.99,0,352.48,299.61,SKIPPED,352.48,352.48,299.61,299.61,0,148.54,172.72,172.72,0,105.74,151.57,151.57,299.61
5690305,510,99205,,,,,,,LVL3 TECH(99203)-LVL5 PROF(99205),443.84,177.54,0,443.84,377.26,SKIPPED,443.84,443.84,377.26,377.26,0,187.03,217.48,217.48,0,133.15,190.85,190.85,377.26
5690401,510,99201,,,,,,,LVL4 TECH(99204)-LVL1 PROF(99201),94.74,37.9,0,94.74,80.53,SKIPPED,94.74,94.74,80.53,80.53,0,39.93,46.42,46.42,0,28.42,40.74,40.74,80.53
5690402,510,99202,,,,,,,LVL4 TECH(99204)-LVL2 PROF(99202),160.06,64.02,0,160.06,136.05,SKIPPED,160.06,160.06,136.05,136.05,0,67.45,78.43,78.43,0,48.02,68.83,68.83,136.05
5690403,510,99203,,,,,,,LVL4 TECH(99204)-LVL3 PROF(99203),230.28,92.11,0,230.28,195.74,SKIPPED,230.28,230.28,195.74,195.74,0,97.04,112.84,112.84,0,69.08,99.02,99.02,195.74
5690404,510,99204,,,,,,,LVL4 TECH(99204)-LVL4 PROF(99204),352.48,140.99,0,352.48,299.61,SKIPPED,352.48,352.48,299.61,299.61,0,148.54,172.72,172.72,0,105.74,151.57,151.57,299.61
5690405,510,99205,,,,,,,LVL4 TECH(99204)-LVL5 PROF(99205),443.84,177.54,0,443.84,377.26,SKIPPED,443.84,443.84,377.26,377.26,0,187.03,217.48,217.48,0,133.15,190.85,190.85,377.26
5690501,510,99201,,,,,,,LVL5 TECH(99205)-LVL1 PROF(99201),94.74,37.9,0,94.74,80.53,SKIPPED,94.74,94.74,80.53,80.53,0,39.93,46.42,46.42,0,28.42,40.74,40.74,80.53
5690502,510,99202,,,,,,,LVL5 TECH(99205)-LVL2 PROF(99202),160.06,64.02,0,160.06,136.05,SKIPPED,160.06,160.06,136.05,136.05,0,67.45,78.43,78.43,0,48.02,68.83,68.83,136.05
5690503,510,99203,,,,,,,LVL5 TECH(99205)-LVL3 PROF(99203),230.28,92.11,0,230.28,195.74,SKIPPED,230.28,230.28,195.74,195.74,0,97.04,112.84,112.84,0,69.08,99.02,99.02,195.74
5690504,510,99204,,,,,,,LVL5 TECH(99205)-LVL4 PROF(99204),352.48,140.99,0,352.48,299.61,SKIPPED,352.48,352.48,299.61,299.61,0,148.54,172.72,172.72,0,105.74,151.57,151.57,299.61
5690505,510,99205,,,,,,,LVL5 TECH(99205)-LVL5 PROF(99205),443.84,177.54,0,443.84,377.26,SKIPPED,443.84,443.84,377.26,377.26,0,187.03,217.48,217.48,0,133.15,190.85,190.85,377.26
5691111,510,99211,,,,,,,LVL1 TECH(99211)-LVL1 PROF(99211),45.78,18.31,0,44.32,38.91,SKIPPED,44.32,44.32,38.91,38.91,0,19.3,22.43,22.43,0,13.73,19.69,19.69,38.91
5691112,510,99212,,,,,,,LVL1 TECH(99211)-LVL2 PROF(99212),93.38,37.35,0,93.38,79.37,SKIPPED,93.38,93.38,79.37,79.37,0,39.35,45.76,45.76,0,28.01,40.15,40.15,79.37
5691113,510,99213,,,,,,,LVL1 TECH(99211)-LVL3 PROF(99213),155.94,62.38,0,155.94,132.55,SKIPPED,155.94,155.94,132.55,132.55,0,65.71,76.41,76.41,0,46.78,67.05,67.05,132.55
5691114,510,99214,,,,,,,LVL1 TECH(99211)-LVL4 PROF(99214),230.5,92.2,0,230.5,195.92,SKIPPED,230.5,230.5,195.92,195.92,0,97.14,112.94,112.94,0,69.15,99.12,99.12,195.92
5691115,510,99215,,,,,,,LVL1 TECH(99211)-LVL5 PROF(99215),311.12,124.45,0,311.12,264.45,SKIPPED,311.12,311.12,264.45,264.45,0,131.1,152.45,152.45,0,93.34,133.78,133.78,264.45
5691211,510,99211,,,,,,,LVL2 TECH(99212)-LVL1 PROF(99211),45.78,18.31,0,44.32,38.91,SKIPPED,44.32,44.32,38.91,38.91,0,19.3,22.43,22.43,0,13.73,19.69,19.69,38.91
5691212,510,99212,,,,,,,LVL2 TECH(99212)-LVL2 PROF(99212),93.38,37.35,0,93.38,79.37,SKIPPED,93.38,93.38,79.37,79.37,0,39.35,45.76,45.76,0,28.01,40.15,40.15,79.37
5691213,510,99213,,,,,,,LVL2 TECH(99212)-LVL3 PROF(99213),155.94,62.38,0,155.94,132.55,SKIPPED,155.94,155.94,132.55,132.55,0,65.71,76.41,76.41,0,46.78,67.05,67.05,132.55
5691214,510,99214,,,,,,,LVL2 TECH(99212)-LVL4 PROF(99214),230.5,92.2,0,230.5,195.92,SKIPPED,230.5,230.5,195.92,195.92,0,97.14,112.94,112.94,0,69.15,99.12,99.12,195.92
5691215,510,99215,,,,,,,LVL2 TECH(99212)-LVL5 PROF(99215),311.12,124.45,0,311.12,264.45,SKIPPED,311.12,311.12,264.45,264.45,0,131.1,152.45,152.45,0,93.34,133.78,133.78,264.45
5691311,510,99211,,,,,,,LVL3 TECH(99213)-LVL1 PROF(99211),45.78,18.31,0,44.32,38.91,SKIPPED,44.32,44.32,38.91,38.91,0,19.3,22.43,22.43,0,13.73,19.69,19.69,38.91
5691312,510,99212,,,,,,,LVL3 TECH(99213)-LVL2 PROF(99212),93.38,37.35,0,93.38,79.37,SKIPPED,93.38,93.38,79.37,79.37,0,39.35,45.76,45.76,0,28.01,40.15,40.15,79.37
5691313,510,99213,,,,,,,LVL3 TECH(99213)-LVL3 PROF(99213),155.94,62.38,0,155.94,132.55,SKIPPED,155.94,155.94,132.55,132.55,0,65.71,76.41,76.41,0,46.78,67.05,67.05,132.55
5691314,510,99214,,,,,,,LVL3 TECH(99213)-LVL4 PROF(99214),230.5,92.2,0,230.5,195.92,SKIPPED,230.5,230.5,195.92,195.92,0,97.14,112.94,112.94,0,69.15,99.12,99.12,195.92
5691315,510,99215,,,,,,,LVL3 TECH(99213)-LVL5 PROF(99215),311.12,124.45,0,311.12,264.45,SKIPPED,311.12,311.12,264.45,264.45,0,131.1,152.45,152.45,0,93.34,133.78,133.78,264.45
5691411,510,99211,,,,,,,LVL4 TECH(99214)-LVL1 PROF(99211),45.78,18.31,0,44.32,38.91,SKIPPED,44.32,44.32,38.91,38.91,0,19.3,22.43,22.43,0,13.73,19.69,19.69,38.91
5691412,510,99212,,,,,,,LVL4 TECH(99214)-LVL2 PROF(99212),93.38,37.35,0,93.38,79.37,SKIPPED,93.38,93.38,79.37,79.37,0,39.35,45.76,45.76,0,28.01,40.15,40.15,79.37
5691413,510,99213,,,,,,,LVL4 TECH(99214)-LVL3 PROF(99213),155.94,62.38,0,155.94,132.55,SKIPPED,155.94,155.94,132.55,132.55,0,65.71,76.41,76.41,0,46.78,67.05,67.05,132.55
5691414,510,99214,,,,,,,LVL4 TECH(99214)-LVL4 PROF(99214),230.5,92.2,0,230.5,195.92,SKIPPED,230.5,230.5,195.92,195.92,0,97.14,112.94,112.94,0,69.15,99.12,99.12,195.92
5691415,510,99215,,,,,,,LVL4 TECH(99214)-LVL5 PROF(99215),311.12,124.45,0,311.12,264.45,SKIPPED,311.12,311.12,264.45,264.45,0,131.1,152.45,152.45,0,93.34,133.78,133.78,264.45
5691511,510,99211,,,,,,,LVL5 TECH(99215)-LVL1 PROF(99211),45.78,18.31,0,44.32,38.91,SKIPPED,44.32,44.32,38.91,38.91,0,19.3,22.43,22.43,0,13.73,19.69,19.69,38.91
5691512,510,99212,,,,,,,LVL5 TECH(99215)-LVL2 PROF(99212),93.38,37.35,0,93.38,79.37,SKIPPED,93.38,93.38,79.37,79.37,0,39.35,45.76,45.76,0,28.01,40.15,40.15,79.37
5691513,510,99213,,,,,,,LVL5 TECH(99215)-LVL3 PROF(99213),155.94,62.38,0,155.94,132.55,SKIPPED,155.94,155.94,132.55,132.55,0,65.71,76.41,76.41,0,46.78,67.05,67.05,132.55
5691514,510,99214,,,,,,,LVL5 TECH(99215)-LVL4 PROF(99214),230.5,92.2,0,230.5,195.92,SKIPPED,230.5,230.5,195.92,195.92,0,97.14,112.94,112.94,0,69.15,99.12,99.12,195.92
5691515,510,99215,,,,,,,LVL5 TECH(99215)-LVL5 PROF(99215),311.12,124.45,0,311.12,264.45,SKIPPED,311.12,311.12,264.45,264.45,0,131.1,152.45,152.45,0,93.34,133.78,133.78,264.45
5790935,969,90935,,,,,,,SINGLE EVAL DURING DIALYSIS PROC.,182.51,73,0,155.13,155.13,SKIPPED,138.71,138.71,155.13,155.13,155.13,79.88,89.43,89.43,0,54.75,81.51,81.51,0
5790936,801,90935,,,,,,,INPATIENT DIALYSIS PROCEDURE,1754.9,701.96,0,1491.66,1491.66,SKIPPED,1333.72,1333.72,1491.66,1491.66,1491.66,739.52,859.9,859.9,0,526.47,754.61,754.61,1491.66
5790937,969,90937,,,,,,,REPEAT EVAL DURING DIALYSIS PROC.,261.64,104.66,0,222.39,222.39,SKIPPED,198.85,198.85,222.39,222.39,222.39,114.44,128.2,128.2,0,78.49,116.78,116.78,0
5790940,969,90940,,,,,,,ACCESS FLOW STUDY IN GRAFTS & AVF,273.14,109.26,0,232.17,232.17,SKIPPED,207.59,207.59,232.17,232.17,232.17,0,133.84,133.84,0,81.94,0,0,0
5790951,982,90951,,,,,,,"<2 yoa, 4 OR MORE VISITS",2361.12,944.45,0,2006.95,2006.95,SKIPPED,1794.45,1794.45,2006.95,2006.95,2006.95,1312.4,1156.95,1156.95,0,708.34,1339.18,1339.18,0
5790952,982,90952,,,,,,,"<2 yoa, 2-3 VISITS",1180.56,472.22,0,1003.48,1003.48,SKIPPED,897.23,897.23,1003.48,1003.48,1003.48,0,578.47,578.47,0,354.17,0,0,0
5790953,982,90953,,,,,,,"<2 yoa, 1 VISIT",925.3,370.12,0,786.5,786.5,SKIPPED,703.23,703.23,786.5,786.5,786.5,0,453.4,453.4,0,277.59,0,0,0
5790954,982,90954,,,,,,,"2-11 yoa, 4 OR MORE VISITS",2044.61,817.84,0,1737.92,1737.92,SKIPPED,1553.9,1553.9,1737.92,1737.92,1737.92,1128.35,1001.86,1001.86,0,613.38,1151.38,1151.38,0
5790955,982,90955,,,,,,,"2-11 yoa, 2-3 VISITS",1146.11,458.44,0,974.19,974.19,SKIPPED,871.04,871.04,974.19,974.19,974.19,583.19,561.59,561.59,0,343.83,595.09,595.09,0
5790956,982,90956,,,,,,,"2-11 yoa, 1 VISIT",797.67,319.07,0,678.02,678.02,SKIPPED,606.23,606.23,678.02,678.02,678.02,386.01,390.86,390.86,0,239.3,393.89,393.89,0
5790957,982,90957,,,,,,,"12-19 yoa, 4 VISITS",1617.05,646.82,0,1374.49,1374.49,SKIPPED,1228.96,1228.96,1374.49,1374.49,1374.49,862.24,792.35,792.35,0,485.12,879.84,879.84,0
5790958,982,90958,,,,,,,"12-19 yoa, 2-3 VISITS",1092.5,437,0,928.62,928.62,SKIPPED,830.3,830.3,928.62,928.62,928.62,561.09,535.32,535.32,0,327.75,572.54,572.54,0
5790959,982,90959,,,,,,,"12-19 yoa, 1 VISIT",740.24,296.1,0,629.2,629.2,SKIPPED,562.58,562.58,629.2,629.2,629.2,362.41,362.72,362.72,0,222.07,369.81,369.81,0
5790960,982,90960,,,,,,,"> 20 yoa, 4 VISITS",709.61,283.84,0,603.17,603.17,SKIPPED,539.3,539.3,603.17,603.17,603.17,394.8,347.71,347.71,0,212.88,402.86,402.86,0
5790961,982,90961,,,,,,,"> 20 yoa, 2-3 VISITS",596.02,238.41,0,506.62,506.62,SKIPPED,452.98,452.98,506.62,506.62,506.62,327.31,292.05,292.05,0,178.81,333.99,333.99,0
5790962,982,90962,,,,,,,"> 20 yoa, 1 VISIT",459.47,183.79,0,390.55,390.55,SKIPPED,349.2,349.2,390.55,390.55,390.55,224.7,225.14,225.14,0,137.84,229.29,229.29,0
5790963,982,90963,,,,,,,"<2 yoa, MONTHLY HOME HEMO OR PD VISIT",1364.35,545.74,0,1159.7,1159.7,SKIPPED,1036.91,1036.91,1159.7,1159.7,1159.7,677.53,668.53,668.53,0,409.3,691.36,691.36,0
5790964,982,90963,,,,,,,"2-11yoa, MONTHLY HOME HEMO OR PD VISIT",1192.05,476.82,0,1013.24,1013.24,SKIPPED,905.96,905.96,1013.24,1013.24,1013.24,677.53,584.1,584.1,0,357.62,691.36,691.36,0
5790965,982,90965,,,,,,,"12-19 yoa, MONTHLY HOME HEMO OR PD VISIT",1134.62,453.85,0,964.43,964.43,SKIPPED,862.31,862.31,964.43,964.43,964.43,558.35,555.96,555.96,0,340.39,569.74,569.74,0
5790966,982,90966,,,,,,,">20 yoa, MONTHLY HOME HEMO OR PD VISIT",594.75,237.9,0,505.54,505.54,SKIPPED,452.01,452.01,505.54,505.54,505.54,327.31,291.43,291.43,0,178.42,333.99,333.99,0
5790967,982,90967,,,,,,,"<2 yoa,MONTHLY HOME HEMO OR PD20 yoa,MONTHLY HOME HEMO OR PD 30 MIN,321.63,128.65,0,321.63,273.39,SKIPPED,321.63,321.63,273.39,273.39,273.39,114.83,157.6,157.6,0,96.49,117.17,117.17,0
5799241,983,99241,,,,,,,OFFICE CONSULT- 15 MIN.,111.83,44.73,0,111.83,95.06,SKIPPED,111.83,111.83,95.06,95.06,95.06,0,54.8,54.8,0,33.55,0,0,0
5799242,983,99242,,,,,,,OFFICE CONSULT- 30 MIN.,210.28,84.11,0,210.28,178.74,SKIPPED,210.28,210.28,178.74,178.74,178.74,0,103.04,103.04,0,63.08,0,0,0
5799243,983,99243,,,,,,,OFFICE CONSULT- 40 MIN.,288.07,115.23,0,288.07,244.86,SKIPPED,288.07,288.07,244.86,244.86,244.86,0,141.15,141.15,0,86.42,0,0,0
5799244,983,99244,,,,,,,OFFICE CONSULT- 60 MIN.,430.29,172.12,0,430.29,365.75,SKIPPED,430.29,430.29,365.75,365.75,365.75,0,210.84,210.84,0,129.09,0,0,0
5799245,983,99245,,,,,,,OFFICE CONSULT- 80 MIN.,527.53,211.01,0,527.53,448.4,SKIPPED,527.53,527.53,448.4,448.4,448.4,0,258.49,258.49,0,158.26,0,0,0
5799251,969,99251,,,,,,,IN PATIENT CONSULT 20 MIN,299.92,119.97,0,254.93,254.93,SKIPPED,235.27,235.27,254.93,254.93,254.93,0,146.96,146.96,0,89.98,0,0,0
5799252,969,99252,,,,,,,IN PATIENT CONSULT 40 MIN,385.44,154.18,0,359.72,327.62,SKIPPED,359.72,359.72,327.62,327.62,327.62,0,188.87,188.87,0,115.63,0,0,0
5799253,969,99253,,,,,,,IN PATIENT CONSULT 60 MIN,472.24,188.9,0,472.24,401.4,SKIPPED,472.24,472.24,401.4,401.4,401.4,0,231.4,231.4,0,141.67,0,0,0
5799254,969,99254,,,,,,,IN PATIENT CONSULT 80 MIN,588.36,235.34,0,588.36,500.11,SKIPPED,588.36,588.36,500.11,500.11,500.11,0,288.3,288.3,0,176.51,0,0,0
5799255,969,99255,,,,,,,IN PATIENT CONSULT 110 MIN,737.7,295.08,0,737.7,627.04,SKIPPED,737.7,737.7,627.04,627.04,627.04,0,361.47,361.47,0,221.31,0,0,0
5799291,969,99291,,,,,,,E&M CRIT CARE FIRST 30 MIN,675.15,270.06,0,675.15,573.88,SKIPPED,675.15,675.15,573.88,573.88,573.88,237.73,330.82,330.82,0,202.54,242.58,242.58,0
5799292,969,99292,,,,,,,E&M CRIT CARE EA\ADD 30 MIN,350.98,140.39,0,350.98,298.33,SKIPPED,350.98,350.98,298.33,298.33,298.33,119.35,171.98,171.98,0,105.29,121.79,121.79,0
5850001,995,,,,,,,,SPECIALTY CLINIC RENT DAY-GATESVILLE,138,55.2,0,117.3,117.3,SKIPPED,104.88,104.88,117.3,117.3,117.3,58.15,67.62,67.62,0,41.4,59.34,59.34,0
5850002,995,,,,,,,,SPECIALTY CLINIC RENT 1/2 DAY-GATESVILLE,69,27.6,0,58.65,58.65,SKIPPED,52.44,52.44,58.65,58.65,58.65,29.08,33.81,33.81,0,20.7,29.67,29.67,0
5850003,995,,,,,,,,SPECIALTY CLINIC RECEPTIONIST DAY,108,43.2,0,91.8,91.8,SKIPPED,82.08,82.08,91.8,91.8,91.8,45.51,52.92,52.92,0,32.4,46.44,46.44,0
5850004,995,,,,,,,,SPECIALTY CLINIC RECEPTIONIST 1/2 DAY,54,21.6,0,45.9,45.9,SKIPPED,41.04,41.04,45.9,45.9,45.9,22.76,26.46,26.46,0,16.2,23.22,23.22,0
5850006,995,,,,,,,,Scott & White Gatesville Clinic Lease,10905.33,4362.13,0,9269.53,9269.53,SKIPPED,8288.05,8288.05,9269.53,9269.53,9269.53,4595.5,5343.61,5343.61,0,3271.6,4689.29,4689.29,0
5850008,995,,,,,,,,MA 1/2 DAY,90.4,36.16,0,76.84,76.84,SKIPPED,68.7,68.7,76.84,76.84,76.84,38.09,44.3,44.3,0,27.12,38.87,38.87,0
5850009,995,,,,,,,,MA FULL DAY,180.8,72.32,0,153.68,153.68,SKIPPED,137.41,137.41,153.68,153.68,153.68,76.19,88.59,88.59,0,54.24,77.74,77.74,0
5850010,995,,,,,,,,LVN 1/2 DAY,103.96,41.58,0,88.37,88.37,SKIPPED,79.01,79.01,88.37,88.37,88.37,43.81,50.94,50.94,0,31.19,44.7,44.7,0
5850011,995,,,,,,,,LVN FULL DAY,207.92,83.17,0,176.73,176.73,SKIPPED,158.02,158.02,176.73,176.73,176.73,87.62,101.88,101.88,0,62.38,89.41,89.41,0
5850012,995,,,,,,,,SPECIALTY CLINIC RENT DAY-EPIPHANY,118,47.2,0,100.3,100.3,SKIPPED,89.68,89.68,100.3,100.3,100.3,49.73,57.82,57.82,0,35.4,50.74,50.74,0
5850013,995,,,,,,,,SPECIALTY CLINIC RENT 1/2 DAY- EPIPHANY,59,23.6,0,50.15,50.15,SKIPPED,44.84,44.84,50.15,50.15,50.15,24.86,28.91,28.91,0,17.7,25.37,25.37,0
5850014,995,,,,,,,,SPECIALTY CLINIC RENT DAY-LAMPASAS,112,44.8,0,95.2,95.2,SKIPPED,85.12,85.12,95.2,95.2,95.2,47.2,54.88,54.88,0,33.6,48.16,48.16,0
5850015,995,,,,,,,,SPECIALTY CLINIC RENT 1/2 DAY-LAMPASAS,56,22.4,0,47.6,47.6,SKIPPED,42.56,42.56,47.6,47.6,47.6,23.6,27.44,27.44,0,16.8,24.08,24.08,0
5850016,995,,,,,,,,SPECIALTY CLINIC RENT DAY-MURRAY,112,44.8,0,95.2,95.2,SKIPPED,85.12,85.12,95.2,95.2,95.2,47.2,54.88,54.88,0,33.6,48.16,48.16,0
5850017,995,,,,,,,,SPECIALTY CLINIC RENT 1/2 DAY-MURRAY,56,22.4,0,47.6,47.6,SKIPPED,42.56,42.56,47.6,47.6,47.6,23.6,27.44,27.44,0,16.8,24.08,24.08,0
5850018,995,,,,,,,,HURLEY GUARANTEE- CLIFTON VISITS,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0
5850019,995,,,,,,,,WACO PHYSICAL THERAPY LEASE,7500,3000,0,6375,6375,SKIPPED,5700,5700,6375,6375,6375,3160.5,3675,3675,0,2250,3225,3225,0
5850021,995,,,,,,,,SPECIALTY CLINIC RENT 1/2 DAY-WACO,69,27.6,0,58.65,58.65,SKIPPED,52.44,52.44,58.65,58.65,58.65,29.08,33.81,33.81,0,20.7,29.67,29.67,0
5850022,995,,,,,,,,SPECIALTY CLINIC RENT DAY-WACO,138,55.2,0,117.3,117.3,SKIPPED,104.88,104.88,117.3,117.3,117.3,58.15,67.62,67.62,0,41.4,59.34,59.34,0
5850024,995,,,,,,,,Waco Clinic Lease-Rowe,6800,2720,0,5780,5780,SKIPPED,5168,5168,5780,5780,5780,2865.52,3332,3332,0,2040,2924,2924,0
600513F,510,0513F,,,,,,,ELEV BP PLAN OF CARE DOCD,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
601034F,510,1034F,,,,,,,CURRENT TOBACCO SMOKER,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
601036F,510,1036F,,,,,,,TOBACCO NON-USER,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
601100F,510,1100F,,,,,,,PTFALLS ASSESS-DOCD GE2+/YR,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
601101F,510,1101F,,,,,,,PT FALLS ASSESS DOCD LE 1/YR,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
601110F,510,1110F,,,,,,,PT LFT INPT FAC W//IN 60 DAYS(ACO ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
601111F,510,1111F,,,,,,,DSCHG MED/CURRENT MED MERGE(ACO ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
601158F,510,1158F,,,,,,,ADVANCED CARE PLANNING,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
601220F,510,1220F,,,,,,,PT SCREENED FOR DEPRESSION,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
602024F,510,2024F,,,,,,,7 FILED PHOTO INTERP DOC REV,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
602026F,510,2026F,,,,,,,EYE IMAGE VALID TO DX REV,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
602027F,510,2027F,,,,,,,OPTIC NERVE HEAD EVAL DONE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603008F,510,3008F,,,,,,,BMO DOCUMENTED,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603014F,510,3014F,,,,,,,BREAST CANCER SCREEN,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603017F,510,3017F,,,,,,,COLORECTAL CANCER SCREEN,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603021F,510,3021F,,,,,,,LVEF MOD/SEVER DEPRS,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603044F,510,3044F,,,,,,,HB A1C LEVEL LT 7.0%,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603045F,510,3045F,,,,,,,HG A1C LEVEL 7.0-9.0%,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603046F,510,3046F,,,,,,,HB A1C >9.0%,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603051F,510,3051F,,,,,,,HbA1C Level >/=7% & <8%,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603052F,510,3052F,,,,,,,HbA1C Level >/=8% & = 9%,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603072F,510,3072F,,,,,,,LOW RISK FOR RETINOPATHY,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603085F,510,3085F,,,,,,,SUICIDE RISK ASSESSED,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603288F,510,3288F,,,,,,,FALL RISK ASSESSMENT DOCD,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
603725F,510,3725F,,,,,,,SCREENING FOR DEPRESSION PERFORMED,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
604004F,510,4004F,,,,,,,PT TOBACCO SCREEN RCVD TLK,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
604008F,510,4008F,,,,,,,BETA-BLOCKER THERAPY RXD/TKN,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
604037F,510,4037F,,,,,,,FLU IMMUNIZATION ORDERED OR ADMIN,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
604040F,510,4040F,,,,,,,PNEUM IMMUN ADMINISTERED OR PREVIOUS REC,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
604086F,510,4086F,,,,,,,ASPIRIN/CLOPIDOGREL RXD,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
6077057,510,77067,,,,,,,MAMMO SCREENING,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
6082770,510,82770,,,,,,,BLOOD OCCULT(ACO ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
6082947,510,82947,,,,,,,ASSAY BLOOD GLUCOSE,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0.01,0.01,0,0.01,0,0,0.01
6082950,510,82950,,,,,,,GLUCODE TEST,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0.01,0.01,0,0.01,0,0,0.01
6082951,510,82951,,,,,,,GLUCOSE TOLERANCE TEST,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0.01,0.01,0,0.01,0,0,0.01
6090660,510,90660,,,,,,,"INFLUENZA VIRUS VACCINE, INTRANASAL",0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G0008,510,G0008,,,,,,,ADMIN OF FLU VAC (ALL TYPE FOR IM INJ),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G0104,510,G0104,,,,,,,FLEX SIG COLORECTAL SCREENING,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,SKIPPED,SKIPPED,0,0,0.01
60G0105,510,G0105,,,,,,,COLONOSCOPY SCREEN(ACO ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,SKIPPED,SKIPPED,0,0,0.01
60G0106,510,G0106,,,,,,,COLONOSCOPY SCREEN SIGMOIDSCPY(ACO ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0.01,0,0,0.01
60G0120,510,G0120,,,,,,,COLONOSCOPY SCREEN ALT G0105 ENEMA(ACO),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0.01,0,0,0.01
60G0121,510,G0121,,,,,,,COLONOSCOPY SCREEN NO HI RISK(ACO),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,SKIPPED,SKIPPED,0,0,0.01
60G0202,510,G0202,,,,,,,SCR MAMMO DIR DIGTL BILAT (ACO ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G0204,510,77066,,,,,,,DX MAMMO DIR DIGTL BILA ALL (ACO ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G0206,510,77065,,,,,,,DX MAMMO DIR DIGTL UNILAT ALL(ACO ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G0328,510,G0328,,,,,,,COLONOSCOPY SCREEN 1-3 SIMULANEOUS(ACO),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0.01,0.01,0,0.01,0,0,0.01
60G0436,510,99406,,,,,,,SMOKE TOBACCO CESSATION 3-10 MIN,28.53,11.41,0,28.53,24.25,SKIPPED,28.53,28.53,24.25,24.25,0,12.02,13.98,13.98,0,8.56,12.27,12.27,24.25
60G0437,510,99407,,,,,,,SMOKING TOBACCO CESS CNSL >10 MIN,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G0444,510,G0444,,,,,,,Annual Depression screening; 15 min.,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G0464,510,81528,,,,,,,COLON SCREEN STOOL BASED DNA(ACO ONLY),0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0.01,0.01,0,0,0,0,0.01
60G1035F,510,1035F,,,,,,,SMOKELESS TOBACCO USER,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G273,510,G9273,,,,,,,BLOOD PRESSURE SYST>140 DYST>90,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G482,510,G8482,,,,,,,FLU IMMUN ADMINISTERED OR PREVIOUS RECVD,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8396,510,G8396,,,,,,,LEFT VENT EJECT FRACTION NOT PERFORM/DOC,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8417,510,G8417,,,,,,,CAL BMI ABVE UPPER PARAM F/U DOC MR,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8418,510,G8418,,,,,,,CALC BMI BELOW LOWER PARAM F/U DOC IN MR,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8419,510,G8419,,,,,,,CAL BMI OUTSIDE NL PARAM NO F/U DOC IN M,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8420,510,G8420,,,,,,,CAL BMI W/I NORM PARAM DOC IN MR,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8421,510,G8421,,,,,,,BMI NOT CALCULATED,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8422,510,G8422,,,,,,,PT NOT ELIG FOR BMI CALCULATIONS,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8427,510,G8427,,,,,,,ELIG PROF ATTEST TO UPDATE/REVIEW MEDS,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8428,510,G8428,,,,,,,CUURENT MED NO DOC BY PHYS NOT SPEC(ACO),0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8430,510,G8430,,,,,,,PROV DOC PT NOT ELIG FOR MED ASSESS.(ACO,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8431,510,G8431,,,,,,,POS SCR CLIN DEPRSS AGE APROP STD TOOL,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8433,510,G8433,,,,,,,SCR DEPRS AGE APROP STD TOOL NOT DOC PT,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8473,510,G8473,,,,,,,ACE INHIB/ARB THRY PRESCRIB,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8474,510,G8474,,,,,,,ACE INHIB/ARB TX NOT PRSC RSNS DOC,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8475,510,G8475,,,,,,,ACE INHIB/ARB TX NOT PRSC RSN NOT SPEC,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8482,510,G8482,,,,,,,FLU IMM ADMIN OR PREV RECVD,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8483,510,G8483,,,,,,,FLU IMM NOT GIVEN-DOCUMENTED,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8484,510,G8484,,,,,,,FLU IMM NOT ADMIN-NO REASON GIVEN,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8510,510,G8510,,,,,,,NEG SCR DEPRES AGE APROP STF F/U NOT REQ,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8511,510,G8511,,,,,,,POS SCREEN DEPRESSN AGE APROP STD F/U,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8592,510,G8592,,,,,,,NO DOC BLOOD PRESSURE MEASURMENT,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8598,510,G8598,,,,,,,ASP THERP USED,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8599,510,G8599,,,,,,,NO ASP THERP USED,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8752,510,G8752,,,,,,,Most Recent Systolic BP <149 mmHg.,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8753,510,G8753,,,,,,,Most recent systolic blood pressure >/=,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8754,510,G8754,,,,,,,Most recent Diastolic BP < 90 mmHg.,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8755,510,G8755,,,,,,,Most recent diastolic blood pressure >/=,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8783,510,G8783,,,,,,,B/P SCRN PERFRM RCMDD DEFINED SCRN INTVL,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8815,510,G8815,,,,,,,STATIN THERAPY NOT PRSC FOR DOC RNS,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8938,510,G8938,,,,,,,BMI CALC PT NO F/I PLAN ELIG.,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8950,510,G8950,,,,,,,PRE-HTN OFR HTN DOC F/U INCLD.,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8951,510,G8951,,,,,,,PER-HTN/ HTN DOC NOT PT F/U,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G8952,510,G8952,,,,,,,"PRE-HTN/HTN, NO F/U, NOT GVN",0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9188,510,G9188,,,,,,,BETA NOT GIVEN NO REASON,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9189,510,G9189,,,,,,,BETA BLOCKER THRPY RX OR CURRENTLY TAKEN,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9190,510,G9190,,,,,,,MEDICAL REASON FOR NO BETA,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9191,510,G9191,,,,,,,PT REASON FOR NO BETA,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9192,510,G9192,,,,,,,SYSTEM REASON FOR NO BETA,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9226,510,G9226,,,,,,,Foot exam performed including 3 componen,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9273,510,G9273,,,,,,,B/P SYST<140 DYST<90,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9274,510,G9274,,,,,,,B/P SYST=140 DYST=90,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9393,510,G9393,,,,,,,PT W/ INIT PHQ-9 SCORE GREATER THAN 9,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9395,510,G9395,,,,,,,PT W/ INIT PHQ-9 SCORE GREATER THAN 9,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9396,510,G9396,,,,,,,PT W/ INIT PHQ-9 SCORE GREATER THAN 9,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9508,510,G9508,,,,,,,DOC PATIENT NOT ON STATIN MEDS,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9509,510,G9509,,,,,,,REMISSION AT 12 MONTHS AS DEMO,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9510,510,G9510,,,,,,,REMISSION AT 12 MONTHS NOT DEMO,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9511,510,G9511,,,,,,,INDEX DATE PHQ 9 SCORE GREATER THAN 9DOC,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9662,510,G9662,,,,,,,PREV DX OR HAVE ACTIVE DX OF CLIN ASCVD,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9663,510,G9663,,,,,,,ANY FASATING OR DIRECT LDL-C LAB =190MG,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9664,510,G9664,,,,,,,PT WHO CURRENTLY STATIN THERAPY USERS,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9665,510,G9665,,,,,,,PT WHO CURRENTLY STATIN THERAPY USERS,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9666,510,G9666,,,,,,,HIGHEST FASTING OR DIRECT LDL-C LAB RESU,0.01,0,0,0.01,0.01,SKIPPED,0,0,0.01,0.01,0,0,0,0,0,0,0,0,0.01
60G9667,510,G9667,,,,,,,DOC MED RSN FOR NOT CURRENT BEING A STAT,0.01,0,0,0.01,0.01,SKIPPED,0.01,0.01,0.01,0.01,0,0,0,0,0,0,0,0,0.01
63277,360,63277,,,,,,,BX/EXC XDRL LESION LUMBAR,9698.24,3879.3,0,8243.5,8243.5,SKIPPED,7707.02,7707.02,8243.5,8243.5,8243.5,4086.84,0,0,0,2909.47,4170.24,4170.24,8243.5